According to the June 18th report from the online cancer journal, The Annals of Oncology, the international panel of experts that assembled for the 11th St. Gallen Health Conference in March, proposed a potentially radically different approach when it comes to deciding upon the best treatment options for early breast cancer.

While the panel still agrees that no case of breast cancer is exactly the same and each patient should received personalized care, it has put forward a new, more standardized approach when it comes to assessing disease risks and appropriate treatment strategies.

They go on to suggest that these vital clinical systems must address three distinct questions: "(i) what justifies the use of endocrine therapy, (ii) what justifies the use of anti-HER2 therapy, and (iii) what justifies the use of chemotherapy." This is a change from the traditional method of identifying a single-risk category and then a subsequent and separate therapy recommendation.

Furthermore, the panel gave a new algorithm for clinicians to use when they are attempting to decide what will be the most effective treatment approach for their patient. As one of the members, Professor Richard Gelber of Harvard University said, "We have identified 'thresholds for indication' of each type of systemic treatment modality (endocrine therapy, anti-HER2 therapy, chemotherapy) based on criteria specific to each modality. We expect the refined algorithm to change clinical practice because it clarifies the indications for each treatment modality available today."

The panel's report emphasizes the importance of identifying which type of breast cancer a patient has and which treatment, or combination of treatments, are most likely to be successful. They recommend the increased use of genetic profiling using microarrays as a means for improved identification, especially for the forms that have been more difficult to analyze. Additionally, the panel discussed the importance of conducting extensive clinical trials because they can "provide essential information on the safety and efficacy of treatments."

Yet, while their discussion highlights the importance of standardization from medical professionals, the panel knows who will make the final call. Professor Alan Coates of the University of Sydney expressed how the patients must be at the center of all treatment decisions saying, "We recognize the importance of quality of life, supportive care and patient preference in the treatment decision-making process."

More specific treatment recommendations and further details can be seen in the original Annals of Oncology doi: 10.1093/annonc/mdp322

Susan Hardwicke, Ph.D. is a cognitive psychologist who has pioneered the field of neuro-nutrition. S08-1956.he has recently published an ebook on titled The Chemo Brain Report, which is available through http://www.vabion.com, http://www.healthafterchemo.com, or calling the office at (804) 308-1956.

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