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Management of early-stage triple-negative breast cancer: recommendations of a panel of experts from the Brazilian Society of Mastology

BACKGROUND: Triple-negative breast cancer (TNBC) is a heterogenous subtype involving different patterns of behavior and clinical course, demanding a complex, individualized sequence of treatment. The knowledge and attitudes of the affiliated members of the Brazilian Society of Mastology regarding TN...

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Autores principales: Freitas-Junior, Ruffo, de Oliveira, Vilmar Marques, Frasson, Antonio Luiz, Cavalcante, Francisco Pimentel, Mansani, Fabio Postiglione, Mattar, André, Zerwes, Felipe Pereira, de Oliveira Freitas, Adriana Magalhães, de Souza, Alessandra Borba Anton, Damin, Andrea P., dos Santos, Annamaria Massahud Rodrigues, Ruiz, Carlos Alberto, de Lucena, Clécio Ênio Murta, Millen, Eduardo Camargo, Bagnoli, Fábio, Andrade, Felipe, Rodrigues, Frank Lane Braga, Facina, Gil, Novita, Guilherme, Pedrini, Jose Luiz, Guará, José Pereira, Soares, Leonardo Ribeiro, de Nigro Corpa, Marcus Vinicius, Passos, Mauro, de Lucena Ferreira, Nancy Cristina Ferraz, Freitas, Nilceana Maya Aires, Machado, Rafael Henrique Szymanski, da Cunha Amaral, Roberto Kepler, Reinert, Tomás, Budel, Vinicius Milani
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9682792/
https://www.ncbi.nlm.nih.gov/pubmed/36419031
http://dx.doi.org/10.1186/s12885-022-10250-x
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author Freitas-Junior, Ruffo
de Oliveira, Vilmar Marques
Frasson, Antonio Luiz
Cavalcante, Francisco Pimentel
Mansani, Fabio Postiglione
Mattar, André
Zerwes, Felipe Pereira
de Oliveira Freitas, Adriana Magalhães
de Souza, Alessandra Borba Anton
Damin, Andrea P.
dos Santos, Annamaria Massahud Rodrigues
Ruiz, Carlos Alberto
de Lucena, Clécio Ênio Murta
Millen, Eduardo Camargo
Bagnoli, Fábio
Andrade, Felipe
Rodrigues, Frank Lane Braga
Facina, Gil
Novita, Guilherme
Pedrini, Jose Luiz
Guará, José Pereira
Soares, Leonardo Ribeiro
de Nigro Corpa, Marcus Vinicius
Passos, Mauro
de Lucena Ferreira, Nancy Cristina Ferraz
Freitas, Nilceana Maya Aires
Machado, Rafael Henrique Szymanski
da Cunha Amaral, Roberto Kepler
Reinert, Tomás
Budel, Vinicius Milani
author_facet Freitas-Junior, Ruffo
de Oliveira, Vilmar Marques
Frasson, Antonio Luiz
Cavalcante, Francisco Pimentel
Mansani, Fabio Postiglione
Mattar, André
Zerwes, Felipe Pereira
de Oliveira Freitas, Adriana Magalhães
de Souza, Alessandra Borba Anton
Damin, Andrea P.
dos Santos, Annamaria Massahud Rodrigues
Ruiz, Carlos Alberto
de Lucena, Clécio Ênio Murta
Millen, Eduardo Camargo
Bagnoli, Fábio
Andrade, Felipe
Rodrigues, Frank Lane Braga
Facina, Gil
Novita, Guilherme
Pedrini, Jose Luiz
Guará, José Pereira
Soares, Leonardo Ribeiro
de Nigro Corpa, Marcus Vinicius
Passos, Mauro
de Lucena Ferreira, Nancy Cristina Ferraz
Freitas, Nilceana Maya Aires
Machado, Rafael Henrique Szymanski
da Cunha Amaral, Roberto Kepler
Reinert, Tomás
Budel, Vinicius Milani
author_sort Freitas-Junior, Ruffo
collection PubMed
description BACKGROUND: Triple-negative breast cancer (TNBC) is a heterogenous subtype involving different patterns of behavior and clinical course, demanding a complex, individualized sequence of treatment. The knowledge and attitudes of the affiliated members of the Brazilian Society of Mastology regarding TNBC were evaluated and a consensus regarding management and treatment was reached. METHODS: Affiliates completed a survey involving 44 objective questions. In addition, a specialist meeting was held with 27 experts and 3 ad hoc consultants. The panelists completed the survey before and after brainstorming. Answers achieving 70% of agreement were considered consensual. The chi-square test was used to compare answers between panelists and affiliates and the Kappa coefficient to calculate agreement. RESULTS: Consensus among the panelists increased from 26 (59.1%) to 32 questions (72.7%) following brainstorming (p = 0.17), including 7/10 questions on systemic treatment. Among the affiliates, consensus was achieved for 24 questions (54.5%), resulting in moderate agreement (κ = 0.445). Neoadjuvant chemotherapy should be indicated for almost all cases (except cT1a-b N0) and should include platinum agents. When indicated, immunotherapy is part of the standard of care. The panel reaffirmed the concept of no ink on tumor as indicative of adequate margins and the possibility of sentinel lymph node biopsy for cN1 patients who become cN0 following neoadjuvant therapy. Controversies remain on combining immunotherapy with capecitabine/olaparib in pertinent cases. CONCLUSION: Expert consensus was achieved for > 70% of the questions, with moderate agreement between panelists and affiliates. Educational interventions on systemic breast cancer treatment affected decision-making in 60% of the questions. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12885-022-10250-x.
