Current St. Gallen Recommendations on Primary Therapy of Early Breast Cancer*

At the 2007 10th International Conference on Primary Therapy of Early Breast Cancer in St. Gallen, the expert panel confirmed the risk classification (low, intermediate, high risk), and the definition of hormone responsiveness (endocrine responsive, endocrine non-responsive, uncertain) defined in 2005. No adjuvant therapy is only an option in the low-risk group. In the intermediate- and highrisk group, adjuvant therapy is mandatory. The choice of chemotherapy, endocrine therapy and trastuzumab therapy depends on endocrine responsiveness and risk category. Adjuvant chemotherapy should contain anthracyclines. However, in the case of node-positive tumors, taxanes should also be included. In premenopausal patients, tamoxifen is still the standard of endocrine treatment, and in some cases, ovarian function suppression should be added. In postmenopausal patients, aromatase inhibitors are an alternative to the standard tamoxifen therapy.