title: International expert consensus on primary systemic therapy in the management of early breast cancer: highlights of the Fourth Symposium on Primary Systemic Therapy in the Management of Operable Breast Cancer, Cremona, Italy (2010).
abstract: A panel of international breast cancer experts formulated a declaration of consensus regarding many key issues in the use of primary systemic therapy (PST) either in clinical routine or research practice. The attainment of pathological complete response (pCR), defined as no residual invasive tumor in the surgical specimens both in breast and in axillary nodes, is one of the main goals of PST, and pCR can be used as the primary objective in prospective clinical trials. However, pCR is not a reliable endpoint with all treatment approaches, and alternatives such as Ki67 index of the residual invasive disease or after 2 weeks of PST are also potential endpoints. PST has several advantages: breast conservation and the unique opportunity to obtain information on the interaction between treatment and tumor biology. Changes in tumor biology after PST are an early phenomenon; so, an additional core biopsy performed after 14 days from treatment start should be considered in clinical trials.
authors: Oncologia Medica, Dipartimento di Scienze Cliniche e Biologiche, Università di Torino, Azienda Ospedaliera Universitaria San Luigi di Orbassano, Orbassano, Italy. alberto.bottini@email.it
authors: Alfredo
authors: A
authors: Berruti
authors: Daniele
authors: D
authors: Generali
authors: Manfred
authors: M
authors: Kaufmann
authors: Lajos
authors: L
authors: Puztai
authors: Giuseppe
authors: G
authors: Curigliano
authors: Massimo
authors: M
authors: Aglietta
authors: Luca
authors: L
authors: Gianni
authors: William R
authors: WR
authors: Miller
authors: Michael
authors: M
authors: Untch
authors: Christos
authors: C
authors: Sotiriou
authors: Mariagrazia
authors: M
authors: Daidone
authors: Pierfranco
authors: P
authors: Conte
authors: Derek
authors: D
authors: Kennedy
authors: Giovanna
authors: G
authors: Damia
authors: Piergiorgio
authors: P
authors: Petronini
authors: Serena
authors: S
authors: Di Cosimo
authors: Paolo
authors: P
authors: Bruzzi
authors: Mitch
authors: M
authors: Dowsett
authors: Christine
authors: C
authors: Desmedt
authors: Robert E
authors: RE
authors: Mansel
authors: Lucio
authors: L
authors: Olivetti
authors: Carlo
authors: C
authors: Tondini
authors: Anna
authors: A
authors: Sapino
authors: Privato
authors: P
authors: Fenaroli
authors: Gianpaolo
authors: G
authors: Tortora
authors: Hather
authors: H
authors: Thorne
authors: Francesco
authors: F
authors: Bertolini
authors: Francesco
authors: F
authors: Ferrozzi
authors: Marco
authors: M
authors: Danova
authors: Elda
authors: E
authors: Tagliabue
authors: Evandro
authors: E
authors: de Azambuja
authors: Andreas
authors: A
authors: Makris
authors: Marco
authors: M
authors: Tampellini
authors: Gabriela
authors: G
authors: Dontu
authors: Laura
authors: L
authors: Van't Veer
authors: Adrian L
authors: AL
authors: Harris
authors: Stephen B
authors: SB
authors: Fox
authors: Luigi
authors: L
authors: Dogliotti
authors: Alberto
authors: A
authors: Bottini
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001706:Biopsy / Q000379:methods; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D015201:Meta-Analysis as Topic; D020360:Neoadjuvant Therapy / Q000379:methods; D010173:Palpation; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D012074:Remission Induction; D016896:Treatment Outcome; D016217:Ultrasonography, Mammary
chemical_list: D000970:Antineoplastic Agents; D018931:Antineoplastic Agents, Hormonal; D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D018719:Erb-b2 Receptor Tyrosine Kinases