{'fraction_non_alphanumeric': 0.02897743103928671, 'fraction_numerical': 0.013652828085817777, 'mean_word_length': 5.157804459691252, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
ABC2 Consensus Conference on Advanced Breast Cancer: Brief Summary of the Consensus Panel on Saturday November 9, 2013

The Advanced Breast Cancer Second International Consensus Conference (ABC2) took place in Lisbon, Portugal, from 7–9 November 2013. More than 1,000 participants from 71 countries attended the 2 days of state-of-the art lectures on locally advanced and metastatic breast cancer and the consensus panel discussion. This article briefly summarizes the topics discussed at the public consensus meeting in Lisbon on Saturday morning – a more detailed discussion of the consensus and its conclusions in the light of the German guidelines will follow in the first issue of Breast Care in 2014. Under the chairmanship of Fatima Cardoso (Portugal), Alberto Costa (Italy), Larry Norton (USA) and Eric Winer (USA), 41 international and multidisciplinary panel members (table ​(table1)1) discussed the ABC2 statements. These statements included new statements for ABC2, statements of the ABC1 consensus (2011) that, based on new evidence, needed some modifications, and last but not least ABC1 statements that were still considered valid and thus were not discussed again. Given the limited time available on the Saturday morning, the international panel primarily discussed the new statements for ABC2. This report only briefly summarizes the results of the consensus discussion and voting in Lisbon. The final ABC2 consensus with the final written version of the consensus statements and all modified ABC1 statements will be published in the official consensus publication by Dr. Cardoso and her colleagues in early 2014. 
 
 
 
Table 1 
 
ABC 2 consensus panellists 
 
 
 
 
Locally Advanced Breast Cancer (LABC) 
This topic was one of the main themes of ABC2 and refers to inoperable LABC without distant metastases. The panel agreed on the need for a pre-therapeutic biopsy to determine histology and tumor biology (estrogen receptor (ER), progesterone (PR), HER2, and proliferation). Given the high risk for distant metastasis, the panel unanimously opted for a subtle staging work-up, including clinical history, physical examination, and extensive imaging before the start of therapy. The panelists agreed on systemic therapy and not surgery or radiotherapy as the first therapeutic choice in this setting. If the tumor remains inoperable after systemic treatment and radiotherapy, ‘palliative’ mastectomy should only be used in cases for which an overall improvement of quality of life can be expected. A multidisciplinary treatment approach was seen as indicated for the majority of LABC cases. After systemic therapy (with or without radiotherapy), surgery would still be possible in the majority of cases. This would usally consist of mastectomy plus axillary dissection, although in a small proportion of patients breast conserving therapy may be an option. 
 
The different tumor-biological subtypes were then discussed separately. For triple-negative LABC, anthracycline-and taxane-based chemotherapy was considered optimal. In HER2-positive LABC, concurrent taxane and anti-HER2 therapy is recommended and anthracyclines should be incorporated sequentially. In ER-positive LABC, anthracycline-and taxane-based chemotherapy as well as endocrine therapy were accepted as therapeutic options. In the discussion it was emphasized that the choice of chemotherapy vs. endocrine therapy as the primary treatment depends on the patient (e.g. menopausal status, performance status, comorbidities, and preference) as well as tumor (e.g. grade and biomarkers) characteristics.