# Understanding breast cancer complexity to improve patient outcomes: The St Gallen International Consensus Conference for the Primary Therapy of Individuals with Early Breast Cancer 2023.

**Organizacion:** St-Gallen
**Autores:** Curigliano G, Burstein HJ, Gnant M et al.
**Revista:** Ann Oncol (2023)
**PMID:** 37683978 | **PMCID:** -
**DOI:** [10.1016/j.annonc.2023.08.017](https://doi.org/10.1016/j.annonc.2023.08.017)
**Fuente:** PubMed (abstract only)

## Relevancia
Conferencia internacional de consenso bianual; punto de referencia mundial para la toma de decisiones en cancer de mama temprano. El panel multidisciplinar vota sobre escenarios clinicos clave, incluyendo des-escalada quirurgica axilar post-NAC en pacientes cN+ que convierten a ypN0.

## Recomendaciones clave (resumen)
- Acepta BSGC post-NAC en pacientes cN+ que convierten a cN0 si se cumplen estandares de calidad (>=3 ganglios, doble trazador, marcaje del ganglio biopsiado).
- Tendencia consistente a des-escalada quirurgica axilar en respondedoras.
- Recomienda evaluacion clinica/ecografica axilar post-NAC antes de la cirugia.
- TAD (Targeted Axillary Dissection) reconocida como tecnica aceptable para reducir tasa de falsos negativos.

## Abstract
The 18th St Gallen International Breast Cancer Conference held in March 2023, in Vienna, Austria, assessed significant new findings for local and systemic therapies for early breast cancer with a focus on the evaluation of multimodal treatment options. The emergence of more effective, innovative agents in both the preoperative (primary or neoadjuvant) and post-operative (adjuvant) settings has underscored the pivotal role of a multidisciplinary approach in treatment decision making, particularly when selecting systemic therapy for an individual patient. The importance of multidisciplinary discussions regarding the clinical benefits of interventions was explicitly emphasized by the consensus panel as an integral part of developing an optimal treatment plan with the 'right' degree of intensity and duration. The panelists focused on controversies surrounding the management of common ductal/no special type and lobular breast cancer histology, which account for the vast majority of breast tumors. The expert opinion of the panelists was based on interpretations of available data, as well as current practices in their professional environments, personal and socioeconomic factors affecting patients, and cognizant of varying reimbursement and accessibility constraints around the world. The panelists strongly advocated patient participation in well-designed clinical studies whenever feasible. With these considerations in mind, the St Gallen Consensus Conference aims to offer guidance to clinicians regarding appropriate treatments for early-stage breast cancer and assist in balancing the realistic trade-offs between treatment benefit and toxicity, enabling patients and clinicians to make well-informed choices through a shared decision-making process.

## Acceso
Via [DOI](https://doi.org/10.1016/j.annonc.2023.08.017) o suscripcion institucional.

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*Datos de PubMed. Citar: doi 10.1016/j.annonc.2023.08.017*
