Update Breast Cancer 2021 Part 1 – Prevention and Early Stages

Stickeler, Elmar; Aktas, Bahriye; Behrens, Annika; Belleville, Erik; Ditsch, Nina; Fasching, Peter A.; Fehm, Tanja N.; Hartkopf, Andreas D.; Jackisch, Christian; Janni, Wolfgang; Kolberg-Liedtke, Cornelia; Kolberg, Hans-Christian; Lüftner, Diana; Lux, Michael P.; Müller, Volkmar; Schneeweiss, Andreas; Schütz, Florian; Schulmeyer, Carla E.; Tesch, Hans; Thomssen, Christoph; Uleer, Christoph; Untch, Michael; Welslau, Manfred; Wöckel, Achim; Wurmthaler, Lena A.; Würstlein, Rachel; Thill, Marc

This review summarises not only the latest evidence on prevention, but also the current research on the treatment of early-stage breast cancer patients. Recent years have seen a growing body of evidence on the risk of high- and moderate-penetrance breast cancer susceptibility genes. A large international consortium has now been able to further refine the answer to the question of the significance of the so-called panel genes. Moreover, the data on treatment selection regarding endocrine efficacy and the decision for or against chemotherapy have also been advanced markedly. There is also new data on adjuvant CDK4/6 (cyclin-dependent kinase 4/6) inhibitors, which are standard in first-line treatment in patients with metastatic HER2-negative, hormone receptor-positive (HR+) breast cancer. For other therapies such as immune checkpoint inhibitors, which have successfully improved the rate of pathologic complete response (pCR) in neoadjuvant treatment settings for patients with triple-negative breast cancer (TNBC), there is a growing understanding of the quality of life and side effects. This is especially important in situations where patients could possibly be cured without such a regimen.