Radical new approach to treating early breast cancer

As my own diagnosis was early breast cancer, (defined as breast cancer that is confined to the breast, with or without axillary lymph node involvement, and which is easily removable by surgery), I am interested to hear of the latest report from the 11th St Gallen conference and can’t help wishing it had been around four and half years ago, when I had to make my own treatment decisions.

A radically different approach to choosing the best treatment options for early breast cancer has been proposed by an international panel of experts in a report from the 11th St Gallen conference. The report is published online in the cancer journal, Annals of Oncology, and represents the consensus on early breast cancer treatment that emerged from the conference of more than 4,800 participants from 101 countries, which took place in March 2009.

The authors expect the consensus report to change clinical practice. While it continues to recognise that early breast cancer is a heterogeneous disease and that patients should receive personalised care targeted at their particular type of disease, the report proposes a different way of assessing the disease, its risk and the appropriate treatment.

The authors write: “In distilling patient and tumour features to reach patient treatment decisions, the panel has adopted a fundamentally different approach from that used in previous consensus reports. Clinical decisions in systemic adjuvant therapy of early breast cancer must address three distinct questions: (i) what justifies the use of endocrine therapy, (ii) what justifies the use of anti-HER2 therapy, and (iii) what justifies the use of chemotherapy. Because these decisions are based on quite separate criteria, the previous attempt to produce a single-risk categorization and a separate therapy recommendation are no longer considered appropriate.” The authors then give a new algorithm for clinicians to use when deciding on the best treatment approach for each patient.

The report emphasises the importance of identifying which type of breast cancer a patient has and which treatment, or combination of treatments, are most likely to be successful.

The authors believe that the patient should be at the centre of all treatment decisions. “We recognize the importance of quality of life, supportive care and patient preference in the treatment decision-making process,” said one of the co-authors Professor Alan Coates (Clinical Professor at the School of Public Health, University of Sydney, Sydney, New South Wales, Australia and Co-Chair of the Scientific Committee, International Breast Cancer Study Group).

Read the full article at Medical News Today