Evidence map›Paper›PMID 19535820›Full record

ArticleAnnals of oncology : official journal of the European Society for Medical Oncology2009

Thresholds for therapies: highlights of the St Gallen International Expert Consensus on the primary therapy of early breast cancer 2009.

A Goldhirsch, J N Ingle, R D Gelber, A S Coates, B Thürlimann, H-J Senn, Panel members

Registry-linked trialOpen access · greenAbstract readConsensus Statement
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of oncology : official journal of the European Society for Medical Oncology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02167490 (A Randomized Trial Comparing Sentinel Lymph Node Biopsy Vs no Axillary Surgical Staging in Patients With Small Breast Cancer and a Negative Preoperative Axillary Assessment), which is not on this map. Cited by 454 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
454citing papers in PubMed, 5 pooled it
68.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02167490 naactive not recruitingnot on this mapstarted 2012, after this paper: background citation

A Randomized Trial Comparing Sentinel Lymph Node Biopsy Vs no Axillary Surgical Staging in Patients With Small Breast Cancer and a Negative Preoperative Axillary Assessment (IEO S637/311)

TypeinterventionalSponsorEuropean Institute of OncologyRan2012 to 2025Enrolled1,560ConditionsEarly Stage Breast CarcinomaArmsArm 1: sentinel node biopsy
3 · Its place in the literature

Who cites it

454 citing papers in PubMed, 5 syntheses or guidelines pooled it, 1,367 citations in OpenAlex.

  1. Pooled it
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  6. Neoadjuvant Abemaciclib plus Letrozole Versus Chemotherapy in Patients with HR+/HER2- Highly Proliferative Breast Cancer.Clinical cancer research : an official journal of the American Association for Cancer Research · 2026
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  15. Relative Effectiveness of Letrozole Compared With Tamoxifen for Patients With Lobular Carcinoma in the BIG 1-98 Trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2015
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394 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 6 institutions in 4 countries.

A GoldhirschInternational Breast Cancer Study Group, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland. aron.goldhirsch@ibcsg.org
J N Ingle
R D Gelber
A S Coates
B Thürlimann
H-J Senn
Panel members
Breast Center · CHDana-Farber Cancer Institute · USInternational Breast Cancer Study Group · CHMayo Clinic · USTumor- und Brustzentrum ZeTuP Silberturm · CHUniversity of Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The 11(th) St Gallen (Switzerland) expert consensus meeting on the primary treatment of early breast cancer in March 2009 maintained an emphasis on targeting adjuvant systemic therapies according to subgroups defined by predictive markers. Any positive level of estrogen receptor (ER) expression is considered sufficient to justify the use of endocrine adjuvant therapy in almost all patients. Overexpression or amplification of HER2 by standard criteria is an indication for anti-HER2 therapy for all but the very lowest risk invasive tumours. The corollary is that ER and HER2 must be reliably and accurately measured. Indications for cytotoxic adjuvant therapy were refined, acknowledging the role of risk factors with the caveat that risk per se is not a target. Proliferation markers, including those identified in multigene array analyses, were recognised as important in this regard. The threshold for indication of each systemic treatment modality thus depends on different criteria which have been separately listed to clarify the therapeutic decision-making algorithm.

Indexed as

AlgorithmsAntineoplastic Agents, HormonalBreast NeoplasmsBreast Neoplasms, MaleChemotherapy, AdjuvantDecision Support TechniquesErb-b2 Receptor Tyrosine KinasesFemaleHumansMaleNeoplasms, Hormone-DependentRadiotherapy, AdjuvantReceptors, EstrogenAntineoplastic Agents, HormonalErb-b2 Receptor Tyrosine KinasesReceptors, Estrogen

Identifiers

PMID19535820
PMCPMC2720818
OpenAlexW2155803397

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.