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Recommendations from an International Consensus Conference on the Current Status and Future of Neoadjuvant Systemic Therapy in Primary Breast Cancer

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

The use of neoadjuvant systemic therapy (NST) for the treatment of primary breast cancer has constantly increased, especially in trials of new therapeutic regimens. In the 1980 s, NST was shown to substantially improve breast-conserving surgery rates and was first typically used for patients with inoperable locally advanced or inflammatory breast cancer. Investigators have since also used NST as an in vivo test for chemosensitivity by assessing pathologic complete response. Today, by using pathologic response and other biomarkers as intermediate end points, results from trials of new regimens and therapies that use NST are aimed to precede and anticipate the results from larger adjuvant trials. In 2003, a panel of representatives from various breast cancer clinical research groups was first convened in Biedenkopf to formulate recommendations on the use of NST. The obtained consensus was updated in two subsequent meetings in 2004 and 2006. The most recent conference on recommendations on the use of NST took place in 2010 and forms the basis of this report.

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References

  1. Kaufmann M, von Minckwitz G, Bear HD, et al. Recommendations from an international expert panel on the use of neoadjuvant (primary) systemic treatment of operable breast cancer: new perspectives, 2006. Ann Oncol. 2007;18:1927–34.

    Article  PubMed  CAS  Google Scholar 

  2. Kaufmann M, Hortobagyi GN, Goldhirsch A, et al. Recommendations from an international expert panel on the use of neoadjuvant (primary) systemic treatment of operable breast cancer: an update. J Clin Oncol. 2006;24:1940–9.

    Article  PubMed  Google Scholar 

  3. Caudle AS, Hunt KK. The neoadjuvant approach in breast cancer treatment: it is not just about chemotherapy anymore. Curr Opin Obstet Gynecol. 2011;23:31–6.

    Article  PubMed  Google Scholar 

  4. Von Minckwitz G, Kaufmann M, Kuemmel S, et al., for the GBG and AGO-B Study Groups. Correlation of various pathologic complete response (pCR) definitions with long-term outcome and the prognostic value of pCR in various breast cancer subtypes: results from the German neoadjuvant meta-analysis. J Clin Oncol. 2011;29(Suppl.):1028.

    Google Scholar 

  5. Montagna E, Bagnardi V, Rotmensz N, et al. Pathological complete response after preoperative systemic therapy and outcome: relevance of clinical and biologic baseline features. Breast Cancer Res Treat. 2010;124:689–99.

    Article  PubMed  Google Scholar 

  6. Kaufmann M, Pusztai L; Biedenkopf Expert Panel Members. Use of standard markers and incorporation of molecular markers into breast cancer therapy. Cancer. 2011;117:1575–82.

    Article  PubMed  Google Scholar 

  7. Robertson RM, Bondy M, Yang W, et al. Inflammatory breast cancer. CA Cancer J Clin. CA Cancer J Clin. 2010;60:351–75.

    Google Scholar 

  8. Boughey JC, Wagner J, Garrett BJ, et al. Neoadjuvant chemotherapy in invasive lobular carcinoma may not improve rates of breast conservation. Ann Surg Oncol. 2009;16:1606–11.

    Article  PubMed  Google Scholar 

  9. Boughey JC, Peintinger F, Meric-Bernstam F, et al. Impact of preoperative versus postoperative chemotherapy on the extent and number of surgical procedures in patients treated in randomized clinical trials for breast cancer. Ann Surg. 2006;244:464–70.

    PubMed  Google Scholar 

  10. Kim SI, Sohn J, Koo JS, Park SH, Park HS, Park BW. Molecular subtypes and tumor response to neoadjuvant chemotherapy in patients with locally advanced breast cancer. Oncology. 2010;79:324–30.

    Article  PubMed  CAS  Google Scholar 

  11. Huober J, von Minckwitz G, Denkert C, et al. Effect of neoadjuvant anthracycline-taxane-based chemotherapy in different biological breast cancer phenotypes: overall results from the GeparTrio study. Breast Cancer Res Treat. 2010;124:133–40.

    Article  PubMed  CAS  Google Scholar 

  12. Penault-Llorca F, Abrial C, Raoelfils I, et al. Comparison of the prognostic significance of Chevallier and Sataloff’s pathologic classifications after neoadjuvant chemotherapy of operable breast cancer. Hum Pathol. 2008;39:1221–8.

