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International Expert Panel on the Use of Primary (Preoperative) Systemic Treatment of Operable Breast Cancer: Review and Recommendations

Manfred Kaufmann, Gunter von Minckwitz, Roy Smith, Vicente Valero, Luca Gianni, Wolfgang Eiermann, Anthony Howell, Serban Dan Costa, Philippe Beuzeboc, Michael Untch, Jens-Uwe Blohmer, Hans-Peter Sinn, Rolf Sittek, Rainer Souchon, Augustinos H. Tulusan, Tanja Volm, Hans-Jörg Senn

From the Department of Gynecology and Obstetrics, Goethe University, Frankfurt am Main; Red Cross Gynecological Hospital; University Großhadern, Munich; Charité Hospital, Berlin; University of Heidelberg, Heidelberg; General Hospital, Hagen; General Hospital, Bayreuth; University Hospital, Ulm; Germany; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; The University of Texas M.D. Anderson Cancer Center, Houston, TX; National Cancer Institute, Milan, Italy; Christie Hospital NHS Trust, Manchester, United Kingdom; Institute Curie, Paris, France; and Center for Tumor Prevention, St Gallen, Switzerland.

Address reprint requests to Manfred Kaufmann, MD, Klinik für Gynäkologie und Geburtshilfe, J.W. Goethe-Universität Frankfurt am Main, Theodor-Stern Kai 7, D-60590 Frankfurt am Main, Germany; email: M.Kaufmann{at}em.uni-frankfurt.de.

Primary systemic therapy (PST) represents the standard of care in patients with locally advanced breast cancer. In addition, there is increasing information on PST in operable breast disease that supports the use of PST in routine practice. However, current regimens and techniques vary. To address this concern, a group of representatives from breast cancer clinical research groups in France, Germany, Italy, the United Kingdom, and the United States reviewed all available data on prospective randomized trials in this setting. Recommendations are made regarding terminology, indications, regimen, diagnosis before treatment, monitoring of efficacy, tumor localization, surgery, pathologic evaluation, and postoperative treatment.

This consensus symposium received financial support from the BANSS Foundation, a nonprofit body based in Biedenkopf an der Lahn, Germany. The founder of the BANSS Foundation, who died from breast cancer, wished to help extend the information resources available to clinicians and investigators in the field of oncology. Both the symposium and the preparation of this manuscript were conducted in an independent and unbiased fashion.

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