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Recommendations From an International Expert Panel on the Use of Neoadjuvant (Primary) Systemic Treatment of Operable Breast Cancer: An Update

Manfred Kaufmann, Gabriel N. Hortobagyi, Aron Goldhirsch, Suzy Scholl, Andreas Makris, Pinuccia Valagussa, Jens-Uwe Blohmer, Wolfgang Eiermann, Raimund Jackesz, Walter Jonat, Annette Lebeau, Sibylle Loibl, William Miller, Sigfried Seeber, Vladimir Semiglazov, Roy Smith, Rainer Souchon, Vered Stearns, Michael Untch, Gunter von Minckwitz

From the J.W. Goethe-University, Frankfurt am Main; St. Gertrauden, Berlin; Krankenhuas vom Roten Kreuz, Frauenklinik; Ludwig-Maximillians University, Institute of Pathology; Ludwig-Maximillian University, München; University Hospital, Kiel; Tumorzentrum, Essen; Allgemeines Krankenhaus Hagen, Hagen; German Breast Group, Neu-Isenburg/Frankfurt am Main, Germany; European School of Oncology; Istituto Nazionale Tumori; Milano, Italy; Institute Curie, Paris, France; Mount Vernon Hospital, Northwood, Middlesex; Western General Hospital; University of Edinburgh, Edinburgh, United Kingdom; Universtitätsklinik für Chirurgie, Wien, Austria; NN Petrov Research Inst of Oncology, St Petersburg, Russia; The University of Texas M.D. Anderson Cancer Center, Houston, TX; National Surgical Adjuvant Breast and Bowel Project, Pittsburgh, PA; and The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD

Address reprint requests to address: Manfred Kaufmann, MD, Professor and Head of the Department of Obstetrics and Gynecology, J.W. Goethe-University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany; e-mail: M.Kaufmann{at}em.uni-frankfurt.de

Neoadjuvant (primary systemic) treatment is the standard treatment for locally advanced breast cancer and a standard option for primary operable disease. Because of new treatments and new understandings of breast cancer, however, recommendations published in 2003 regarding neoadjuvant treatment for operable disease required updating. Therefore, a second international panel of representatives of a number of breast cancer clinical research groups was convened in September 2004 to update these recommendations. As part of this effort, data published to date were reviewed critically and indications for neoadjuvant treatment were newly defined.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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