Kyoto
Breast Cancer Consensus Conference, Kyoto, Japan, 18-20 February 2014 The loco-regional management of
breast cancer is increasingly complex with application of primary systemic
therapies, oncoplastic techniques and genetic testing for
breast cancer susceptibility. Personalization of loco-regional treatment is integral to optimization of
breast cancer care. Clinical and pathological
tumor stage,
biological features and host factors influence loco-regional treatment strategies and extent of
surgical procedures. Key issues including axillary staging, axillary
treatment, radiation therapy, primary systemic
therapy (PST), preoperative hormonal
therapy and
genetic predisposition were identified and discussed at the Kyoto
Breast Cancer Consensus Conference (KBCCC2014). In the second of a two part conference scene, consensus recommendations for
radiation treatment, primary systemic
therapies and management of
genetic predisposition are reported and focus on the following topics: influence of both clinical response to PST and stage at presentation on recommendations for postmastectomy
radiotherapy; use of regional nodal irradiation in selected node-positive patients and those with adverse pathological factors; extent of surgical resection following downstaging of
tumors with PST; use of preoperative hormonal
therapy in premenopausal women with larger, node-negative
luminal A-like
tumors and managing increasing demands for contralateral
prophylactic mastectomy in patients with a unilateral sporadic
breast cancer.