    Article  PubMed  Google Scholar 

  13. Mazouni C, Peintinger F, Wan-Kau S, et al. Residual ductal carcinoma in situ in patients with complete eradication of invasive breast cancer after neoadjuvant chemotherapy does not adversely affect patient outcome. J Clin Oncol. 2007;25:2650–5.

    Article  PubMed  CAS  Google Scholar 

  14. Gralow JR, Burstein HJ, Wood W, et al. Preoperative therapy in invasive breast cancer: pathologic assessment and systemic therapy issues in operable disease. J Clin Oncol. 2008;26:814–9.

    Article  PubMed  Google Scholar 

  15. Fisher ER, Wang J, Bryant J, Fisher B, Mamounas E, Wolmark N. Pathobiology of preoperative chemotherapy: findings from the National Surgical Adjuvant Breast and Bowel (NSABP) protocol B-18. Cancer. 2002;95:681–95.

    Article  PubMed  Google Scholar 

  16. Ellis MJ, Tao Y, Luo J, et al. Outcome prediction for estrogen receptor-positive breast cancer based on postneoadjuvant endocrine therapy tumor characteristics. J Natl Cancer Inst. 2008;100:1380–8.

    Article  PubMed  CAS  Google Scholar 

  17. Hammond ME, Hayes DF, Dowsett M, Allred DC, Hagerty KL, Badve S, Fitzgibbons PL, Francis G, Goldstein NS, Hayes M, Hicks DG, Lester S, Love R, Mangu PB, McShane L, Miller K, Osborne CK, Paik S, Perlmutter J, Rhodes A, Sasano H, Schwartz JN, Sweep FC, Taube S, Torlakovic EE, Valenstein P, Viale G, Visscher D, Wheeler T, Williams RB, Wittliff JL, Wolff AC; American Society of Clinical Oncology; College of American Pathologists. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer (unabridged version). Arch Pathol Lab Med. 2010;134(7):e48–72

    PubMed  CAS  Google Scholar 

  18. Wolff AC, Hammond ME, Schwartz JN, et al. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for human epidermal growth factor receptor 2 testing in breast cancer. J Clin Oncol. 2007;25:118–45.

    Article  PubMed  CAS  Google Scholar 

  19. Londero V, Bazzocchi M, Del Frate C, et al. Locally advanced breast cancer: comparison of mammography, sonography and MR imaging in evaluation of residual disease in women receiving neoadjuvant chemotherapy. Eur Radiol. 2004;14:1371–9.

    Article  PubMed  Google Scholar 

  20. Schott AF, Roubidoux MA, Helvie MA, et al. Clinical and radiological assessments to predict breast cancer pathologic complete response to neoadjuvant chemotherapy. Breast Cancer Res Treat. 2005;92:231–8.

    Article  PubMed  CAS  Google Scholar 

  21. Roubidoux MA, LeCarpentier GL, Fowlkes JB, et al. Sonographic evaluation of early-stage breast cancers that undergo neoadjuvant chemotherapy. J Ultrasound Med. 2005;24:885–95.

    PubMed  Google Scholar 

  22. Yang WT, Le-Petross HT, Macapinlac H, et al. Inflammatory breast cancer: PET/CT, MRI, mammography, and sonography findings. Breast Cancer Res Treat. 2008;109:417–26.

    Article  PubMed  CAS  Google Scholar 

  23. van Deurzen CH, Vriens BE, Tjan-Heijnen VC, et al. Accuracy of sentinel node biopsy after neoadjuvant chemotherapy in breast cancer patients: a systematic review. Eur J Cancer. 2009;45:3124–30.

    Article  PubMed  Google Scholar 

  24. Schwartz GF, Tannebaum JE, Jernigan AM, Palazzo JP. Axillary sentinel lymph node biopsy after neoadjuvant chemotherapy for carcinoma of the breast. Cancer. 2010;116:1243–51.

    Article  PubMed  Google Scholar 

  25. Budman DR. Dose and schedule as determinants of outcomes in chemotherapy for breast cancer. Semin Oncol. 2004;31(6 Suppl. 15):3–9.

    Article  PubMed  Google Scholar 

  26. Caudle AS, Gonzalez-Angulo AM, Hunt KK, et al. Predictors of tumor progression during neoadjuvant chemotherapy in breast cancer. J Clin Oncol. 2010;28:1821–8.

