High Risk and Prevention

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1 Wednesday, April 28, 2010 Time Topic Presenter Aims 09:00-09:15 Welcome J.C. Acevedo & Kent C. Osborne, MD High Risk and Prevention To give the welcome and explain some particularities of the actual meeting 09:15-09:45 Plenary Conference: Risk for breast cancer classification and its management in high risk women 09:45-10:05 Breast imaging: Magnetic resonance, mammography and ultrasound for the surveillance in high risk population women. 10:05-10:25 Management of patients with high risk benign histology lesions. Judith Garber, MD Director, Cancer Risk and Prevention Program; Associate Professor of Medicine, Harvard Medical School, Emily Sedgwick, MD Assistant Professor of Radiology at Baylor College of Medicine, Director of Breast Imaging at the Smith Breast Center, Octavio Peralta, MD Cirujano, Centro To discuss the methodology for different models of risk assessment and which of them could be used in a particular woman To perform an up-date of the different methods utilized for the screening in high risk population To discuss the management of patients with lesions that carry on increasing risk for breast cancer. Different medical and surgical procedures for risk management

2 10:25-10:45 Management of patients with breast cancer and BRCA 1 or 2 mutations, including contra-lateral breast. Judith Garber, MD Director, Cancer Risk and Prevention Program; Associate Professor of Medicine, Harvard Medical School, To discuss any special care for this type of patients (surgical, medical) and at the same time the type of care of the other breast (mainly imaging and surgical or medical prevention) 10:45-11:05 Coffee break All 11:05-11:25 Advances in breast cancer prevention 11:25-11:35 Prevalence of pre-malignant and malignant lesions in specimens of women treated with prophylactic mastectomy. 11:45-12:05 Psychological counseling for high risk patient and her family. Judith Garber, MD Director, Cancer Risk and Prevention Program; Associate Professor of Medicine, Harvard Medical School, Álvaro Ibarra, MD Anátomo Patólogo, Condes. Verónica Robert, Ps Psiconcóloga, Instituto Oncológico, To discuss the different strategies for breast cancer prevention To review data about histological findings in specimens from prophylactic risk reduction mastectomies To review the psychological impact of BRCA 1 and 2 testing and carrier for the woman and her family Lunch Time All Imaging of Breast Cancer 14:30-15:00 Plenary conference: Future of the breast imaging: MRI and spectroscopy, nano-technology, diffusion 15:00 15:20 Breast cancer screening: benefits and controversies Emily Sedgwick, MD Assistant Professor of Radiology at Baylor College of Medicine, Director of Breast Imaging at the Smith Breast Center, Paulina Neira, MD Radióloga, Centro To give an analytic review of the data regarding advances in breast cancer screening, utilizing different imaging

3 15:20-15:40 Imaging the tumor in women undergoing neo-adjuvant therapy Emily Sedgwick, MD Assistant Professor of Radiology at Baylor College of Medicine, Director of Breast Imaging at the Smith Breast Center, methods. The use of imaging for the measurement of chemotherapy response in patients with neoadjuvant treatment is of crucial relevance. In this topic, the aim is to discuss the usefulness of different breast imaging methods and their results 15:40-16:10 Coffee break All 16:10-16:30 BIRADS and pathological correlation for patients undergoing percutaneous biopsy Dra. Bernardita Aguirre Radióloga, Centro Dr. Álvaro Ibarra Anátomo Patólogo, Condes To review the experience of the Breast Imaging Department from Clinica Las Condes and results from literature 16:30-17:30 Clinical cases discussion. Chairs: Dra. Bernardita Aguirre Radióloga, Centro In this section, clinical cases will be presented and discussed by the panel Juan Carlos Acevedo Director Centro Integral de la Mama, Clínica Las Condes. Participants: Emily Sedgwick, MD Assistant Professor of Radiology at Baylor College of Medicine, Director of Breast Imaging at the Smith Breast Center,

