The 2016 Assisi Think Tank Meeting on breast cancer: white paper.
To identify weak points in daily routine use of radiation therapy (RT) for non-metastatic breast cancer patients, particularly when data are lacking or equivocal, a "think tank" of experts met in Assisi.



Before the meeting, controversial issues on non-metastatic breast cancer were identified and reviewed, and clinical practice investigated by means of an online questionnaire. During the 3-day meeting, topics were discussed in-depth with attendees and potential sponsors that are involved in breast cancer treatment.



Three issues were identified as needing further investigation: (1) Regional lymph node treatment in early-stage breast cancer; (2) Combined post-mastectomy RT and breast reconstruction; (3) RT in patients treated with primary systemic therapy. Future research proposals included the following: (1) Participating in appropriately selected on-going clinical trials; (2) Designing new randomized controlled clinical trials and prospective population cohort studies; (3) Setting-up large database(s) to generate predictive response models and detect biomarkers for tailored loco-regional treatments.



It is hoped that the ATTM findings, as described in the present white paper, will stimulate a new generation of radiation oncologists to focus on research in these areas, and that the white paper will become a tool for multidisciplinary groups to help them design research proposals and strategies.
Radiation Oncology Section, Department of Surgical and Biomedical Sciences, University of Perugia and Perugia General Hospital, Sant'Andrea delle Fratte, 06156, Perugia, Italy. cynthia.aristei@unipg.it.
Cynthia
C
Aristei
Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC, USA.|Oncology Institute, Rambam Medical Center, Haifa, Israel.
Orit
O
Kaidar-Person
Department of Radiation Oncology, Hospital Universitari Sant Joan de Reus, Tarragona, Spain.
Meritxell
M
Arenas
Oncology Centre, Cambridge University Hospitals NHS Trust, Cambridge, UK.
Charlotte
C
Coles
Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.
Birgitte V
BV
Offersen
Département de radiothérapie oncologique/Inserm U1194, Institut du Cancer de Montpellier (ICM-Val d'Aurelle), Université de Montpellier, Montpellier, France.
Celine
C
Bourgier
Dipartimento di Oncologia, Azienda Sanitaria di Bologna, Bologna, Italy.
Giovanni
G
Frezza
Radiotherapy Division, European Institute of Oncology, Milan, Italy.
Maria Cristina
MC
Leonardi
Radiation Oncology Department, Università Cattolica del Sacro Cuore, Rome, Italy.
Vincenzo
V
Valentini
Radboud university medical center, Nijmegen, The Netherlands.
Philip M P
PM
Poortmans
D001943:Breast Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans
Breast cancer; Breast reconstruction; Post-mastectomy radiation therapy; Primary systemic therapy; Radiation therapy; Regional lymph node treatment