• Peter Dubsky, Katja Pinker, Fatima Cardoso, Giacomo Montagna, Mathilde Ritter, Carsten Denkert, Isabel T Rubio, Evandro de Azambuja, Giuseppe Curigliano, Oreste Gentilini, Michael Gnant, Andreas Günthert, Nik Hauser, Joerg Heil, Michael Knauer, Mona Knotek-Roggenbauerc, Susan Knox, Tibor Kovacs, Henry M Kuerer, Sibylle Loibl, Meinrad Mannhart, Icro Meattini, Frederique Penault-Llorca, Nina Radosevic-Robin, Patrizia Sager, Tanja Španić, Petra Steyerova, Christoph Tausch, Peeters Marie-Jeanne T F D Vrancken MTFDV Department of Surgery, Antoni van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam, Netherlands., Walter P Weber, Maria J Cardoso, and Philip Poortmans.
• Breast Centre, Hirslanden Klinik St Anna, Luzern, Switzerland; Department of Surgery, Medical University of Vienna, Vienna, Austria; Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. Electronic address: leitung-brustzentrum.stanna@hirslanden.ch.
• Lancet Oncol. 2021 Jan 1; 22 (1): e18-e28.

AbstractPrimary systemic therapy is increasingly used in the treatment of patients with early-stage breast cancer, but few guidelines specifically address optimal locoregional therapies. Therefore, we established an international consortium to discuss clinical evidence and to provide expert advice on technical management of patients with early-stage breast cancer. The steering committee prepared six working packages to address all major clinical questions from diagnosis to surgery. During a consensus meeting that included members from European scientific oncology societies, clinical trial groups, and patient advocates, statements were discussed and voted on. A consensus was reached in 42% of statements, a majority in 38%, and no decision in 21%. Based on these findings, the panel developed clinical guidance recommendations and a toolbox to overcome many clinical and technical requirements associated with the diagnosis, response assessment, surgical planning, and surgery of patients with early-stage breast cancer. This guidance could convince clinicians and patients of the major clinical advancements purported by primary systemic therapy, the use of less extensive and more targeted surgery to improve the lives of patients with breast cancer.Copyright © 2021 Elsevier Ltd. All rights reserved.

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