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The 2016 Assisi Think Tank Meeting on breast cancer: white paper

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Abstract

Purpose

To identify weak points in daily routine use of radiation therapy (RT) for non-metastatic breast cancer patients, particularly when data are lacking or equivocal, a “think tank” of experts met in Assisi.

Methods

Before the meeting, controversial issues on non-metastatic breast cancer were identified and reviewed, and clinical practice investigated by means of an online questionnaire. During the 3-day meeting, topics were discussed in-depth with attendees and potential sponsors that are involved in breast cancer treatment.

Results

Three issues were identified as needing further investigation: (1) Regional lymph node treatment in early-stage breast cancer; (2) Combined post-mastectomy RT and breast reconstruction; (3) RT in patients treated with primary systemic therapy. Future research proposals included the following: (1) Participating in appropriately selected on-going clinical trials; (2) Designing new randomized controlled clinical trials and prospective population cohort studies; (3) Setting-up large database(s) to generate predictive response models and detect biomarkers for tailored loco-regional treatments.

Conclusions

It is hoped that the ATTM findings, as described in the present white paper, will stimulate a new generation of radiation oncologists to focus on research in these areas, and that the white paper will become a tool for multidisciplinary groups to help them design research proposals and strategies.

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Abbreviations

ATTM:

Assisi Think Tank Meeting

ESTRO:

European Society for RadioTherapy & Oncology

RT:

Radiation therapy

PMRT:

Post-mastectomy radiation therapy

PST:

Primary systemic therapy

ALND:

Axillary lymph node dissection

IBCSG:

International Breast Cancer Study Group

SLN:

Sentinel lymph node

ACOSOG:

American College of Surgeons Oncology Group

EORTC:

European Organisation for Research and Treatment of Cancer

DBCG-IMN:

Danish breast cancer cooperative group—internal mammary nodes

EBCTCG:

Early Breast Cancer Trialists’ Collaborative Group

IMRT:

Intensity-modulated radiation therapy

pCR:

Pathological complete response

CTNeoBC:

Collaborative Trials in Neoadjuvant Breast Cancer

HER2:

Human Epidermal Growth Factor Receptor 2

FNR:

False-negative rate

SENTINA:

Sentinel-Lymph-Node Biopsy in Patients with Breast Cancer Before and After Neoadjuvant Chemotherapy

MARI:

Marking axillary’s lymph node with radioactive iodine seed

NSABP:

National Surgical Adjuvant Breast Project

NCDB:

National Cancer Database

ER:

Estrogen receptor

PR:

Progesterone receptor

AI:

Aromatase inhibitors

FNA:

Fine-needle aspiration

CNB:

Core needle biopsy

References

  1. Galimberti V, Cole BF, Zurrida S, Viale G, Luini A, Veronesi P, Baratella P, Chifu C, Sargenti M, Intra M et al (2013) Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01): a phase 3 randomised controlled trial. Lancet Oncol 14(4):297–305

    Article  PubMed  PubMed Central  Google Scholar 

  2. Giuliano AE, Hunt KK, Ballman KV, Beitsch PD, Whitworth PW, Blumencranz PW, Leitch AM, Saha S, McCall LM, Morrow M (2011) Axillary dissection vs no axillary dissection in women with invasive breast cancer and sentinel node metastasis: a randomized clinical trial. JAMA 305(6):569–575

    Article  CAS  PubMed  Google Scholar 

  3. Donker M, van Tienhoven G, Straver ME, Meijnen P, van de Velde CJ, Mansel RE, Cataliotti L, Westenberg AH, Klinkenbijl JH, Orzalesi L et al (2014) Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): a randomised, multicentre, open-label, phase 3 non-inferiority trial. Lancet Oncol 15(12):1303–1310

    Article  PubMed  PubMed Central  Google Scholar 

  4. Jagsi R, Chadha M, Moni J, Ballman K, Laurie F, Buchholz TA, Giuliano A, Haffty BG (2014) Radiation field design in the ACOSOG Z0011 (Alliance) Trial. J Clin Oncol 32(32):3600–3606

    Article  PubMed  PubMed Central  Google Scholar 

  5. Whelan TJ, Olivotto IA, Parulekar WR, Ackerman I, Chua BH, Nabid A, Vallis KA, White JR, Rousseau P, Fortin A et al (2015) Regional nodal irradiation in early-stage breast cancer. N Engl J Med 373(4):307–316