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spelling pubmed-96827922022-11-24 Management of early-stage triple-negative breast cancer: recommendations of a panel of experts from the Brazilian Society of Mastology Freitas-Junior, Ruffo de Oliveira, Vilmar Marques Frasson, Antonio Luiz Cavalcante, Francisco Pimentel Mansani, Fabio Postiglione Mattar, André Zerwes, Felipe Pereira de Oliveira Freitas, Adriana Magalhães de Souza, Alessandra Borba Anton Damin, Andrea P. dos Santos, Annamaria Massahud Rodrigues Ruiz, Carlos Alberto de Lucena, Clécio Ênio Murta Millen, Eduardo Camargo Bagnoli, Fábio Andrade, Felipe Rodrigues, Frank Lane Braga Facina, Gil Novita, Guilherme Pedrini, Jose Luiz Guará, José Pereira Soares, Leonardo Ribeiro de Nigro Corpa, Marcus Vinicius Passos, Mauro de Lucena Ferreira, Nancy Cristina Ferraz Freitas, Nilceana Maya Aires Machado, Rafael Henrique Szymanski da Cunha Amaral, Roberto Kepler Reinert, Tomás Budel, Vinicius Milani BMC Cancer Research BACKGROUND: Triple-negative breast cancer (TNBC) is a heterogenous subtype involving different patterns of behavior and clinical course, demanding a complex, individualized sequence of treatment. The knowledge and attitudes of the affiliated members of the Brazilian Society of Mastology regarding TNBC were evaluated and a consensus regarding management and treatment was reached. METHODS: Affiliates completed a survey involving 44 objective questions. In addition, a specialist meeting was held with 27 experts and 3 ad hoc consultants. The panelists completed the survey before and after brainstorming. Answers achieving 70% of agreement were considered consensual. The chi-square test was used to compare answers between panelists and affiliates and the Kappa coefficient to calculate agreement. RESULTS: Consensus among the panelists increased from 26 (59.1%) to 32 questions (72.7%) following brainstorming (p = 0.17), including 7/10 questions on systemic treatment. Among the affiliates, consensus was achieved for 24 questions (54.5%), resulting in moderate agreement (κ = 0.445). Neoadjuvant chemotherapy should be indicated for almost all cases (except cT1a-b N0) and should include platinum agents. When indicated, immunotherapy is part of the standard of care. The panel reaffirmed the concept of no ink on tumor as indicative of adequate margins and the possibility of sentinel lymph node biopsy for cN1 patients who become cN0 following neoadjuvant therapy. Controversies remain on combining immunotherapy with capecitabine/olaparib in pertinent cases. CONCLUSION: Expert consensus was achieved for > 70% of the questions, with moderate agreement between panelists and affiliates. Educational interventions on systemic breast cancer treatment affected decision-making in 60% of the questions. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12885-022-10250-x. BioMed Central 2022-11-22 /pmc/articles/PMC9682792/ /pubmed/36419031 http://dx.doi.org/10.1186/s12885-022-10250-x Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Freitas-Junior, Ruffo
de Oliveira, Vilmar Marques
Frasson, Antonio Luiz
Cavalcante, Francisco Pimentel
Mansani, Fabio Postiglione
Mattar, André
Zerwes, Felipe Pereira
de Oliveira Freitas, Adriana Magalhães
de Souza, Alessandra Borba Anton
Damin, Andrea P.
dos Santos, Annamaria Massahud Rodrigues
Ruiz, Carlos Alberto
de Lucena, Clécio Ênio Murta
Millen, Eduardo Camargo
Bagnoli, Fábio
Andrade, Felipe
Rodrigues, Frank Lane Braga
Facina, Gil
Novita, Guilherme
Pedrini, Jose Luiz
Guará, José Pereira
Soares, Leonardo Ribeiro
de Nigro Corpa, Marcus Vinicius
Passos, Mauro
de Lucena Ferreira, Nancy Cristina Ferraz
Freitas, Nilceana Maya Aires
Machado, Rafael Henrique Szymanski
da Cunha Amaral, Roberto Kepler
Reinert, Tomás
Budel, Vinicius Milani
Management of early-stage triple-negative breast cancer: recommendations of a panel of experts from the Brazilian Society of Mastology
title Management of early-stage triple-negative breast cancer: recommendations of a panel of experts from the Brazilian Society of Mastology
title_full Management of early-stage triple-negative breast cancer: recommendations of a panel of experts from the Brazilian Society of Mastology
title_fullStr Management of early-stage triple-negative breast cancer: recommendations of a panel of experts from the Brazilian Society of Mastology
title_full_unstemmed Management of early-stage triple-negative breast cancer: recommendations of a panel of experts from the Brazilian Society of Mastology
title_short Management of early-stage triple-negative breast cancer: recommendations of a panel of experts from the Brazilian Society of Mastology
title_sort management of early-stage triple-negative breast cancer: recommendations of a panel of experts from the brazilian society of mastology
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9682792/
https://www.ncbi.nlm.nih.gov/pubmed/36419031
http://dx.doi.org/10.1186/s12885-022-10250-x
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