Preoperative systemic therapy in locoregional management of early breast cancer: Highlights from the Kyoto Breast Cancer Consensus Conference

Masakazu Toi, John R. Benson, Eric P. Winer, John F. Forbes, Gunter Von Minckwitz, Mehra Golshan, John F.R. Robertson, Hironobu Sasano, Bernard F. Cole, Louis W.C. Chow, Mark D. Pegram, Wonshik Han, Chiun Sheng Huang, Tadashi Ikeda, Shotaro Kanao, Eun Sook Lee, Shinzaburo Noguchi, Shinji Ohno, Ann H. Partridge, Roman RouzierMitsuhiro Tozaki, Tomoharu Sugie, Akira Yamauchi, Takashi Inamoto

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Data reviewed at the Kyoto Breast Cancer Consensus Conference (KBCCC) showed that preoperative systemic therapy (PST) could optimize surgery through the utilization of information relating to pre- and post-PST tumor stage, therapeutic sensitivity, and treatment-induced changes in the biological characteristics of the tumor. As such, it was noted that the biological characteristics of the tumor, such as hormone receptors, human epidermal growth factor receptor-2, histological grade, cell proliferative activity, mainly defined by the Ki67 labeling index, and the tumor's multi-gene signature, should be considered in the planning of both systemic and local therapy. Furthermore, the timing of axillary sentinel lymph node diagnosis (i.e., before or after the PST) was also noted to be critical in that it may influence the likelihood of axillary preservation, even in node positive cases. In addition, axillary diagnosis with ultrasound and concomitant fine needle aspiration cytology or core needle biopsy (CNB) was reported to contribute to the construction of a treatment algorithm for patient-specific or individualized axillary surgery. Following PST, planning for breast surgery should therefore be based on tumor subtype, tumor volume and extent, therapeutic response to PST, and patient preference. Nomograms for predicting nodal status and drug sensitivity were also recognized as a tool to support decision-making in the selection of surgical treatment. Overall, review of data at the KBCCC showed that PST increases the likelihood of patients receiving localized surgery and individualized treatment regimens.

Original languageEnglish
Pages (from-to)919-926
Number of pages8
JournalBreast Cancer Research and Treatment
Volume136
Issue number3
DOIs
Publication statusPublished - 2012 Dec

Keywords

  • Breast cancer
  • Breast-conserving therapy
  • Preoperative systemic therapy
  • Sentinel lymph node

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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