International expert consensus on primary systemic therapy in the management of early breast cancer: Highlights of the fourth symposium on primary systemic therapy in the management of operable breast cancer, Cremona, Italy (2010)

Alfredo Berruti, Daniele Generali, Manfred Kaufmann, Lajos Puztai, Giuseppe Curigliano, Massimo Aglietta, Luca Gianni, William R. Miller, Michael Untch, Christos Sotiriou, Mariagrazia Daidone, PierFranco Conte, Derek Kennedy, Giovanna Damia, Piergiorgio Petronini, Serena Di Cosimo, Paolo Bruzzi, Mitch Dowsett, Christine Desmedt, Robert E. ManselLucio Olivetti, Carlo Tondini, Anna Sapino, Privato Fenaroli, Gianpaolo Tortora, Hather Thorne, Francesco Bertolini, Francesco Ferrozzi, Marco Danova, Elda Tagliabue, Evandro de Azambuja, Andreas Makris, Marco Tampellini, Gabriela Dontu, Laura Van t Veer, Adrian L. Harris, Stephen B. Fox, Luigi Dogliotti, Alberto Bottini

Research output: Contribution to journalArticle


A panel of international breast cancer experts formulated a declaration of consensus regarding many key issues in the use of primary systemic therapy (PST) either in clinical routine or research practice. The attainment of pathological complete response (pCR), defined as no residual invasive tumor in the surgical specimens both in breast and in axillary nodes, is one of the main goals of PST, and pCR can be used as the primary objective in prospective clinical trials. However, pCR is not a reliable endpoint with all treatment approaches, and alternatives such as Ki67 index of the residual invasive disease or after 2 weeks of PST are also potential endpoints. PST has several advantages: breast conservation and the unique opportunity to obtain information on the interaction between treatment and tumor biology. Changes in tumor biology after PST are an early phenomenon; so, an additional core biopsy performed after 14 days from treatment start should be considered in clinical trials.

Original languageEnglish
Pages (from-to)147-151
Number of pages5
JournalJournal of the National Cancer Institute - Monographs
Issue number43
Publication statusPublished - Oct 2011


ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

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