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Poortmans PM, Collette S, Kirkove C, Van Limbergen E, Budach V, Struikmans H, Collette L, Fourquet A, Maingon P, Valli M et al (2015) Internal mammary and medial supraclavicular irradiation in breast cancer. N Engl J Med 373(4):317–327

    Article  CAS  PubMed  Google Scholar 

  7. Thorsen LB, Offersen BV, Dano H, Berg M, Jensen I, Pedersen AN, Zimmermann SJ, Brodersen HJ, Overgaard M, Overgaard J (2016) DBCG-IMN: a population-based cohort study on the effect of internal mammary node irradiation in early node-positive breast cancer. J Clin Oncol 34(4):314–320

    Article  PubMed  Google Scholar 

  8. OPTimizing irradiation through molecular assessment of lymph node (OPTIMAL). https://clinicaltrials.gov/ct2/show/NCT02335957. Accessed 13 Sept 2016

  9. Sentinel node biopsy in breast cancer: omission of axillary clearance after macrometastases. A randomized Trial. https://clinicaltrials.gov/ct2/show/NCT02240472. Accessed 13 Sept 2016

  10. Goyal A, Dodwell D (2015) POSNOC: a randomised trial looking at axillary treatment in women with one or two sentinel nodes with macrometastases. Clin Oncol (R Coll Radiol) 27(12):692–695

    Article  CAS  Google Scholar 

  11. Early Breast Cancer Trialists’ Collaborative G, McGale P, Taylor C, Correa C, Cutter D, Duane F, Ewertz M, Gray R, Mannu G, Peto R et al (2014) Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials. Lancet 383(9935):2127–2135

    Article  Google Scholar 

  12. Frasier LL, Holden S, Holden T, Schumacher JR, Leverson G, Anderson B, Greenberg CC, Neuman HB (2016) Temporal trends in postmastectomy radiation therapy and breast reconstruction associated with changes in national comprehensive cancer network guidelines. JAMA Oncol 2(1):95–101

    Article  PubMed  PubMed Central  Google Scholar 

  13. Krueger EA, Wilkins EG, Strawderman M, Cederna P, Goldfarb S, Vicini FA, Pierce LJ (2001) Complications and patient satisfaction following expander/implant breast reconstruction with and without radiotherapy. Int J Radiat Oncol Biol Phys 49(3):713–721

    Article  CAS  PubMed  Google Scholar 

  14. Seth AK, Silver HR, Hirsch EM, Kim JY, Fine NA (2015) Comparison of delayed and immediate tissue expander breast reconstruction in the setting of postmastectomy radiation therapy. Ann Plast Surg 75(5):503–507

    Article  CAS  PubMed  Google Scholar 

  15. Jhaveri JD, Rush SC, Kostroff K, Derisi D, Farber LA, Maurer VE, Bosworth JL (2008) Clinical outcomes of postmastectomy radiation therapy after immediate breast reconstruction. Int J Radiat Oncol Biol Phys 72(3):859–865

    Article  PubMed  Google Scholar 

  16. Momoh AO, Ahmed R, Kelley BP, Aliu O, Kidwell KM, Kozlow JH, Chung KC (2014) A systematic review of complications of implant-based breast reconstruction with prereconstruction and postreconstruction radiotherapy. Ann Surg Oncol 21(1):118–124

    Article  PubMed  Google Scholar 

  17. Kelley BP, Ahmed R, Kidwell KM, Kozlow JH, Chung KC, Momoh AO (2014) A systematic review of morbidity associated with autologous breast reconstruction before and after exposure to radiotherapy: are current practices ideal? Ann Surg Oncol 21(5):1732–1738

    Article  PubMed  PubMed Central  Google Scholar 

  18. Motwani SB, Strom EA, Schechter NR, Butler CE, Lee GK, Langstein HN, Kronowitz SJ, Meric-Bernstam F, Ibrahim NK, Buchholz TA (2006) The impact of immediate breast reconstruction on the technical delivery of postmastectomy radiotherapy. Int J Radiat Oncol Biol Phys 66(1):76–82

    Article  PubMed  Google Scholar 

  19. Blitzblau RC, Horton JK (2013) Treatment planning technique in patients receiving postmastectomy radiation therapy. Pract Radiat Oncol 3(4):241–248

