Maastricht Delphi consensus on event definitions for classification of recurrence in breast cancer research Journal Article


Authors: Moossdorff, M.; van Roozendaal, L. M.; Strobbe, L. J. A.; Aebi, S.; Cameron, D. A.; Dixon, J. M.; Giuliano, A. E.; Haffty, B. G.; Hickey, B. E.; Hudis, C. A.; Klimberg, V. S.; Koczwara, B.; Kühn, T.; Lippman, M. E.; Lucci, A.; Piccart, M.; Smith, B. D.; Tjan-Heijnen, V. C.G.; Van de Velde, C. J. H.; Van Zee, K. J.; Vermorken, J. B.; Viale, G.; Voogd, A. C.; Wapnir, I. L.; White, J. R.; Smidt, M. L.
Article Title: Maastricht Delphi consensus on event definitions for classification of recurrence in breast cancer research
Abstract: BACKGROUND: In breast cancer studies, many different endpoints are used. Definitions are often not provided or vary between studies. For instance, "local recurrence" may include different components in similar studies. This limits transparency and comparability of results. This project aimed to reach consensus on the definitions of local event, second primary breast cancer, regional and distant event for breast cancer studies. METHODS: The RAND-UCLA Appropriateness method (modified Delphi method) was used. A Consensus Group of international breast cancer experts was formed, including representatives of all involved clinical disciplines. Consensus was reached in two rounds of online questionnaires and one meeting. RESULTS: Twenty-four international breast cancer experts participated. Consensus was reached on 134 items in four categories. Local event is defined as any epithelial breast cancer or ductal carcinoma in situ (DCIS) in the ipsilateral breast, or skin and subcutaneous tissue on the ipsilateral thoracic wall. Second primary breast cancer is defined as epithelial breast cancer in the contralateral breast. Regional events are breast cancer in ipsilateral lymph nodes. A distant event is breast cancer in any other location. Therefore, this includes metastasis in contralateral lymph nodes and breast cancer involving the sternal bone. If feasible, tissue sampling of a first, solitary, lesion suspected for metastasis is highly recommended. CONCLUSION: This project resulted in consensus-based event definitions for classification of recurrence in breast cancer research. Future breast cancer research projects should adopt these definitions to increase transparency. This should facilitate comparison of results and conducting reviews as well as meta-analysis.
Keywords: lymph node metastasis; lymphatic metastasis; neoplasm recurrence, local; skin neoplasms; pathology; breast neoplasms; questionnaires; questionnaire; skin tumor; consensus development; delphi study; delphi technique; neoplasms, second primary; thorax wall; thoracic wall; carcinoma, intraductal, noninfiltrating; international cooperation; secondary; humans; human; female
Journal Title: JNCI: Journal of the National Cancer Institute
Volume: 106
Issue: 12
ISSN: 0027-8874
Publisher: Oxford University Press  
Date Published: 2014-11-07
Start Page: dju288
Language: English
DOI: 10.1093/jnci/dju288
PUBMED: 25381395
PROVIDER: scopus
PMCID: PMC4357796
DOI/URL:
Notes: Export Date: 2 March 2015 -- Source: Scopus
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  1. Clifford Hudis
    905 Hudis
  2. Kimberly J Van Zee
    293 Van Zee