Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy

Walter P. Weber; Martin Haug; Christian Kurzeder; Vesna Bjelic-Radisic; Rupert Koller; Roland Reitsamer; Florian Fitzal; Jorge Biazus; Fabricio Brenelli; Cicero Urban; Régis Resende Paulinelli; Jens Uwe Blohmer; Jörg Heil; Jürgen Hoffmann; Zoltan Matrai; Giuseppe Catanuto; Viviana Galimberti; Oreste Gentilini; Mitchel Barry; Tal Hadar; Tanir M. Allweis; Oded Olsha; Maria João Cardoso; Pedro F. Gouveia; Isabel T. Rubio; Jana de Boniface; Tor Svensjö; Susanne Bucher; Peter Dubsky; Jian Farhadi; Mathias K. Fehr; Ilario Fulco; Ursula Ganz-Blättler; Andreas Günthert; Yves Harder; Nik Hauser; Elisabeth A. Kappos; Michael Knauer; Julia Landin; Robert Mechera; Francesco Meani; Giacomo Montagna; Mathilde Ritter; Ramon Saccilotto; Fabienne D. Schwab; Daniel Steffens; Christoph Tausch; Jasmin Zeindler; Savas D. Soysal; Visnu Lohsiriwat; Tibor Kovacs; Anne Tansley; Lynda Wyld; Laszlo Romics; Mahmoud El-Tamer; Andrea L. Pusic; Virgilio Sacchini; Michael Gnant

doi:10.1007/s10549-018-4937-1

Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy

Walter P. Weber^*, Martin Haug, Christian Kurzeder, Vesna Bjelic-Radisic, Rupert Koller, Roland Reitsamer, Florian Fitzal, Jorge Biazus, Fabricio Brenelli, Cicero Urban, Régis Resende Paulinelli, Jens Uwe Blohmer, Jörg Heil, Jürgen Hoffmann, Zoltan Matrai, Giuseppe Catanuto, Viviana Galimberti, Oreste Gentilini, Mitchel Barry, Tal HadarTanir M. Allweis, Oded Olsha, Maria João Cardoso, Pedro F. Gouveia, Isabel T. Rubio, Jana de Boniface, Tor Svensjö, Susanne Bucher, Peter Dubsky, Jian Farhadi, Mathias K. Fehr, Ilario Fulco, Ursula Ganz-Blättler, Andreas Günthert, Yves Harder, Nik Hauser, Elisabeth A. Kappos, Michael Knauer, Julia Landin, Robert Mechera, Francesco Meani, Giacomo Montagna, Mathilde Ritter, Ramon Saccilotto, Fabienne D. Schwab, Daniel Steffens, Christoph Tausch, Jasmin Zeindler, Savas D. Soysal, Visnu Lohsiriwat, Tibor Kovacs, Anne Tansley, Lynda Wyld, Laszlo Romics, Mahmoud El-Tamer, Andrea L. Pusic, Virgilio Sacchini, Michael Gnant

^*Corresponding author for this work

Faculty of Medicine

Research output: Contribution to journal › Review article › peer-review

83 Scopus citations

Abstract

Purpose: Indications for nipple-sparing mastectomy (NSM) have broadened to include the risk reducing setting and locally advanced tumors, which resulted in a dramatic increase in the use of NSM. The Oncoplastic Breast Consortium consensus conference on NSM and immediate reconstruction was held to address a variety of questions in clinical practice and research based on published evidence and expert panel opinion. Methods: The panel consisted of 44 breast surgeons from 14 countries across four continents with a background in gynecology, general or reconstructive surgery and a practice dedicated to breast cancer, as well as a patient advocate. Panelists presented evidence summaries relating to each topic for debate during the in-person consensus conference. The iterative process in question development, voting, and wording of the recommendations followed the modified Delphi methodology. Results: Consensus recommendations were reached in 35, majority recommendations in 24, and no recommendations in the remaining 12 questions. The panel acknowledged the need for standardization of various aspects of NSM and immediate reconstruction. It endorsed several oncological contraindications to the preservation of the skin and nipple. Furthermore, it recommended inclusion of patients in prospective registries and routine assessment of patient-reported outcomes. Considerable heterogeneity in breast reconstruction practice became obvious during the conference. Conclusions: In case of conflicting or missing evidence to guide treatment, the consensus conference revealed substantial disagreement in expert panel opinion, which, among others, supports the need for a randomized trial to evaluate the safest and most efficacious reconstruction techniques.

