Patient-Based Council

Breast Cancer Council

Breast cancer is not a single disease. The patient’s priorities shape the treatment plan as much as subtype and stage do; our council addresses this decision holistically.

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About the disease

Breast cancer is divided into different subtypes according to hormone receptor (ER/PR) status, HER2 status and the Ki-67 index. These subtypes differ markedly in treatment response and course.

Preoperative (neoadjuvant) treatment can shrink the tumor to allow breast-conserving surgery and provides valuable information about treatment response. The extent of surgery and the approach to the axilla are planned accordingly.

In early stage disease, genomic tests (such as Oncotype DX) can clarify whether chemotherapy is needed. In advanced disease, CDK4/6 inhibitors, anti-HER2 agents and options shaped by BRCA status come into play.

Which specialties evaluate it?

In this council your case is reviewed jointly by the disciplines below.

Breast Surgery / General Surgery
Medical Oncology
Radiation Oncology
Radiology
Pathology
Plastic & Reconstructive Surgery
Genetics
Psycho-oncology

Files requested from the patient

Pathology report (ER, PR, HER2, Ki-67)
Mammography, breast ultrasound and breast MRI images and reports
PET/CT or staging investigation reports (if available)
Genomic test results (Oncotype DX, etc., if available)
Genetic test result (BRCA1/2, if available)
Discharge summary and a summary of treatments received

Clinical questions answered

Is breast-conserving surgery suitable for me?
Should I receive chemotherapy before surgery?
Can I avoid chemotherapy, and would a genomic test clarify this?
How should the axillary lymph nodes be approached?
What are my reconstruction options and when should it be done?
How does my genetic test result affect my treatment and my family?

Scope of the council report

Written opinion confirming the case was reviewed by a multidisciplinary council
Council confirmation of the diagnosis, stage and risk group
Recommended treatment options and the reasoning behind them
Alignment with current guidelines (ESMO / NCCN) and a level-of-evidence note
Comparison of alternative options and their expected side-effect profiles
Recommendations for any additional tests or consultations
Potentially suitable clinical trial options

Scope of the second opinion

Independent review of the current diagnosis and staging
Re-evaluation of pathology and imaging findings
Confirmation that the ongoing or planned treatment is appropriate
Comparative presentation of alternative treatment approaches
Clarification of unanswered clinical questions
Assessment of how well the decision fits the patient’s priorities and quality-of-life goals