    Article  PubMed  Google Scholar 

  20. Dundas KL, Pogson EM, Batumalai V, Boxer MM, Yap ML, Delaney GP, Metcalfe P, Holloway L (2015) Australian survey on current practices for breast radiotherapy. J Med Imaging Radiat Oncol 59(6):736–742

    Article  PubMed  Google Scholar 

  21. Petit JY, Lohsiriwat V, Clough KB, Sarfati I, Ihrai T, Rietjens M, Veronesi P, Rossetto F, Scevola A, Delay E (2011) The oncologic outcome and immediate surgical complications of lipofilling in breast cancer patients: a multicenter study—Milan–Paris–Lyon experience of 646 lipofilling procedures. Plast Reconstr Surg 128(2):341–346

    Article  CAS  PubMed  Google Scholar 

  22. Ho A, Cordeiro P, Disa J, Mehrara B, Wright J, Van Zee KJ, Hudis C, McLane A, Chou J, Zhang Z et al (2012) Long-term outcomes in breast cancer patients undergoing immediate 2-stage expander/implant reconstruction and postmastectomy radiation. Cancer 118(9):2552–2559

    Article  PubMed  Google Scholar 

  23. Cordeiro PG, Albornoz CR, McCormick B, Hu Q, Van Zee K (2014) The impact of postmastectomy radiotherapy on two-stage implant breast reconstruction: an analysis of long-term surgical outcomes, aesthetic results, and satisfaction over 13 years. Plast Reconstr Surg 134(4):588–595

    Article  CAS  PubMed  Google Scholar 

  24. Kaidar-Person O, Kuten A, Belkacemi Y (2014) Arome: primary systemic therapy and whole breast irradiation for locally advanced breast cancer: a systematic review. Crit Rev Oncol Hematol 92(2):143–152

    Article  PubMed  Google Scholar 

  25. Giacalone PL, Rathat G, Daures JP, Benos P, Azria D, Rouleau C (2010) New concept for immediate breast reconstruction for invasive cancers: feasibility, oncological safety and esthetic outcome of post-neoadjuvant therapy immediate breast reconstruction versus delayed breast reconstruction: a prospective pilot study. Breast Cancer Res Treat 122(2):439–451

    Article  CAS  PubMed  Google Scholar 

  26. Monrigal E, Dauplat J, Gimbergues P, Le Bouedec G, Peyronie M, Achard JL, Chollet P, Mouret-Reynier MA, Nabholtz JM, Pomel C (2011) Mastectomy with immediate breast reconstruction after neoadjuvant chemotherapy and radiation therapy. A new option for patients with operable invasive breast cancer. Results of a 20 years single institution study. Eur J Surg Oncol 37(10):864–870

    Article  CAS  PubMed  Google Scholar 

  27. Proton radiation therapy for invasive breast cancer following mastectomy. https://clinicaltrials.gov/ct2/show/NCT01340495. Accessed 10 Sept 2016

  28. Study assessing the potential for reduced rates of implant failure using multi-beam intensity-modulated radiation therapy for locally advanced breast cancer patients with implant reconstructions. https://clinicaltrials.gov/ct2/show/NCT02086578. Accessed 15 sept 2016

  29. Skin sparing mastectomy and immediate breast reconstruction with latissimus dorsi flap after neoadjuvant chemotherapy and radiotherapy (M-RIC) (M-RIC). https://clinicaltrials.gov/ct2/show/NCT01199354. Accessed 15 Sept 2016

  30. Kaufmann M, von Minckwitz G, Mamounas EP, Cameron D, Carey LA, Cristofanilli M, Denkert C, Eiermann W, Gnant M, Harris JR et al (2012) Recommendations from an international consensus conference on the current status and future of neoadjuvant systemic therapy in primary breast cancer. Ann Surg Oncol 19(5):1508–1516

    Article  PubMed  Google Scholar 

  31. Cortazar P, Zhang L, Untch M, Mehta K, Costantino JP, Wolmark N, Bonnefoi H, Cameron D, Gianni L, Valagussa P et al (2014) Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis. Lancet 384(9938):164–172

