title: Personalization of loco-regional care for primary breast cancer patients (part 2).
abstract: Kyoto Breast Cancer Consensus Conference, Kyoto, Japan, 18-20 February 2014 The loco-regional management of breast cancer is increasingly complex with application of primary systemic therapies, oncoplastic techniques and genetic testing for breast cancer susceptibility. Personalization of loco-regional treatment is integral to optimization of breast cancer care. Clinical and pathological tumor stage, biological features and host factors influence loco-regional treatment strategies and extent of surgical procedures. Key issues including axillary staging, axillary treatment, radiation therapy, primary systemic therapy (PST), preoperative hormonal therapy and genetic predisposition were identified and discussed at the Kyoto Breast Cancer Consensus Conference (KBCCC2014). In the second of a two part conference scene, consensus recommendations for radiation treatment, primary systemic therapies and management of genetic predisposition are reported and focus on the following topics: influence of both clinical response to PST and stage at presentation on recommendations for postmastectomy radiotherapy; use of regional nodal irradiation in selected node-positive patients and those with adverse pathological factors; extent of surgical resection following downstaging of tumors with PST; use of preoperative hormonal therapy in premenopausal women with larger, node-negative luminal A-like tumors and managing increasing demands for contralateral prophylactic mastectomy in patients with a unilateral sporadic breast cancer.
authors.affiliation: Breast Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawara-cho, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Toi
authors.forename: Eric P
authors.initials: EP
authors.lastname: Winer
authors.forename: John R
authors.initials: JR
authors.lastname: Benson
authors.forename: Takashi
authors.initials: T
authors.lastname: Inamoto
authors.forename: John F
authors.initials: JF
authors.lastname: Forbes
authors.forename: Gunter
authors.initials: G
authors.lastname: von Minckwitz
authors.forename: John F R
authors.initials: JF
authors.lastname: Robertson
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Grobmyer
authors.forename: Ismail
authors.initials: I
authors.lastname: Jatoi
authors.forename: Hironobu
authors.initials: H
authors.lastname: Sasano
authors.forename: Ian
authors.initials: I
authors.lastname: Kunkler
authors.forename: Alice Y
authors.initials: AY
authors.lastname: Ho
authors.forename: Chikako
authors.initials: C
authors.lastname: Yamauchi
authors.forename: Louis W C
authors.initials: LW
authors.lastname: Chow
authors.forename: Chiun-Sheng
authors.initials: CS
authors.lastname: Huang
authors.forename: Wonshik
authors.initials: W
authors.lastname: Han
authors.forename: Shinzaburo
authors.initials: S
authors.lastname: Noguchi
authors.forename: Mark D
authors.initials: MD
authors.lastname: Pegram
authors.forename: Hideko
authors.initials: H
authors.lastname: Yamauchi
authors.forename: Eun-Sook
authors.initials: ES
authors.lastname: Lee
authors.forename: Alexey A
authors.initials: AA
authors.lastname: Larionov
authors.forename: Jose L B
authors.initials: JL
authors.lastname: Bevilacqua
authors.forename: Michio
authors.initials: M
authors.lastname: Yoshimura
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Sugie
authors.forename: Akira
authors.initials: A
authors.lastname: Yamauchi
authors.forename: Ian E
authors.initials: IE
authors.lastname: Krop
authors.forename: Dong Young
authors.initials: DY
authors.lastname: Noh
authors.forename: V Suzanne
authors.initials: VS
authors.lastname: Klimberg
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D019468:Disease Management; D005260:Female; D006801:Humans; D057285:Precision Medicine
keywords: BRCA1/2; breast cancer; luminal type; postmastectomy radiation therapy