Strategies for subtypes—dealing with the diversity of breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011

By A. Goldhirsch, W. Wood, A. Coates, R. Gelber, B. Thürlimann, H. Senn, Panel Members. Annals of Oncology, 2011

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The 12th St Gallen International Breast Cancer Conference (2011) Expert Panel adopted a new approach to the classification of patients for therapeutic purposes based on the recognition of intrinsic biological subtypes within the breast cancer spectrum. For practical purposes, these subtypes may be approximated using clinicopathological rather than gene expression array criteria. In general, systemic therapy recommendations follow the subtype classification. Thus, ‘Luminal A’ disease generally requires only endocrine therapy, which also forms part of the treatment of the ‘Luminal B’ subtype. Chemotherapy is considered indicated for most patients with ‘Luminal B', ‘Human Epidermal growth factor Receptor 2 (HER2) positive’, and ‘Triple negative (ductal)’ disease, with the addition of trastuzumab in ‘HER2 positive’ disease. Progress was also noted in defining better tolerated local therapies in selected cases without loss of efficacy, such as accelerated radiation therapy and the omission of axillary dissection under defined circumstances. Broad treatment recommendations are presented, recognizing that detailed treatment decisions need to consider disease extent, host factors, patient preferences, and social and economic constraints.

Subfields: Cancer Research, Oncology, Pathology and Forensic Medicine

View Paper: https://www.semanticscholar.org/paper/fff123e1eaa7eaf63feb07ce7031d4f0f838a8e4

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Citations in the corpus

Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. (2015, methodology): “According to the 2011 and 2013 St Gallen guidelines, the decision on systemic adjuvant therapies should be based on the surrogate intrinsic phenotype determined by ER/PgR, HER2 and Ki67 assessment (Tables 2 and 5) with the selective help of first-generation genomic tests when available (such as Mamm”
Ki-67 is a prognostic parameter in breast cancer patients: results of a large population-based cohort of a cancer registry (2013, background): “Different subtypes exist which can be defined either by means of genetic array testing or based on approaches using immunohistochemical analyses [1].”
Molecular biology in breast cancer: intrinsic subtypes and signaling pathways. (2012, background): “Chemotherapy is considered the recommended treatment for most luminal B, HER2 positive and Triple Negative diseases with the addition of trastuzumab in HER2 positive disease.(47) Nevertheless, the NCCN international guidelines 2011 have not yet incorporated the”