4 17:30-18:00 Plenary Conference: The role of magnetic resonance imaging in the breast cancer patient Fattaneh A. Tavassoli, M.D. Professor of Pathology and Obstetrics, Gynecology, and Reproductive Sciences; Director, Pathology Women's Health Program, Yale University School of Medicine, Monica Morrow, MD Chief of Breast Surgery at Memorial Sloan- Kettering Cancer Center in Manhattan, NY, Dr. Antonio Solá Oncólogo Médico, Instituto Oncológico, Edith Perez, M.D. Professor of Medicine at Mayo Medical School, in Rochester, MN; Director of the Cancer Clinical Study Unit at the Mayo Clinic in Jacksonville, Florida, Monica Morrow, MD Chief of Breast Surgery at Memorial Sloan- Kettering Cancer Center in Manhattan, NY, To review the evidence that justify or not, the use of MRI in this patient setting 18:00-18:20 Q & A 18:20 18:40 Plenary Conference: The United States -Latin America Breast Cancer Pilot Project Jorge Gómez, MD Director, Office of Latin American Cancer Program Development. Office of the Director, National Cancer To describe the methodology and objectives of this program, that is really important for Latin American countries

5 18:40 19:00 Panel discussion Institute, Edith Perez, M.D. Professor of Medicine at Mayo Medical School, in Rochester, MN; Director of the Cancer Clinical Study Unit at the Mayo Clinic in Jacksonville, Florida, Jorge Gómez, MD Director, Office of Latin American Cancer Program Development. Office of the Director, National Cancer Institute, 19:00 20:00 Welcome reception Thursday, April 29, 2010 Pathology of Breast Cancer Time Topic Presenter Aims 09:00-09:30 Plenary Conference: Diagnostic and prognostic markers for breast cancer. 09:30-09:50 Minimal residual disease and its significance for breast cancer therapy. Fattaneh A. Tavassoli, M.D. Professor of Pathology and Obstetrics, Gynecology, and Reproductive Sciences; Director, Pathology Women's Health Program, Yale University School of Medicine, Luis Cereceda, MD Oncólogo Médico, Condes. To discuss the role of minimal residual disease both in lymph nodes and bone marrow and its importance for medical

6 treatment decisions 09:50-10:10 Micro and macro environment in breast cancer. Fattaneh A. Tavassoli, M.D. Professor of Pathology and Obstetrics, Gynecology, and Reproductive Sciences; Director, Pathology Women's Health Program, Yale University School of Medicine, 10:10-10:30 Tamoxifen and endometrium. Luis Contreras, MD Anátomo Patólogo, Condes. To describe the experience with 10:30-11:00 Coffee break All 11:00-11:20 Ductal intra-epithelial neoplasm' s: Morphology, associated risk and molecular disturbances. 11:20-12:00 Standardization for c-erb-b-2 assessment: Immunohistochemestry, CISH, FISH. 12:00-12:20 Cytological assessment of surgical margins in breast pathology and sentinel lymph node Industry Symposium Roche Fattaneh A. Tavassoli, M.D. Professor of Pathology and Obstetrics, Gynecology, and Reproductive Sciences; Director, Pathology Women's Health Program, Yale University School of Medicine, Luis Contreras, MD Anátomo Patólogo, Condes. Dr. Álvaro Ibarra Anátomo Patólogo, Condes Edith Perez, M.D. Professor of Medicine at Mayo Medical School, in Rochester, MN; Director of the

