AGO Recommendations for Diagnosis and Treatment of Patients with Early Breast Cancer: Update 2013

Scharl, A.; Thomssen, Christoph; Harbeck, Nadia; Müller, Volkmar

doi:10.1159/000353617

Cited by 7 publications

(5 citation statements)

References 36 publications

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“…However, many studies have shown that hypofractionated radiotherapy has been a safe and effective option for patients with breast cancer in early stage; it provides a lower total radiation dose given in a few slightly larger fractions and delivered over a short period time by use of hypofractionation schedules [ 42 ].…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with the Incidence of Local Recurrences of Breast Cancer in Women Who Underwent Conservative Surgery

Tovar¹,

Zandonade

Amorim

2014

International Journal of Breast Cancer

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Conservative surgery is considered the procedure of choice for women who are affected by early stage tumours. The local recurrence of cancer as a consequence of breast tissue conservation is a growing concern. This study aimed to describe the sociodemographic and clinical profiles of women who had local recurrences of breast cancer after conservative surgery and to examine the associations between sociodemographic and clinical variables and the incidence of tumour recurrence in these women. The retrospective cohort included 880 women who were diagnosed with breast cancer and underwent conservative surgery between January 2000 and December 2010. Recurrences occurred in 60 patients, and the mean age of the women at diagnosis was 48.8 years. Predictive factors for local recurrence were young age (<39 years) (P = 0.028 and OR = 10.93), surgical margin involvement (P = 0.001 and OR = 3.66), and Her-2 overexpression (P = 0.045 and OR = 1.94). The establishment of sociodemographic and clinical characteristics might help to select optimum treatments, which is a crucial challenge for public health in Brazil, especially with regard to reductions of surgery and hospitalisation expenditures in the Unified Health System (Sistema Único de Saúde—SUS).

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Section: Discussionmentioning

confidence: 99%

Factors Associated with the Incidence of Local Recurrences of Breast Cancer in Women Who Underwent Conservative Surgery

Tovar¹,

Zandonade

Amorim

2014

International Journal of Breast Cancer

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“…10 Table 2(B) lists the grades of recommendation (GOR) used during the electronic voting. 11 The level of consensus (LOC) was considered “high” when ≥ 80% of participants agreed/strongly agreed or disagreed/strongly disagreed with a particular statement ( Table 2C ). 12 A “moderate” LOC was achieved when 60 to 79% of participants agreed/strongly agreed or disagreed/strongly disagreed with a particular statement.…”

Section: Methodsmentioning

confidence: 99%

“…10 ►Table 2(B) lists the grades of recommendation (GOR) used during the electronic voting. 11 The level of consensus (LOC) was considered "high" when ! 80% of participants agreed/strongly agreed or disagreed/ strongly disagreed with a particular statement (►Table 2C).…”

Section: Consensus Processmentioning

confidence: 99%

Management of Locally Advanced Unresectable or Metastatic Urothelial Carcinoma: Expert Opinion from an Indian Panel via Delphi Consensus Method