Original language	English
Pages (from-to)	523-537
Number of pages	15
Journal	Breast Cancer Research and Treatment
Volume	172
Issue number	3
DOIs	https://doi.org/10.1007/s10549-018-4937-1
State	Published - 1 Dec 2018

Bibliographical note

Funding Information:
Funding The face-to-face meeting held for all panelists in Basel, Switzerland, on 15 March, 2018, was supported by the Swiss Cancer League, the Swiss Cancer Research Foundation, the Claudia von Schilling Foundation for Breast Cancer Research, as well as by Sandoz, Roche, and Kiechle Orthopädie Technik. We also acknowledge both financial and in-kind support provided by the University Hospital Basel. None of the funding sources were involved in the selection of topics; in the choice of panelists; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit for publication.

Funding Information:
We would like to thank Mr. Andreas Gyr for his assistance in drawing up this report. Dr. Gnant reports grants from AstraZeneca, Novartis, Pfizer and Roche, as well as personal fees from Accelsiors, Amgen, AstraZeneca, Celgene, Elli Lilly, Ipsen, Nano String Technologies, Novartis, Pfizer and Roche. Dr. Hadar reports reimbursement of travel expenses by Medison and Roche. Dr. Pusic is a co-developer of BREAST-Q, FACE-Q and BODY-Q, which are owned by Memorial Sloan-Kettering Cancer Center; she receives license fee payments for the use of BREAST-Q, FACE-Q and BODY-Q in industry-sponsored clinical trials. Dr Fitzal reports grants and advisory board as well as meeting support by Pfizer, Novartis, Astra Zeneca, Roche, Comesa, Bondimed. Dr. Saccilotto reports personal fees from the Oncoplastic Breast Consortium during the conduct of the study. All other authors report no competing interests.

Funding Information:
Conflict of interest Dr. Gnant reports grants from AstraZeneca, Novartis, Pfizer and Roche, as well as personal fees from Accelsiors, Amgen, AstraZeneca, Celgene, Elli Lilly, Ipsen, Nano String Technologies, Novartis, Pfizer and Roche. Dr. Hadar reports reimbursement of travel expenses by Medison and Roche. Dr. Pusic is a co-developer of BREAST-Q, FACE-Q and BODY-Q, which are owned by Memorial Sloan-Kettering Cancer Center; she receives license fee payments for the use of BREAST-Q, FACE-Q and BODY-Q in industry-sponsored clinical trials. Dr Fitzal reports grants and advisory board as well as meeting support by Pfizer, Novartis, Astra Zeneca, Roche, Comesa, Bondimed. Dr. Saccilotto reports personal fees from the Oncoplastic Breast Consortium during the conduct of the study. All other authors report no competing interests.

Publisher Copyright:
© 2018, The Author(s).

Keywords

Breast cancer surgery
Immediate breast reconstruction
Nipple-sparing mastectomy

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s10549-018-4937-1

Cite this

Weber, W. P., Haug, M., Kurzeder, C., Bjelic-Radisic, V., Koller, R., Reitsamer, R., Fitzal, F., Biazus, J., Brenelli, F., Urban, C., Paulinelli, R. R., Blohmer, J. U., Heil, J., Hoffmann, J., Matrai, Z., Catanuto, G., Galimberti, V., Gentilini, O., Barry, M., ... Gnant, M. (2018). Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy. Breast Cancer Research and Treatment, 172(3), 523-537. https://doi.org/10.1007/s10549-018-4937-1

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title = "Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy",

abstract = "Purpose: Indications for nipple-sparing mastectomy (NSM) have broadened to include the risk reducing setting and locally advanced tumors, which resulted in a dramatic increase in the use of NSM. The Oncoplastic Breast Consortium consensus conference on NSM and immediate reconstruction was held to address a variety of questions in clinical practice and research based on published evidence and expert panel opinion. Methods: The panel consisted of 44 breast surgeons from 14 countries across four continents with a background in gynecology, general or reconstructive surgery and a practice dedicated to breast cancer, as well as a patient advocate. Panelists presented evidence summaries relating to each topic for debate during the in-person consensus conference. The iterative process in question development, voting, and wording of the recommendations followed the modified Delphi methodology. Results: Consensus recommendations were reached in 35, majority recommendations in 24, and no recommendations in the remaining 12 questions. The panel acknowledged the need for standardization of various aspects of NSM and immediate reconstruction. It endorsed several oncological contraindications to the preservation of the skin and nipple. Furthermore, it recommended inclusion of patients in prospective registries and routine assessment of patient-reported outcomes. Considerable heterogeneity in breast reconstruction practice became obvious during the conference. Conclusions: In case of conflicting or missing evidence to guide treatment, the consensus conference revealed substantial disagreement in expert panel opinion, which, among others, supports the need for a randomized trial to evaluate the safest and most efficacious reconstruction techniques.",