7 Cancer Clinical Study Unit at the Mayo Clinic in Jacksonville, Florida, Triple negative disease 14:30-15:00 Plenary Conference: Clinical and pathological issues in basallike breast cancer. Fattaneh A. Tavassoli, M.D. Professor of Pathology and Obstetrics, Gynecology, and Reproductive Sciences; Director, Pathology Women's Health Program, Yale University School of Medicine, To state the difference between triple negative and basal-like tumor To give the pathological issues that characterized the basal-like breast cancer and correlate these issues with clinical out-come. 15:00-15:20 Triple negative breast cancer: Epidemiology, biology and treatment overview 15:20-16:10 Which is the best adjuvant therapy and it sequence for triple negative disease? 16:10-16:40 Triple negative metastasic patient: How do we proceed after antracyclines and taxanes. 16:40-17:00 Coffee Break 17:00-17:20 Molecular therapies for triple negative disease. Dr. Jorge Gutiérrez Oncólogo Médico, Condes. Edith Perez, M.D. Professor of Medicine at Mayo Medical School, in Rochester, MN; Director of the Cancer Clinical Study Unit at the Mayo Clinic in Jacksonville, Florida, Dennis J. Slamon, M.D., Ph.D. Professor of Medicine, Chief of the Division of Hematology/Oncology at UCLA, Edith Perez, M.D. Professor of Medicine at Mayo Medical School, in Rochester, MN; Director of the Cancer Clinical Study To review the actual concept of epidemiology, biology and treatment of triple negative disease patients To discuss the role of adjuvant chemotherapy for this type of patients, the way it must be given and the best schedule for them To discuss the treatment modalities for these patients, mainly the role of platinum agents or other chemotherapy agents To discuss the advance of research of new molecules for the treatment of triple negative patients

8 17:20-17:50 Plenary Conference: Plenary Conference: Are we ready for personalized adjuvant breast cancer treatment? Oncotype-DX, Mamma-Print, and others. 18:00-19:00 Industry Symposium Glaxo Unit at the Mayo Clinic in Jacksonville, Florida, Kent Osborne M.D. Director L. Duncan Cancer Center, Baylor College of Medicine, Houston, Dennis J. Slamon, M.D., Ph.D. Professor of Medicine, Chief of the Division of Hematology/Oncology at UCLA, To make an up-date of the data supporting the use of genetic signaling as predictive and prognostic factor Friday, April 30, 2010 Time Topic Speaker Aims 09:00-09:30 Plenary Conference: The role of surgery in the metastatic breast cancer: the primary breast tumor and solitary metastases 09:30-09:50 Is there still a role for adjuvant chemotherapy in postmenopausal patients? 09:50-10:05 Is there still a role for Tamoxifeno in the adjuvant treatment of postmenopausal patients? Monica Morrow, M.D. Chief of Breast Surgery at Memorial Sloan-Kettering Cancer Center in Manhattan, NY, Dennis J. Slamon, M.D., Ph.D. Professor of Medicine, Chief of the Division of Hematology/Oncology at UCLA, Dr. José Miguel Reyes Oncólogo Médico, Condes To discuss the role of surgery in the treatment for patients with metastatic disease and with primary not treated and to discuss the role of surgery for those patients with only one or two, organ confined, lesion(s) To discuss the current role of chemotherapy in post menopausal patients, mainly referred to selection and of patients and type of therapy To discuss the new evidence about the role of TAM and AI in the endocrine treatment of post menopausal breast cancer patients