Rajappa

Raja

Desai

et al. 2023

Indian J Med Paediatr Oncol

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Introduction Currently, there are no guidelines for the management of locally advanced unresectable or metastatic urothelial carcinoma (mUC) from an Indian perspective. There is a lack of consensus on the utility of treatment options in first-line (1L) and second-line (2L) settings, especially in cisplatin- and platinum-unfit mUC patient subgroups. Objective This articles aims to develop evidence-based practical consensus recommendations for the management of mUC in Indian settings. Methods Modified Delphi consensus methodology was considered to arrive at a consensus. An expert scientific committee of 15 medical oncologists from India constituted the panel. Twelve clinically relevant questions were grouped into five categories for presentation and discussion: (1) cisplatin and platinum ineligibility criteria; (2) programmed death ligand 1 and fibroblast growth factor receptor (FGFR) testing in mUC patients; (3) treatment options in 1L settings; (4) role of switch maintenance; and (5) treatment options in 2L. Statements that reached high (≥ 80%) and moderate (60–79%) levels of consensus in the first round (electronic survey) did not undergo the second Delphi round. The questions that received a low level of consensus (< 60%) were discussed during the virtual meeting. Results Renal impairment (creatinine clearance [CrCl] < 60 mL/min) and New York Heart Association class 3 heart failure are important assessment criteria for determining cisplatin ineligibility. Patients are unfit for any platinum-based chemotherapy in case of Eastern Cooperative Oncology Group performance status> 3 or severe renal impairment (CrCl < 30 mL/min). Gemcitabine and platinum with cisplatin over carboplatin were preferred in 1L settings. In patients unfit for cisplatin-based regimens, carboplatin–gemcitabine chemotherapy was preferred over immunotherapy (atezolizumab or pembrolizumab). Selected patients who are platinum ineligible may be considered for immunotherapy. Post-induction chemotherapy, those who do not progress may be strongly considered for avelumab maintenance. Experts recommended erdafitinib in FGFR-positive mUC patients in 2L settings. In FGFR-negative patients, immunotherapy (pembrolizumab, nivolumab, or avelumab) may be preferred over chemotherapy (paclitaxel, docetaxel, or vinflunine). Enfortumab vedotin and sacituzumab govitecan may be considered for further lines of therapy. Conclusion Expert panel consensus will offer expert guidance to oncologists/clinicians on the management of mUC in Indian settings. Key Points

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“…The commercially available 21-gene Oncotype DX Breast Recurrence Score® assay (Exact Sciences, Redwood City, CA, USA) is already implemented in clinical routine [13][14][15][16][17]. In a retrospective study from our group, the 21-gene assay was shown to be associated with detection of DTCs in patients with ER-positive/HER2-negative EBC [18].…”

Section: Introductionmentioning

confidence: 99%

Detection of Disseminated Tumor Cells in Patients with Early Breast Cancer is Associated with 21-Gene-Assay: Results from the Impact of Recurrence Score ® Result on Adjuvant Treatment Decisions and Tumor Cell Dissemination in Estrogen Receptor-Positive and HER2-Negative Patients with Early Breast Cancer (IRMA) Trial

Volmer

Dannehl

Engler

et al. 2023

Preprint

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Disseminated tumor cells (DTCs) in the bone marrow (BM) are known to be of prognostic value for patients with early breast cancer (EBC). In addition to histopathological features, multigene expression assays, such as the commercially available 21-gene Breast Recurrence Score® assay, have been validated for evaluating prognosis and making decisions concerning adjuvant treatment in EBC. In a previous retrospective study from our group, the 21-gene assay was shown to be associated with DTC-detection. A key endpoint of the prospective IRMA trial was to evaluate the association between Recurrence Score® (RS) result and tumor cell dissemination in patients with EBC. DTC-status and RS result were assessed in patients with ER-positive/HER2-negative EBC with 0–3 pathologic lymph nodes who underwent primary surgical treatment at the Department for Women’s Health of Tuebingen University, Germany. Patients with a high RS result (≥ 26) were more frequently DTC-positive (22.6%) than patients with a low RS result (8.6%, p=0.034). The odds for DTC-positivity increased with rising RS values (p= 0.047). We therefore confirm that a high genomic risk is associated with tumor cell dissemination into the BM. Further trials are needed to investigate whether therapeutic decisions could be further individualized by combining DTC-status and prognostic gene signature testing.

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AGO Recommendations for Diagnosis and Treatment of Patients with Early Breast Cancer: Update 2013

Cited by 7 publications

References 36 publications

Factors Associated with the Incidence of Local Recurrences of Breast Cancer in Women Who Underwent Conservative Surgery

Factors Associated with the Incidence of Local Recurrences of Breast Cancer in Women Who Underwent Conservative Surgery

Management of Locally Advanced Unresectable or Metastatic Urothelial Carcinoma: Expert Opinion from an Indian Panel via Delphi Consensus Method

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