    Article  PubMed  Google Scholar 

  27. Rouzier R, Pusztai L, Delaloge S, et al. Nomograms to predict pathologic complete response and metastasis-free survival after preoperative chemotherapy for breast cancer. J Clin Oncol. 2005;23:8331–9.

    Article  PubMed  Google Scholar 

  28. Lee JK, Coutant C, Kim YC, et al. Prospective comparison of clinical and genomic multivariate predictors of response to neoadjuvant chemotherapy in breast cancer. Clin Cancer Res. 2010;16:711–8.

    Article  PubMed  CAS  Google Scholar 

  29. Tabchy A, Valero V, Vidaurre T, et al. Evaluation of a 30-gene paclitaxel, fluorouracil, doxorubicin, and cyclophosphamide chemotherapy response predictor in a multicenter randomized trial in breast cancer. Clin Cancer Res. 2010;16:5351–61.

    Article  PubMed  CAS  Google Scholar 

  30. von Minckwitz G, Kaufmann M, Kümmel S, et al. Integrated meta-analysis on 6402 patients with early breast cancer receiving neoadjuvant anthracycline-taxane ± trastuzumab containing chemotherapy. Cancer Res. 2009;69(Suppl. 2):79.

    Article  Google Scholar 

  31. Buzdar AU, Valero V, Ibrahim NK, et al. Neoadjuvant therapy with paclitaxel followed by 5-fluorouracil, epirubicin, and cyclophosphamide chemotherapy and concurrent trastuzumab in human epidermal growth factor receptor 2-positive operable breast cancer: an update of the initial randomized study population and data of additional patients treated with the same regimen. Clin Cancer Res. 2007;13:228–33.

    Article  PubMed  CAS  Google Scholar 

  32. Gianni L, Eiermann W, Semiglazov V, et al. Neoadjuvant chemotherapy with trastuzumab followed by adjuvant trastuzumab versus neoadjuvant chemotherapy alone, in patients with HER2-positive locally advanced breast cancer (the NOAH trial): a randomised controlled superiority trial with a parallel HER2-negative cohort. Lancet. 2010;375(9712):377–84.

    Article  PubMed  CAS  Google Scholar 

  33. Guarneri V, Frassoldati A, Bottini A, et al. Safety and activity report of a randomized phase II trial of preoperative anthracycline-based chemotherapy plus lapatinib, trastuzumab or both in HER2 positive breast cancer: CHERLOB Trial. Cancer Res. 2009;69(Suppl. 3):1093.

    Article  Google Scholar 

  34. Rayson D, Suter T, van der Vegt S, et al. Interim results of BACH: randomized phase ii trial evaluating the safety of two chemotherapy regimens as adjuvant therapy in patients with HER2-positive breast cancer: PLD + cyclophosphamide + trastuzumab (PLD + C + H), or doxorubicin + cyclophosphomide (A + C), each followed by paclitaxel + trastuzumab (T + H). Cancer Res. 2009;69(24 Suppl. 3):2085.

  35. Mathew J, Asgeirsson KS, Jackson LR, Cheung KL, Robertson JF. Neoadjuvant endocrine treatment in primary breast cancer—review of literature. Breast. 2009;18:339–44.

    Article  PubMed  CAS  Google Scholar 

  36. Smith IE, Dowsett M, Ebbs SR, et al.; IMPACT Trialists Group. Neoadjuvant treatment of postmenopausal breast cancer with anastrozole, tamoxifen, or both in combination: the Immediate Preoperative Anastrozole, Tamoxifen, or Combined with Tamoxifen (IMPACT) multicenter double-blind randomized trial. J Clin Oncol. 2005;23:5108–16.

    Article  PubMed  CAS  Google Scholar 

  37. Eiermann W, Paepke S, Appfelstaedt J, et al.; Letrozole Neo-Adjuvant Breast Cancer Study Group. Preoperative treatment of postmenopausal breast cancer patients with letrozole: a randomized double-blind multicenter study. Ann Oncol. 2001;12:1527–32.

    Article  PubMed  CAS  Google Scholar 

  38. Semiglazov VF, Semiglazov VV, Dashyan GA, et al. Phase 2 randomized trial of primary endocrine therapy versus chemotherapy in postmenopausal patients with estrogen receptor–positive breast cancer. Cancer. 2007;110:244–54.

