caa a22 4500 445335718 CHVBK 20180317142754.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1245/s10434-011-1666-7 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1666-7 Identifying Gaps in the Locoregional Management of Early Breast Cancer: Highlights from the Kyoto Consensus Conference [Elektronische Daten] [Masakazu Toi, Eric Winer, Takashi Inamoto, John Benson, John Forbes, Michihide Mitsumori, John Robertson, Hironobu Sasano, Gunter von Minckwitz, Akira Yamauchi, V. Klimberg] A consensus conference was held to investigate issues related to the local management of early breast cancer. Here, we highlight the major topics discussed at the conference and propose ideas for future studies. Regarding axillary management, we examined three major issues. First, we discussed whether the use of axillary reverse mapping could clarify the lymphatic system of breast and whether the ipsilateral arm might help avoid lymphedema. Second, the use of an indocyanine green fluorescent navigation system was discussed for intraoperative lymphatic mapping. These new issues should be examined further in practice. Finally, some agreement was reached on the importance of "four-node diagnosis” to aid in the diagnostic accuracy of sentinel nodes. Regarding breast treatment, there was general agreement that the clinical value of surgical margins in predicting local failure was dependent on the tumor's intrinsic biology and subtypes. For patients treated with preoperative chemotherapy, less extensive excision may be feasible in those who respond to systemic therapy in an acceptable manner. Most trials of preoperative chemotherapy lack outcome data on local recurrence. Therefore, there is a need for such data for overview analysis. We also agreed that radiation after mastectomy may be beneficial in node-positive cases where more than four nodes are involved. Throughout the discussions for both invasive and noninvasive disease, the investigation of nomograms was justified for major issues in the decision-making process, such as the presence or absence of microinvasion and the involvement of nonsentinel nodes in sentinel node-positive patients. Society of Surgical Oncology, 2011 Toi Masakazu Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawara-cho, Sakyo-ku, Kyoto, Japan aut Winer Eric Breast Oncology Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA aut Inamoto Takashi Department of Breast Surgery, Kitano Hospital, Osaka, Japan aut Benson John Cambridge Breast Unit, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK aut Forbes John Department of Surgical Oncology, University of Newcastle, Newcastle, Australia aut Mitsumori Michihide Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine at Kyoto University, Kyoto, Japan aut Robertson John Professorial Unit of Surgery, Division of Breast Surgery, University of Nottingham, Nottingham, UK aut Sasano Hironobu Department of Pathology, Tohoku University School of Medicine, Sendai, Japan aut von Minckwitz Gunter Department of Gynecology and Obstetrics, Goethe University, Frankfurt am Main, Germany aut Yamauchi Akira Department of Breast Surgery, Kitano Hospital, Osaka, Japan aut Klimberg V. Division of Breast Surgical Oncology, Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA aut Annals of Surgical Oncology Springer-Verlag 18/10(2011-10-01), 2885-2892 1068-9265 18:10<2885 2011 18 10434 https://doi.org/10.1245/s10434-011-1666-7 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1666-7 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Toi Masakazu Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawara-cho, Sakyo-ku, Kyoto, Japan aut NATIONALLICENCE 700 1- Winer Eric Breast Oncology Center, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA aut NATIONALLICENCE 700 1- Inamoto Takashi Department of Breast Surgery, Kitano Hospital, Osaka, Japan aut NATIONALLICENCE 700 1- Benson John Cambridge Breast Unit, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK aut NATIONALLICENCE 700 1- Forbes John Department of Surgical Oncology, University of Newcastle, Newcastle, Australia aut NATIONALLICENCE 700 1- Mitsumori Michihide Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine at Kyoto University, Kyoto, Japan aut NATIONALLICENCE 700 1- Robertson John Professorial Unit of Surgery, Division of Breast Surgery, University of Nottingham, Nottingham, UK aut NATIONALLICENCE 700 1- Sasano Hironobu Department of Pathology, Tohoku University School of Medicine, Sendai, Japan aut NATIONALLICENCE 700 1- von Minckwitz Gunter Department of Gynecology and Obstetrics, Goethe University, Frankfurt am Main, Germany aut NATIONALLICENCE 700 1- Yamauchi Akira Department of Breast Surgery, Kitano Hospital, Osaka, Japan aut NATIONALLICENCE 700 1- Klimberg V. Division of Breast Surgical Oncology, Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/10(2011-10-01), 2885-2892 1068-9265 18:10<2885 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer