Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Dec 26;34(1):56.
doi: 10.1186/s43046-022-00156-x.

Primary therapy of early breast cancer: Egyptian view of 2021 St. Gallen consensus

Hussein Khaled  1 , Yousry Wasef Nada  2 , Kareem Mohamed Ramadan  2 , Shawkat Fekry  2 , Mohamed Samy Seleam  2 , Rabab Gaafar  3 , Mohamed Lotayef  4
Affiliations

Primary therapy of early breast cancer: Egyptian view of 2021 St. Gallen consensus

Hussein Khaled et al. J Egypt Natl Canc Inst. .

Abstract

Purpose: The theme of the St. Gallen International Breast Cancer Conference 2021 held virtually for the first time, due to the COVID-19 pandemic, was on tailoring therapies for patients with early breast cancer. A monkey survey that included an Egyptian Panel voted on most of the questions of the original St. Gallen consensus, and some added new questions most relevant to oncology practice in the country, to be able to compare voting results that reflect differences in breast cancer management and decision making.

Methods: The panel included 74 Egyptian scientists from different oncology specialties. Management issues including controversial diagnostic and therapeutic interventions were prepared by a small committee and then projected using the online monkey survey website: https://www.surveymonkey.com . The survey included 130 questions. Results were then analyzed, tabulated, and compared to the voting results of the original St. Gallen consensus.

Results and conclusions: Voting questions and resulting percentages of answers from the Egyptian panel were summarized. There was no consensus between the Egyptian and the original St. Gallen panels on 28/130 statements. They mostly included genetic and pathologic aspects, specifically the routine use of gene signature assays and a few queries involving surgical, radiotherapeutic, and systemic interventions. Probably, available resources and healthcare system differences in Egypt compared to European and the USA were the cause of these differences. This would also be applicable to other low- and low-middle-income healthcare scenarios present in many countries, especially with the present constraints of the COVID-19 pandemic.

Keywords: Adjuvant therapy; Breast cancer; Egypt.

PubMed Disclaimer

Conflict of interest statement

Prof Hussein Khaled is a co-author of this study and the Editor-in-Chief of the journal. He was not involved in handling this manuscript during the review process. The rest of the authors have no conflict of interest to declare.

Figures

Fig. 1
Fig. 1
In node-negative ER-positive PR-positive HER2-negative tumors, the Ki-67 threshold that justifies chemotherapy would be a Ki-67 of at least 30%
Fig. 2
Fig. 2
Egyptian panel recommendations for genomic signature testing in ER-positive and HER2-negative early-stage breast cancer
Fig. 3
Fig. 3
Is axillary dissection required for residual cancer in lymph nodes after standard neoadjuvant chemotherapy?
Fig. 4
Fig. 4
Do you consider hypofractionation?
Fig. 5
Fig. 5
Egyptian panel recommendation of size threshold for initiating systemic therapy by tumor type and treatment
Fig. 6
Fig. 6
The contribution of chemotherapy-induced ovarian function suppression (OFS) to the total effect of chemotherapy in premenopausal, ER-positive early stage with favorable biological features
Fig. 7
Fig. 7
Panel recommendation for premenopausal women with 1–3 positive lymph nodes and recurrence score <25 or other low-range genomic signature
See this image and copyright information in PMC

References

    1. Burstein J, Curigliano G, Thürlimann B, Weber WB, Poortmans P, et al. Customizing local and systemic therapies for women with early breast cancer: the St. Gallen International Consensus Guidelines for treatment of early breast cancer. Ann Oncol. 2021;32(10):1216–1235. doi: 10.1016/j.annonc.2021.06.023. - DOI - PMC - PubMed
    1. Khaled H, Gamal H, Lotayef M, et al. The St. Gallen International Expert Consensus conference on the primary therapy of early breast cancer, 2017: Egyptian view. Breast Cancer Res Treat. 2018;172:545–550. doi: 10.1007/s10549-018-4945-1. - DOI - PubMed
    1. Thomssen C, Balic M, Harbeck N, et al. St. Gallen/Vienna 2021: a brief summary of the consensus discussion on customizing therapies for women with early breast cancer. Breast Care. 2021;16:135–143. doi: 10.1159/000516114. - DOI - PMC - PubMed
    1. Holm J, Erikssn L, Ploner A, et al. Assessment of breast cancer risk factors reveals subtype heterogeneity. Cancer Res. 2017;77(13):3708–3717. doi: 10.1158/0008-5472.CAN-16-2574. - DOI - PubMed
    1. Smith I, Robertson J, Kilburn L, et al. Long-term outcome and prognostic value of Ki67 after perioperative endocrine therapy in postmenopausal women with hormone-sensitive early breast cancer (POETIC): an open-label, multicentre, parallel-group, randomised, phase 3 trial. Lancet Oncol. 2020;21(11):1443–1454. doi: 10.1016/S1470-2045(20)30458-7. - DOI - PMC - PubMed

LinkOut - more resources