[Systemic treatment of early breast cancer - current state of knowledge after the conference St Gallen 2017].

Breast cancer is the most commonly diagnosed malignancy in women around the globe. It is also the world's first cause of female deaths from cancer. With the introduction of screening programs in most developed countries, more and more cases of this cancer are diagnosed at local or localized stages, enabling radical treatment to be successful. At the same time, systemic treatment of early breast cancer is one of the most complex issues in clinical oncology. Because of the many prognostic factors that need to be taken into account when considering eligibility for treatment such as age, reproductive status (before or after menopause), type of cancer and severity of the disease, it is impossible to establish clear standards of conduct for many clinical situations. The international biennial St Gallen conference, the world's most prominent breast cancer specialists, who are struggling to address major clinical problems in the treatment of early breast cancer. St Gallen's recommendations address all issues related to the treatment of early breast cancer (in particular surgery, radiotherapy, and systemic treatment) and are set by a group of 52 experts by voting. This method allows us to establish consensus on issues that can not be clearly identified in the results of randomized clinical trials. In this way, more than 200 clinical issues were answered. The most important changes in day-to-day practice are the duration of ajuvant hormone therapy (10 instead of 5 years), the possibility of using aromatase inhibitors (in combination with ovarian function suppresion) in premenopausal women with high risk of recurrence and the timing of sentinel node biopsy after neo-adjuvant chemotherapy. There are also recommendations, which patients should undergo genetic testing to assess the risk of recurrence of breast cancer.