9 10:05-10:35 Coffee Break 10:35-10:55 Role of HER-2 inhibitors in the adjuvant setting. 10:55-11:15 Role of HER-2 inhibitors in the metastatic setting. 11:15-11:35 Endocrine adjuvant treatment in the pre-menopausal patient: Role of ovarian ablation/supresion. 11:35-12:00 Plenary Conference: Dual inhibition: use of growth factor inhibitors and endocrine blockade: Ready for clinical use? 12:00-12:30 Plenary Conference: Minimizing local recurrence: What is proven and what is not Lunch and Industry Symposium. Edith Perez, M.D. Professor of Medicine at Mayo Medical School, in Rochester, MN; Director of the Cancer Clinical Study Unit at the Mayo Clinic in Jacksonville, Florida, Dennis J. Slamon, M.D., Ph.D. Professor of Medicine, Chief of the Division of Hematology/Oncology at UCLA, Dr. Carlos Regonesi Oncólogo Médico, Condes. Kent Osborne M.D. Director L. Duncan Cancer Center, Baylor College of Medicine, Houston, Monica Morrow, M.D. Chief of Breast Surgery at Memorial Sloan-Kettering Cancer Center in Manhattan, NY, To review the achievements in the field of HER-2 inhibition for the adjuvant treatment of breast cancer patients To highlight the role of HER-2 inhibitors in the management of HER-2 positive disease To up-date the role of endocrine therapy for premenopausal patients, with special reference to the new data of metaanalysis To up-date the research and clinical progress of dual o triple association of endocrine therapy and other molecular therapies for the treatment of breast cancer 14:30-15:00 Plenary Conference: Breast onco-plastic surgery: Past, present and future. Dr. Eduardo González Cirujano Oncoplástico. Jefe Unidad de Reconstrucción Mamaria, Depto. de Mastología, Instituto

10 Ángel H. Roffo, Buenos Aires, 15:00-15:15 Immediate breast reconstruction. Dra. Nuvia Aliaga Cirujana, Centro 15:15-15:30 Breast reconstruction using expanders and prosthesis. Dr. Hernando Paredes Cirujano, Centro 15:30-15:50 Indications guide for breast reconstruction after breast previous or adjuvant radiotherapy. 15:50 16:05 Radiotherapy and reconstructive surgery 15:50-16:10 Technical videos: Skin sparing mastectomy, sentinel lymph node and immediate breast reconstruction with expanders. Skin sparing mastectomy, axillary clearance and immediate reconstruction with microsurgical TRAM. Dr. Alberto Rancati Jefe Servicio Cirugía Plástica y Reconstrucción. Instituto Quirúrgico del Callao, Buenos Aires, Dr. Antonio Solá Oncólogo Médico, Instituto Oncológico, Clínica Las Condes Dr. Eduardo González Cirujano Oncoplástico. Jefe Unidad de Reconstrucción Mamaria, Depto. de Mastología, Instituto Ángel H. Roffo, Buenos Aires, Deferred breast reconstruction with dorsal width and definitive expander. 16:10-16:30 Round table. Chair: Dr. Hernando Paredes Cirujano, Centro Panelists:

11 16:30-16:50 Coffee break. All Dra. Nuvia Aliaga Cirujana, Centro Dr. Eduardo González Cirujano Oncoplástico. Jefe Unidad de Reconstrucción Mamaria, Depto. de Mastología, Instituto Ángel H. Roffo, Buenos Aires, Dr. Alberto Rancati Jefe Servicio Cirugía Plástica y Reconstrucción. Instituto Quirúrgico del Callao, Buenos Aires, 16:50-17:00 Partial mastectomy and its repair with local flaps: Indications and techniques. Dr. Alberto Rancati Jefe Servicio Cirugía Plástica y Reconstrucción. Instituto Quirúrgico del Callao, Buenos Aires, 17:00-17:20 Breast reconstruction with flaps. Dr. Hernando Paredes Cirujano, Centro 17:20-17:40 Research on and clinical use of stem cells and growth factors for the repair of sequelaes from surgical breast cancer treatment. Dr. Alberto Rancati Jefe Servicio Cirugía Plástica y Reconstrucción. Instituto Quirúrgico del Callao, Buenos Aires, 17:40-18:00 Surgical techniques videos: Dr. Alberto Rancati Jefe Servicio Cirugía

12 Lipofiling and conservative treatment of breast cancer. Breast reduction and conservative treatment of breast cancer. 17:20-17:40 Mastectomías con conservación de piel y reconstrucción mamaria inmediata. Plástica y Reconstrucción. Instituto Quirúrgico del Callao, Buenos Aires, Dr. Oscar Bernabó Jefe del Servicio de Mastología del Hospital Británico de Buenos Aires, 18:00 18:15 Video discusión. 18:15 Adjourn.

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