keywords = "Breast cancer surgery, Immediate breast reconstruction, Nipple-sparing mastectomy",

author = "Weber, {Walter P.} and Martin Haug and Christian Kurzeder and Vesna Bjelic-Radisic and Rupert Koller and Roland Reitsamer and Florian Fitzal and Jorge Biazus and Fabricio Brenelli and Cicero Urban and Paulinelli, {R{\'e}gis Resende} and Blohmer, {Jens Uwe} and J{\"o}rg Heil and J{\"u}rgen Hoffmann and Zoltan Matrai and Giuseppe Catanuto and Viviana Galimberti and Oreste Gentilini and Mitchel Barry and Tal Hadar and Allweis, {Tanir M.} and Oded Olsha and Cardoso, {Maria Jo{\~a}o} and Gouveia, {Pedro F.} and Rubio, {Isabel T.} and {de Boniface}, Jana and Tor Svensj{\"o} and Susanne Bucher and Peter Dubsky and Jian Farhadi and Fehr, {Mathias K.} and Ilario Fulco and Ursula Ganz-Bl{\"a}ttler and Andreas G{\"u}nthert and Yves Harder and Nik Hauser and Kappos, {Elisabeth A.} and Michael Knauer and Julia Landin and Robert Mechera and Francesco Meani and Giacomo Montagna and Mathilde Ritter and Ramon Saccilotto and Schwab, {Fabienne D.} and Daniel Steffens and Christoph Tausch and Jasmin Zeindler and Soysal, {Savas D.} and Visnu Lohsiriwat and Tibor Kovacs and Anne Tansley and Lynda Wyld and Laszlo Romics and Mahmoud El-Tamer and Pusic, {Andrea L.} and Virgilio Sacchini and Michael Gnant",

note = "Publisher Copyright: {\textcopyright} 2018, The Author(s).",

year = "2018",

month = dec,

day = "1",

doi = "10.1007/s10549-018-4937-1",

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Weber, WP, Haug, M, Kurzeder, C, Bjelic-Radisic, V, Koller, R, Reitsamer, R, Fitzal, F, Biazus, J, Brenelli, F, Urban, C, Paulinelli, RR, Blohmer, JU, Heil, J, Hoffmann, J, Matrai, Z, Catanuto, G, Galimberti, V, Gentilini, O, Barry, M, Hadar, T, Allweis, TM, Olsha, O, Cardoso, MJ, Gouveia, PF, Rubio, IT, de Boniface, J, Svensjö, T, Bucher, S, Dubsky, P, Farhadi, J, Fehr, MK, Fulco, I, Ganz-Blättler, U, Günthert, A, Harder, Y, Hauser, N, Kappos, EA, Knauer, M, Landin, J, Mechera, R, Meani, F, Montagna, G, Ritter, M, Saccilotto, R, Schwab, FD, Steffens, D, Tausch, C, Zeindler, J, Soysal, SD, Lohsiriwat, V, Kovacs, T, Tansley, A, Wyld, L, Romics, L, El-Tamer, M, Pusic, AL, Sacchini, V & Gnant, M 2018, 'Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy', Breast Cancer Research and Treatment, vol. 172, no. 3, pp. 523-537. https://doi.org/10.1007/s10549-018-4937-1

TY - JOUR

T1 - Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy

AU - Weber, Walter P.

AU - Haug, Martin

AU - Kurzeder, Christian

AU - Bjelic-Radisic, Vesna

AU - Koller, Rupert

AU - Reitsamer, Roland

AU - Fitzal, Florian

AU - Biazus, Jorge

AU - Brenelli, Fabricio

AU - Urban, Cicero

AU - Paulinelli, Régis Resende

AU - Blohmer, Jens Uwe

AU - Heil, Jörg

AU - Hoffmann, Jürgen

AU - Matrai, Zoltan

AU - Catanuto, Giuseppe

AU - Galimberti, Viviana

AU - Gentilini, Oreste

AU - Barry, Mitchel

AU - Hadar, Tal

AU - Allweis, Tanir M.