    Article  PubMed  Google Scholar 

  32. Bossuyt V, Provenzano E, Symmans WF, Boughey JC, Coles C, Curigliano G, Dixon JM, Esserman LJ, Fastner G, Kuehn T et al (2015) Recommendations for standardized pathological characterization of residual disease for neoadjuvant clinical trials of breast cancer by the BIG-NABCG collaboration. Ann Oncol 26(7):1280–1291

    CAS  PubMed  PubMed Central  Google Scholar 

  33. Kuehn T, Bauerfeind I, Fehm T, Fleige B, Hausschild M, Helms G, Lebeau A, Liedtke C, von Minckwitz G, Nekljudova V et al (2013) Sentinel-lymph-node biopsy in patients with breast cancer before and after neoadjuvant chemotherapy (SENTINA): a prospective, multicentre cohort study. Lancet Oncol 14(7):609–618

    Article  PubMed  Google Scholar 

  34. Boughey JC, Suman VJ, Mittendorf EA, Ahrendt GM, Wilke LG, Taback B, Leitch AM, Kuerer HM, Bowling M, Flippo-Morton TS et al (2013) Sentinel lymph node surgery after neoadjuvant chemotherapy in patients with node-positive breast cancer: the ACOSOG Z1071 (Alliance) clinical trial. JAMA 310(14):1455–1461

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Mamounas EP, Brown A, Anderson S, Smith R, Julian T, Miller B, Bear HD, Caldwell CB, Walker AP, Mikkelson WM et al (2005) Sentinel node biopsy after neoadjuvant chemotherapy in breast cancer: results from national surgical adjuvant breast and bowel project protocol B-27. J Clin Oncol 23(12):2694–2702

    Article  PubMed  Google Scholar 

  36. Straver ME, Loo CE, Alderliesten T, Rutgers EJ, Vrancken Peeters MT (2010) Marking the axilla with radioactive iodine seeds (MARI procedure) may reduce the need for axillary dissection after neoadjuvant chemotherapy for breast cancer. Br J Surg 97(8):1226–1231

    Article  CAS  PubMed  Google Scholar 

  37. Donker M, Straver ME, Wesseling J, Loo CE, Schot M, Drukker CA, van Tinteren H, Sonke GS, Rutgers EJ, Vrancken Peeters MJ (2015) Marking axillary lymph nodes with radioactive iodine seeds for axillary staging after neoadjuvant systemic treatment in breast cancer patients: the MARI procedure. Ann Surg 261(2):378–382

    Article  PubMed  Google Scholar 

  38. Caudle AS, Yang WT, Krishnamurthy S, Mittendorf EA, Black DM, Gilcrease MZ, Bedrosian I, Hobbs BP, DeSnyder SM, Hwang RF et al (2016) Improved axillary evaluation following neoadjuvant therapy for patients with node-positive breast cancer using selective evaluation of clipped nodes: implementation of targeted axillary dissection. J Clin Oncol 34(10):1072–1078

    Article  PubMed  Google Scholar 

  39. Liedtke C, Thill M, Committee AGOB (2016) AGO recommendations for the diagnosis and treatment of patients with early breast cancer: update 2016. Breast Care (Basel) 11(3):204–214

    Article  Google Scholar 

  40. Berruti A, Generali D, Kaufmann M, Puztai L, Curigliano G, Aglietta M, Gianni L, Miller WR, Untch M, Sotiriou C et al (2011) International expert consensus on primary systemic therapy in the management of early breast cancer: highlights of the fourth symposium on primary systemic therapy in the management of operable breast cancer, Cremona, Italy (2010). J Natl Cancer Inst Monogr 2011(43):147–151

    Article  PubMed  Google Scholar 

  41. Honig A, Rieger L, Sutterlin M, Wallwiener D, Dietl J, Solomayer EF (2005) State of the art of neoadjuvant chemotherapy in breast cancer: rationale, results and recent developments. Ger Med Sci. doi:10.1016/j.ejcsup.2013.07.043

    PubMed  PubMed Central  Google Scholar 

  42. Early Breast Cancer Trialists’ Collaborative G, Darby S, McGale P, Correa C, Taylor C, Arriagada R, Clarke M, Cutter D, Davies C, Ewertz M et al (2011) Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet 378(9804):1707–1716

    Article  Google Scholar 

  43. White J, Mamounas E (2014) Locoregional radiotherapy in patients with breast cancer responding to neoadjuvant chemotherapy: a paradigm for treatment individualization. J Clin Oncol 32(6):494–495

