| Title: |
Guidance for Canadian Breast Cancer Practice: National Consensus Recommendations for the Systemic Treatment of Patients with HR+/HER2− Early Breast Cancer 2025 |
| Authors: |
Sandeep Sehdev; Anil Abraham Joy; Jean-François Boileau; Nathaniel Bouganim; Christine Brezden-Masley; Jeffrey Q. Cao; David W. Cescon; Stephen Chia; Scott Edwards; Karen A. Gelmon; Katarzyna J. Jerzak; Aalok Kumar; Kara Laing; Nathalie LeVasseur; Christine Simmons; Marc Webster; Mita Manna; on behalf of Patient Advocacy, Breast Cancer Canada on behalf of Patient Advocacy, Breast Cancer Canada |
| Source: |
Current Oncology ; Volume 33 ; Issue 2 ; Pages: 112 |
| Publisher Information: |
Multidisciplinary Digital Publishing Institute |
| Publication Year: |
2026 |
| Collection: |
MDPI Open Access Publishing |
| Subject Terms: |
hormone receptor-positive breast cancer; HER2-negative; early breast cancer; endocrine therapy; chemotherapy; CDK4/6 inhibitor; bisphosphonates; genomic testing; REAL Alliance; sentinel lymph node biopsy; axillary lymph node dissection |
| Description: |
Hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+/HER2−) early breast cancer (EBC) is the most common breast cancer subtype and encompasses a biologically heterogeneous group of tumours. Endocrine therapy (ET) remains the cornerstone of treatment, but decisions regarding chemotherapy, cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors, and bone-modifying agents must be tailored to tumour biology, clinical stage, and menopausal status. REAL Canadian Breast Cancer Alliance (REAL Alliance), a pan-Canadian group of breast cancer specialists, convened to develop national clinical consensus recommendations for the systemic management of HR+/HER2− EBC. Using a structured consensus process, 28 recommendations were endorsed, spanning neoadjuvant and adjuvant systemic therapy, surgical considerations, and use of bisphosphonates. Key recommendations include the selective use of neoadjuvant chemotherapy for high-risk or locally advanced disease; genomic testing to guide chemotherapy decisions, particularly in postmenopausal patients; ET as the foundation of adjuvant therapy with intensification using CDK4/6 inhibitors in higher-risk patients; and adjuvant bisphosphonates in postmenopausal women to reduce recurrence and improve survival. These consensus recommendations provide practical, evidence-based guidance to support individualized, patient-centred management of HR+/HER2− EBC in the Canadian context. |
| Document Type: |
text |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
Breast Cancer; https://dx.doi.org/10.3390/curroncol33020112 |
| DOI: |
10.3390/curroncol33020112 |
| Availability: |
https://doi.org/10.3390/curroncol33020112 |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.ABDD4BBA |
| Database: |
BASE |