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St. Gallen consensus 2009: A radically different approach to treating early breast cancer
Date:6/17/2009

cerning treatment of women with early breast cancer. While the 2009 consensus maintains an emphasis on targeting adjuvant systemic therapies according to subgroups defined by predictive markers, it further refines the treatment algorithm by identifying 'thresholds for indication' of each type of systemic treatment modality (endocrine therapy, anti-HER2 therapy, chemotherapy) based on criteria specific to each modality. We expect the refined algorithm to change clinical practice because it clarifies the indications for each treatment modality available today."

Early breast cancer is defined as breast cancer that is confined to the breast, with or without axillary lymph node involvement, and which is easily removable by surgery. However, there are many different types, some of which carry a much higher risk of recurrence and metastases than others.

Therefore, the report emphasises the importance of identifying which type of breast cancer a patient has and which treatment, or combination of treatments, are most likely to be successful.

For instance, the panel recommends the inclusion of adjuvant endocrine therapy for most patients whose tumours show evidence of any detectable oestrogen receptor. Anti-HER2 therapy such as trastuzumab (Herceptin) is recommended for almost all patients with HER2-positive disease. The indication for use of adjuvant chemotherapy is more complex. Chemotherapy should be the mainstay of treatment for patients with triple-negative disease and conventionally is used before or concurrently with trastuzumab for patients with HER2 positive disease, while its use is less clear-cut for patients with ER-positive, HER2-negative disease.

The increasing use of genetic profiling using microarrays (gene chip technology) is expected to help in such cases where treatment decisions are more difficult. Another of the authors, Professor Aron Goldhirsch (Professor of Medical Oncology, Director of the Department of Medicine, Eu
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Contact: Emma Mason
wordmason@mac.com
44-771-129-6986
European Society for Medical Oncology
Source:Eurekalert

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