    Article  PubMed  Google Scholar 

  44. Marks LB, Prosnitz LR (2014) Reducing local therapy in patients responding to preoperative systemic therapy: are we outsmarting ourselves? J Clin Oncol 32(6):491–493

    Article  PubMed  Google Scholar 

  45. Senkus E, Kyriakides S, Ohno S, Penault-Llorca F, Poortmans P, Rutgers E, Zackrisson S, Cardoso F, Committee EG (2015) Primary breast cancer: Esmo clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 26(Suppl 5):v8–v30

    Article  PubMed  Google Scholar 

  46. Huang EH, Tucker SL, Strom EA, McNeese MD, Kuerer HM, Buzdar AU, Valero V, Perkins GH, Schechter NR, Hunt KK et al (2004) Postmastectomy radiation improves local-regional control and survival for selected patients with locally advanced breast cancer treated with neoadjuvant chemotherapy and mastectomy. J Clin Oncol 22(23):4691–4699

    Article  PubMed  Google Scholar 

  47. McGuire SE, Gonzalez-Angulo AM, Huang EH, Tucker SL, Kau SW, Yu TK, Strom EA, Oh JL, Woodward WA, Tereffe W et al (2007) Postmastectomy radiation improves the outcome of patients with locally advanced breast cancer who achieve a pathologic complete response to neoadjuvant chemotherapy. Int J Radiat Oncol Biol Phys 68(4):1004–1009

    Article  PubMed  PubMed Central  Google Scholar 

  48. Mamounas EP, Anderson SJ, Dignam JJ, Bear HD, Julian TB, Geyer CE Jr, Taghian A, Wickerham DL, Wolmark N (2012) Predictors of locoregional recurrence after neoadjuvant chemotherapy: results from combined analysis of national surgical adjuvant breast and bowel project B-18 and B-27. J Clin Oncol 30(32):3960–3966

    Article  PubMed  PubMed Central  Google Scholar 

  49. Rusthoven CG, Rabinovitch RA, Jones BL, Koshy M, Amini A, Yeh N, Jackson MW, Fisher CM (2016) The impact of postmastectomy and regional nodal radiation after neoadjuvant chemotherapy for clinically lymph node-positive breast cancer: a national cancer database (NCDB) analysis. Ann Oncol 27(5):818–827

    Article  CAS  PubMed  Google Scholar 

  50. Radiotherapy after primary chemotherapy for breastcancer (RAPCHEM). https://clinicaltrials.gov/ct2/show/NCT01279304. Accessed 13 Sept 2016

  51. Standard or comprehensive radiation therapy in treating patients with early-stage breast cancer previously treated with chemotherapy and surgery. http://www.cancer.gov/about-cancer/treatment/clinical-trials/search/view?cdrid=750327. Accessed 13 Sept 2016

  52. Lymph node dissection and radiation therapy in treating patients with breast cancer previously treated with chemotherapy and surgery. http://www.cancer.gov/about-cancer/treatment/clinical-trials/search/view?cdrid=751211. Accessed 13 Sept 2016

  53. Gaui MF, Amorim G, Arcuri RA, Pereira G, Moreira D, Djahjah C, Biasoli I, Spector N (2007) A phase II study of second-line neoadjuvant chemotherapy with capecitabine and radiation therapy for anthracycline-resistant locally advanced breast cancer. Am J Clin Oncol 30(1):78–81

    Article  CAS  PubMed  Google Scholar 

  54. Alvarado-Miranda A, Arrieta O, Gamboa-Vignolle C, Saavedra-Perez D, Morales-Barrera R, Bargallo-Rocha E, Zinser-Sierra J, Perez-Sanchez V, Ramirez-Ugalde T, Lara-Medina F (2009) Concurrent chemo-radiotherapy following neoadjuvant chemotherapy in locally advanced breast cancer. Radiat Oncol 4:24

    Article  PubMed  PubMed Central  Google Scholar 

  55. Shaughnessy JN, Meena RA, Dunlap NE, Jain D, Riley EC, Quillo AR, Dragun AE (2015) Efficacy of concurrent chemoradiotherapy for patients with locally recurrent or advanced inoperable breast cancer. Clin Breast Cancer 15(2):135–142