    Article  PubMed  CAS  Google Scholar 

  39. Cataliotti L, Buzdar AU, Noguchi S, et al. Comparison of anastrozole versus tamoxifen as preoperative therapy in postmenopausal women with hormone receptor–positive breast cancer: the Pre-Operative “Arimidex” Compared to Tamoxifen (PROACT) trial. Cancer. 2006;106:2095–103.

    Article  PubMed  CAS  Google Scholar 

  40. Ellis MJ, Buzdar A, Unzeitig GW, et al. ACOSOG Z1031: A randomized phase II trial comparing exemestane, letrozole, and anastrozole in postmenopausal women with clinical stage II/III estrogen receptor-positive breast cancer (abstract LBA513). J Clin Oncol. 2010;28(Suppl.):18 s.

    Google Scholar 

  41. Fourquet A, Stoppa-Lyonnet D, Kirova YM, Sigal-Zafrani B, Asselain B; Institut Curie Breast Cancer Study Group; Institut Curie Breast Ovary Cancer Risk Study Group. Familial breast cancer: clinical response to induction chemotherapy or radiotherapy related to BRCA1/2 mutations status. Am J Clin Oncol. 2009;32:127–31.

    Article  PubMed  CAS  Google Scholar 

  42. Pierce LJ, Phillips KA, Griffith KA, et al. Local therapy in BRCA1 and BRCA2 mutation carriers with operable breast cancer: comparison of breast conservation and mastectomy. Breast Cancer Res Treat. 2010;121:389–98.

    Article  PubMed  Google Scholar 

  43. Byrski T, Gronwald J, Huzarski T, et al. Pathologic complete response rates in young women with BRCA1-positive breast cancers after neoadjuvant chemotherapy. J Clin Oncol. 2010;28:375–9.

    Article  PubMed  CAS  Google Scholar 

  44. Silver DP, Richardson AL, Eklund AC, et al. Efficacy of neoadjuvant cisplatin in triple-negative breast cancer. J Clin Oncol. 2010;28:1145–53.

    Article  PubMed  CAS  Google Scholar 

  45. Fong PC, Boss DS, Yap TA, et al. Inhibition of poly(ADP-ribose) polymerase in tumors from BRCA mutation carriers. N Engl J Med. 2009;361:123–34.

    Article  PubMed  CAS  Google Scholar 

  46. Tutt A, Robson M, Garber JE, et al. Oral poly(ADP-ribose) polymerase inhibitor olaparib in patients with BRCA1 or BRCA2 mutations and advanced breast cancer: a proof-of-concept trial. Lancet. 2010;24;376(9737):235–44.

    Google Scholar 

  47. Loibl S, von Minckwitz G, Gwyn K, et al. Breast carcinoma during pregnancy. International recommendations from an expert meeting. Cancer. 2006;106:237–46.

    Article  PubMed  Google Scholar 

  48. Gianni L, Pienkowski T, Im YH, et al. Neoadjuvant pertuzumab (P) and trastuzumab (H): antitumor and safety analysis of a randomized phase II study (“NeoSphere”). Cancer Res. 2011;70:S3–2.

    Google Scholar 

  49. Baselga J, Bradbury I, Eidtmann H, et al. First results of the NeoALTTO Trial (BIG 01-06/EGF 106903): a phase III, randomized, open label, neoadjuvant study of lapatinib, trastuzumab, and their combination plus paclitaxel in women with HER2-positive primary breast cancer. Cancer Res. 2011;70:S3–3.

    Google Scholar 

  50. Kaufmann M, Morrow M, von Minckwitz G, Harris JR; Biedenkopf Expert Panel Members. Locoregional treatment of primary breast cancer: consensus recommendations from an international expert panel. Cancer. 2010;116:1184–91.

    Google Scholar 

  51. Houssami N, Macaskill P, Marinovich ML, et al. Meta-analysis of the impact of surgical margins on local recurrence in women with early-stage invasive breast cancer treated with breast-conserving therapy. Eur J Cancer. 2010;46:3219–32.

    Article  PubMed  Google Scholar 

  52. Dawood S, Merajver SD, Viens P, et al. International expert panel on inflammatory breast cancer: consensus statement for standardized diagnosis and treatment. Ann Oncol. 2011;22:515–23.

    Article  PubMed  CAS  Google Scholar 

  53. Smith BD, Bentzen SM, Correa CR, et al. Fractionation for whole breast irradiation: an American Society for Radiation Oncology (ASTRO) evidence-based guideline. Int J Radiat Oncol Biol Phys. 2011;22:515–23.

