Serbian consensus of neoadjuvant therapy for breast cancer: NeoPULSE

Serbian consensus of neoadjuvant therapy for breast cancer

JBUON 2018; 23(2): 522-532
ISSN: 1107-0625, online ISSN: 2241-6293 • www.jbuon.com
E-mail: editorial_office@jbuon.com

Lazar Popovic1,2, Zorica Tomasevic3,4, Ljiljana Stamatovic3,4, Ivan Markovic4,5, Gorana Matovina-
Brko1,2, Marko Buta4,5, Andrija Golubovic2,6, Vladimir Selakovic6, Jasna Trifunovic1,2,
Zafir Mutrezani7, Nebojsa Ivanovic4,8, Jasmina Nedovic9, Srdjan Ninkovic10,11, Sladjana Filipovic12,13,
Ana Cvetanovic12,13, Nebojsa Djordjevic13,14, Aleksandar Karanikolic13,14, Tatjana
Ivkovic-Kapicl2,6, Ferenc Vicko2,6

1Clinic for Medical Oncology, Institute of Oncology of Vojvodina, Sremska Kamenica, Serbia; 2Medical Faculty, University of
Novi Sad, Novi Sad, Serbia; 3Clinic for Medical Oncology, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia;
4Medical Faculty, University of Belgrade, Belgrade, Serbia; 5Clinic for Surgical Oncology, Institute of Oncology and Radiology
of Serbia, Belgrade, Serbia; 6Clinic for Surgical Oncology, Institute of Oncology of Vojvodina, Sremska Kamenica, Serbia; 7Department
for Medical Oncology, Clinic of Oncology, CHC Bezanijska Kosa, Belgrade, Serbia; 8Department for Surgical Oncology,
Clinic of Oncology, CHC Bezanijska Kosa, Belgrade, Serbia; 9Centre for Oncology and Radiology, Clinical Centre Kragujevac,
Kragujevac, Serbia; 10Clinic for General and Thoracic Surgery, Clinical Centre Kragujevac, Kragujevac, Serbia; 11Medical Faculty,
University of Kragujevac, Kragujevac, Serbia; 12Clinic of Oncology, Clinical Centre Nis, Nis, Serbia; 13Medical Faculty,
University of Nis, Nis, Serbia; 14Clinic for General Surgery, Clinical Centre Nis, Nis, Serbia

Summary
Even though surgery is the primary treatment of operable breast cancer, it has been known for decades that the administration of postoperative adjuvant or preoperative neoadjuvant therapy is extremely important. Indications for neodjuvant therapy administration have been expanded over the years, and nowadays this kind of treatment represents an inevitable option in early breast cancer treatment. The
NeoPULSE project, which gathered a group of experts in the field of breast cancer from five Serbian university centres, was formed with the aim to define optimal breast cancer diagnosis, indications for neoadjuvant therapy, therapeutic combinations in relation to molecular/biological parameters of breast cancer, as well as the treatment after neoadjuvant therapy. During two separate expert meetings involving surgeons,
medical oncologists, radiation oncologists, a pathologist, and a “Blueprint” workshop, the project participants answered questions over the indications for neoadjuvant therapy. The first part covered local practice and referred to the existence and work of a multidisciplinary team, as well as commonly applied therapeutic regimens in the neoadjuvant setting. Experts analysed personal views regarding indications for the administration and benefits of neoadjuvant therapy, their perception on the correlation between achieving a pathological complete response (pCR) and the outcome of treatment, as well as the attitude towards controversies about this type of treatment, primarily regarding a possible
change in the receptor status after therapy and therapeutic options after a suboptimal response. The analysis of the answers pointed to problems and deviations from recommendations in everyday clinical practice, based on which appropriate solutions were proposed. The establishment of such a panel and consensus is an attempt to modernize multidisciplinary teams in Serbia, achieve reaching uniform decisions of all subjects dealing with breast cancer, and therefore, at least in one segment, improve breast cancer treatment in Serbia.
Key words: breast cancer, local practice, multidisciplinary team, neoadjuvant therapy, pathological complete response

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