Meeting Highlights: International Expert Consensus on the Primary Therapy of Early Breast Cancer 2005

Abstract

The ninth St Gallen (Switzerland) expert consensus meeting in January 2005 made a fundamental change in the algorithm for selection of adjuvant systemic therapy for early breast cancer. Rather than the earlier approach commencing with risk assessment, the Panel affirmed that the first consideration was endocrine responsiveness. Three categories were acknowledged: endocrine responsive, endocrine non-responsive and tumors of uncertain endocrine responsiveness. The three categories were further divided according to menopausal status. Only then did the Panel divide patients into low-, intermediate- and high-risk categories. It agreed that axillary lymph node involvement did not automatically define high risk. Intermediate risk included both node-negative disease (if some features of the primary tumor indicated elevated risk) and patients with one to three involved lymph nodes without additional high-risk features such as HER 2/neu gene overexpression. The Panel recommended that patients be offered chemotherapy for endocrine non-responsive disease; endocrine therapy as the primary therapy for endocrine responsive disease, adding chemotherapy for some intermediate- and all high-risk groups in this category; and both chemotherapy and endocrine therapy for all patients in the uncertain endocrine response category except those in the low-risk group.

In vitroexpansion of human breast cancer epithelial and mesenchymal stromal cells: optimization of a coculture model for personalized therapy approaches

“…The two cell types were easily identified by their morphology, and by the expression of specific tissue markers. In fact, the cocultures expressed both the ''epithelial'' markers cytokeratins 8,18,19, and the ''stromal'' marker vimentin. During the short coculture, exponential growth of epithelial cells allows growth inhibition tests with drugs in a defined medium.…”

“…Overviews on breast cancer prognostic factors stress the importance of personalized treatment, and recommend a fundamental change in adjuvant systemic therapy towards endocrine responsiveness (7,8). Tumors have been classified into three types: endocrine-responsive, in which the primary treatment should be endocrine; endocrine nonresponsive, in which endocrine therapy should not be used; and an intermediate group, for which both endocrine and other therapies should be offered.…”

Goserelin plus letrozole as first- or second-line hormonal treatment in premenopausal patients with advanced breast cancer

“…The percentage of positive cells was semiquantified manually. ER and PgR positivity was defined as nuclear staining in more than 10% of tumor cells, as St Gallen 2005 stated for "endocrine responsive" [8]. Based on American Society of Clinical Oncology (ASCO) and the College of American Pathologists (CAP) guidelines [9], for HER2, a positive result is IHC staining of 3+ (uniform, intense membrane staining of 30% of invasive tumor cells).…”

C6ORF97-ESR1 breast cancer susceptibility locus: influence on progression and survival in breast cancer patients

“…All the treatment were decided by risk evaluation in accordance with the recommendations of the St Gallen international expert consensus on the primary therapy of early breast cancer. [10][11][12] Genotyping of SNPs and gene expression analysis Genomic DNA/RNA of tumor and DNA of adjacent normal specimens were extracted using the Allprep DNA/RNA Mini Kit (Qiagen, Tokyo, Japan) and Allprep DNA Mini Kit (Qiagen), respectively, following the manufacturer's protocol without any modification. DNA/RNA quantification was performed using NanoDrop 2000 spectrometer (NanoDrop Technologies, Wilmington, DE, USA) determined with the A260/A280 absorbance ratios.…”