    Google Scholar 

  54. Mamounas EP, Anderson SJ, Bear HD, et al. Predictors of locoregional failure (LRF) in patients receiving neoadjuvant chemotherapy (NC): results from combined analysis of NSABP B-18 and NSABP B-27 (abstract 90). Presented at the 2010 ASCO Breast Cancer Symposium.

  55. Buchholz TA, Tucker SL, Masullo L, et al. Predictors of local-regional recurrence after neoadjuvant chemotherapy and mastectomy without radiation. J Clin Oncol. 2002;20:17–23.

    Article  PubMed  CAS  Google Scholar 

  56. Pusztai L, Viale G, Kelly CM, Hudis CA. Estrogen and HER-2 receptor discordance between primary breast cancer and metastasis. Oncologist. 2010;15:1164–8.

    Article  PubMed  Google Scholar 

  57. Gnant M, Mlineritsch B, Schippinger W, et al. Endocrine therapy plus zoledronic acid in premenopausal breast cancer. N Engl J Med. 2009; 360:679–91.

    Article  PubMed  CAS  Google Scholar 

  58. Coleman RE, Winter MC, Cameron D, et al.; AZURE (BIG01/04) Investigators. The effects of adding zoledronic acid to neoadjuvant chemotherapy on tumour response: exploratory evidence for direct anti-tumour activity in breast cancer. Br J Cancer. 2010;102:1099–105.

    Article  PubMed  CAS  Google Scholar 

  59. Aft R, Naughton M, Trinkaus K, et al. Effect of zoledronic acid on disseminated tumour cells in women with locally advanced breast cancer: an open label, randomised, phase 2 trial. Lancet Oncol. 2010;11:421–8.

    Article  PubMed  CAS  Google Scholar 

  60. Debled M, Mauriac L. Neoadjuvant chemotherapy: are we barking up the right tree? Ann Oncol. 2010;21:675–9.

    Article  PubMed  CAS  Google Scholar 

  61. Hutcheon AW, Heys SD, Sarkar TK; Aberdeen Breast Group. Neoadjuvant docetaxel in locally advanced breast cancer. Breast Cancer Res Treat. 2003;79(Suppl. 1):S19–S24.

    Article  PubMed  CAS  Google Scholar 

  62. Untch M, Möbus V, Kuhn W, et al. Intensive dose-dense compared with conventionally scheduled preoperative chemotherapy for high-risk primary breast cancer. J Clin Oncol. 2009;27:2938–45.

    Article  PubMed  Google Scholar 

  63. Frasci G, D’Aiuto G, Comella P, et al. Preoperative weekly cisplatin, epirubicin, and paclitaxel (PET) improves prognosis in locally advanced breast cancer patients: an update of the Southern Italy Cooperative Oncology Group (SICOG) randomised trial 9908. Ann Oncol. 2010;21:707–16.

    Article  PubMed  CAS  Google Scholar 

  64. Gianni L, Eiermann W, Semiglazov V, et al. Neoadjuvant chemotherapy with trastuzumab followed by adjuvant trastuzumab versus neoadjuvant chemotherapy alone, in patients with HER2-positive locally advanced breast cancer (the NOAH trial): a randomised controlled superiority trial with a parallel HER2-negative cohort. Lancet. 2010;375:377–84.

    Article  PubMed  CAS  Google Scholar 

  65. Buzdar AU, Ibrahim NK, Francis D, et al. Significantly higher pathologic complete remission rate after neoadjuvant therapy with trastuzumab, paclitaxel, and epirubicin chemotherapy: results of a randomized trial in human epidermal growth factor receptor 2-positive operable breast cancer. J Clin Oncol. 2005;23:3676–85.

    Article  PubMed  CAS  Google Scholar 

  66. Bear HD, Anderson S, Smith RE, et al. Sequential preoperative or postoperative docetaxel added to preoperative doxorubicin plus cyclophosphamide for operable breast cancer: National Surgical Adjuvant Breast and Bowel Project Protocol B-27. J Clin Oncol. 2006;24:2019–27.

    Article  PubMed  CAS  Google Scholar 

  67. Evans TR, Yellowlees A, Foster E, et al. Phase III randomized trial of doxorubicin and docetaxel versus doxorubicin and cyclophosphamide as primary medical therapy in women with breast cancer: an anglo-celtic cooperative oncology group study. J Clin Oncol. 2005;23:2988–95.