    Article  PubMed  Google Scholar 

  56. Offersen BV, Boersma LJ, Kirkove C, Hol S, Aznar MC, Sola AB, Kirova YM, Pignol JP, Remouchamps V, Verhoeven K et al (2016) ESTRO consensus guideline on target volume delineation for elective radiation therapy of early stage breast cancer, version 1.1. Radiother Oncol 118(1):205–208

    Article  PubMed  Google Scholar 

  57. Lambin P, Rios-Velazquez E, Leijenaar R, Carvalho S, van Stiphout RG, Granton P, Zegers CM, Gillies R, Boellard R, Dekker A et al (2012) Radiomics: extracting more information from medical images using advanced feature analysis. Eur J Cancer 48(4):441–446

    Article  PubMed  PubMed Central  Google Scholar 

  58. Lambin P, van Stiphout RG, Starmans MH, Rios-Velazquez E, Nalbantov G, Aerts HJ, Roelofs E, van Elmpt W, Boutros PC, Granone P et al (2013) Predicting outcomes in radiation oncology-multifactorial decision support systems. Nat Rev Clin Oncol 10(1):27–40

    Article  PubMed  Google Scholar 

  59. Meldolesi E, van Soest J, Damiani A, Dekker A, Alitto AR, Campitelli M, Dinapoli N, Gatta R, Gambacorta MA, Lanzotti V et al (2016) Standardized data collection to build prediction models in oncology: a prototype for rectal cancer. Future Oncol 12(1):119–136

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

The authors thank all the other ATTM Expert European Board members: Bruno Cutuli, Pierfrancesco Franco, Domenico Genovesi, Vladislav Grinberg, Diclehan Kilic, Vassilis Kouloulias, Lorenzo Livi, Stefano Maria Magrini, Fabio Marazzi, Icro Meattini, Angel Montero Luis, Isabella Palumbo, Elisabetta Perrucci, Luigi Pirtoli, Ugur Selek, Daniela Smaniotto, Fabrizio Stracci, Vincenzo Tombolini, Lurdes Trigo, Cristiana Vidali.

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Authors and Affiliations

  1. Radiation Oncology Section, Department of Surgical and Biomedical Sciences, University of Perugia and Perugia General Hospital, Sant’Andrea delle Fratte, 06156, Perugia, Italy

    Cynthia Aristei

  2. Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC, USA

    Orit Kaidar-Person

  3. Oncology Institute, Rambam Medical Center, Haifa, Israel

    Orit Kaidar-Person

  4. Department of Radiation Oncology, Hospital Universitari Sant Joan de Reus, Tarragona, Spain

    Meritxell Arenas

  5. Oncology Centre, Cambridge University Hospitals NHS Trust, Cambridge, UK

    Charlotte Coles

  6. Department of Oncology, Aarhus University Hospital, Aarhus, Denmark

    Birgitte V. Offersen

  7. Département de radiothérapie oncologique/Inserm U1194, Institut du Cancer de Montpellier (ICM-Val d’Aurelle), Université de Montpellier, Montpellier, France

    Celine Bourgier

  8. Dipartimento di Oncologia, Azienda Sanitaria di Bologna, Bologna, Italy

    Giovanni Frezza

  9. Radiotherapy Division, European Institute of Oncology, Milan, Italy

    Maria Cristina Leonardi

  10. Radiation Oncology Department, Università Cattolica del Sacro Cuore, Rome, Italy

    Vincenzo Valentini

  11. Radboud university medical center, Nijmegen, The Netherlands

    Philip M. P. Poortmans

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  1. Cynthia Aristei
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  2. Orit Kaidar-Person
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  3. Meritxell Arenas
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  4. Charlotte Coles
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  5. Birgitte V. Offersen
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  6. Celine Bourgier
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  8. Maria Cristina Leonardi
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  10. Philip M. P. Poortmans
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Correspondence to Cynthia Aristei.

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The authors declare that they have no conflict of interest. Dr. Charlotte Coles is supported by the Cambridge National Institute of Health Research Biomedical Research Centre.

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Aristei, C., Kaidar-Person, O., Arenas, M. et al. The 2016 Assisi Think Tank Meeting on breast cancer: white paper. Breast Cancer Res Treat 160, 211–221 (2016). https://doi.org/10.1007/s10549-016-3998-2

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