AU - Olsha, Oded

AU - Cardoso, Maria João

AU - Gouveia, Pedro F.

AU - Rubio, Isabel T.

AU - de Boniface, Jana

AU - Svensjö, Tor

AU - Bucher, Susanne

AU - Dubsky, Peter

AU - Farhadi, Jian

AU - Fehr, Mathias K.

AU - Fulco, Ilario

AU - Ganz-Blättler, Ursula

AU - Günthert, Andreas

AU - Harder, Yves

AU - Hauser, Nik

AU - Kappos, Elisabeth A.

AU - Knauer, Michael

AU - Landin, Julia

AU - Mechera, Robert

AU - Meani, Francesco

AU - Montagna, Giacomo

AU - Ritter, Mathilde

AU - Saccilotto, Ramon

AU - Schwab, Fabienne D.

AU - Steffens, Daniel

AU - Tausch, Christoph

AU - Zeindler, Jasmin

AU - Soysal, Savas D.

AU - Lohsiriwat, Visnu

AU - Kovacs, Tibor

AU - Tansley, Anne

AU - Wyld, Lynda

AU - Romics, Laszlo

AU - El-Tamer, Mahmoud

AU - Pusic, Andrea L.

AU - Sacchini, Virgilio

AU - Gnant, Michael

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Purpose: Indications for nipple-sparing mastectomy (NSM) have broadened to include the risk reducing setting and locally advanced tumors, which resulted in a dramatic increase in the use of NSM. The Oncoplastic Breast Consortium consensus conference on NSM and immediate reconstruction was held to address a variety of questions in clinical practice and research based on published evidence and expert panel opinion. Methods: The panel consisted of 44 breast surgeons from 14 countries across four continents with a background in gynecology, general or reconstructive surgery and a practice dedicated to breast cancer, as well as a patient advocate. Panelists presented evidence summaries relating to each topic for debate during the in-person consensus conference. The iterative process in question development, voting, and wording of the recommendations followed the modified Delphi methodology. Results: Consensus recommendations were reached in 35, majority recommendations in 24, and no recommendations in the remaining 12 questions. The panel acknowledged the need for standardization of various aspects of NSM and immediate reconstruction. It endorsed several oncological contraindications to the preservation of the skin and nipple. Furthermore, it recommended inclusion of patients in prospective registries and routine assessment of patient-reported outcomes. Considerable heterogeneity in breast reconstruction practice became obvious during the conference. Conclusions: In case of conflicting or missing evidence to guide treatment, the consensus conference revealed substantial disagreement in expert panel opinion, which, among others, supports the need for a randomized trial to evaluate the safest and most efficacious reconstruction techniques.

AB - Purpose: Indications for nipple-sparing mastectomy (NSM) have broadened to include the risk reducing setting and locally advanced tumors, which resulted in a dramatic increase in the use of NSM. The Oncoplastic Breast Consortium consensus conference on NSM and immediate reconstruction was held to address a variety of questions in clinical practice and research based on published evidence and expert panel opinion. Methods: The panel consisted of 44 breast surgeons from 14 countries across four continents with a background in gynecology, general or reconstructive surgery and a practice dedicated to breast cancer, as well as a patient advocate. Panelists presented evidence summaries relating to each topic for debate during the in-person consensus conference. The iterative process in question development, voting, and wording of the recommendations followed the modified Delphi methodology. Results: Consensus recommendations were reached in 35, majority recommendations in 24, and no recommendations in the remaining 12 questions. The panel acknowledged the need for standardization of various aspects of NSM and immediate reconstruction. It endorsed several oncological contraindications to the preservation of the skin and nipple. Furthermore, it recommended inclusion of patients in prospective registries and routine assessment of patient-reported outcomes. Considerable heterogeneity in breast reconstruction practice became obvious during the conference. Conclusions: In case of conflicting or missing evidence to guide treatment, the consensus conference revealed substantial disagreement in expert panel opinion, which, among others, supports the need for a randomized trial to evaluate the safest and most efficacious reconstruction techniques.

KW - Breast cancer surgery

KW - Immediate breast reconstruction

KW - Nipple-sparing mastectomy

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SN - 0167-6806

VL - 172

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EP - 537

JO - Breast Cancer Research and Treatment

JF - Breast Cancer Research and Treatment

IS - 3

ER -

Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy

Abstract

Bibliographical note

Keywords

UN SDGs

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