    Article  PubMed  CAS  Google Scholar 

  68. Buzdar AU, Singletary SE, Theriault RL, et al. Prospective evaluation of paclitaxel versus combination chemotherapy with fluorouracil, doxorubicin, and cyclophosphamide as neoadjuvant therapy in patients with operable breast cancer. J Clin Oncol. 1999;17:3412–17.

    PubMed  CAS  Google Scholar 

  69. Baldini E, Gardin G, Giannessi PG, et al. Accelerated versus standard cyclophosphamide, epirubicin and 5-fluorouracil or cyclophosphamide, methotrexate and 5-fluorouracil: a randomized phase III trial in locally advanced breast cancer. Ann Oncol. 2003;14:227–32.

    Article  PubMed  CAS  Google Scholar 

  70. Smith IE, A’Hern RP, Coombes GA, et al. TOPIC Trial Group. A novel continuous infusional 5-fluorouracil-based chemotherapy regimen compared with conventional chemotherapy in the neo-adjuvant treatment of early breast cancer: 5 year results of the TOPIC trial. Ann Oncol. 2004;15:751–58.

    Article  PubMed  CAS  Google Scholar 

  71. Chua S, Smith IE, A'Hern RP, et al. TOPIC Trial Group. Neoadjuvant vinorelbine/epirubicin (VE) versus standard adriamycin/cyclophosphamide (AC) in operable breast cancer: analysis of response and tolerability in a randomised phase III trial (TOPIC 2). Ann Oncol. 2005;16:1435–41.

    Google Scholar 

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Acknowledgment

We thank the independent BANSS Foundation, Biedenkopf, Germany, for financial support, and the GBG GmbH, Neu Isenburg, Germany for logistical support of the meeting. All members of the panel had input in the discussion and formulation of the article. This consensus symposium received financial support from the BANSS Foundation, a nonprofit body based in Biedenkopf an der Lahn, Germany. Both the symposium and the preparation of this article was conducted independent of the pharmaceutical industry. The report was drafted in its entirety by the meeting participants without any paid assistance.

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Authors and Affiliations

  1. Department of Gynecology and Obstetrics and Breast Unit, Goethe University, Frankfurt, Germany

    Manfred Kaufmann, Thomas Karn & Eugen Ruckhaeberle

  2. German Breast Group, Neu Isenburg, Germany

    Gunter von Minckwitz

  3. Aultman Cancer Center, Canton, OH, USA

    Elefhterios P. Mamounas

  4. Edinburgh Cancer Research Center, University of Edinburgh, Edinburgh, Scotland, UK

    David Cameron

  5. Division of Hematology-Oncology, University of North Carolina, Chapel Hill, NC, USA

    Lisa A. Carey

  6. Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA

    Massimo Cristofanilli

  7. Institute of Pathology, University Hospital Charité, Berlin, Germany

    Carsten Denkert

  8. Women’s Hospital, Red Cross Clinics, Munich, Germany

    Wolfgang Eiermann

  9. Department of Surgery, Medical University of Vienna, Vienna, Austria

    Michael Gnant

  10. Department of Radiation Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA

    Jay R. Harris

  11. Department of Gynecology and Obstetrics, University Hospital Muenster, Muenster, Germany

    Cornelia Liedtke

  12. Department of Medical Oncology, General Hospital of Lamia, Lamia, Greece

    Davide Mauri

  13. Department of Obstetrics and Gynecology, Hôpital Tenon, Paris, France

    Roman Rouzier

  14. N.N. Petrov Research Institute of Oncology, St. Petersburg, Russia

    Vladimir Semiglazov

  15. Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    W. Fraser Symmans

  16. Breakthrough Breast Cancer Research Unit, Guy’s Hospital Campus, King’s College London School of Medicine, London, UK

    Andrew Tutt

  17. Department of Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Lajos Pusztai

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  1. Manfred Kaufmann
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  2. Gunter von Minckwitz
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  19. Lajos Pusztai
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Correspondence to Manfred Kaufmann.

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Kaufmann, M., von Minckwitz, G., Mamounas, E.P. et al. Recommendations from an International Consensus Conference on the Current Status and Future of Neoadjuvant Systemic Therapy in Primary Breast Cancer. Ann Surg Oncol 19, 1508–1516 (2012). https://doi.org/10.1245/s10434-011-2108-2

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