Interview with Prof Beat Thürlimann

Interview with Professor Beat Thürlimann

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The 17th St. Gallen International Breast Cancer Conference will take place virtually from 17 to 21 March 2021. Held every two years, the congress brings together breast cancer experts from all around the world, and the consensus recommendations on the optimal treatment of early breast cancer are highly respected.

For the full programme of the conference, or for registration, click here:

In view of the conference, BIG interviewed Professor Beat Thürlimann, Dr Fatima Cardoso en Professor David Cameron.  

Prof Beat Thürlimann talks about the establishment of the conference, its early days, its evolution and the legacy of Professor Aron Goldhirsch, Scientific Co-Chair of the St. Gallen conference for about 30 years and one of the main drivers behind the conference and the consensus. His interview can be found below.

On Thursday 18 March 2021, Dr Fatima Cardoso will be honoured with the ESO Umberto Veronesi Memorial Award and will give an Award Lecture on de-escalation of early breast cancer therapy and Umberto Veronesi’s legacy. In the interview BIG had with her, she talks about the progress we are seeing in the field of de-escalation of early breast cancer therapy, the importance of collaboration and the advantages of a global network such as BIG. Her interview will be posted on BIG’s website on Friday 12 March.

On Saturday 20 March 2021, Prof David Cameron will give a lecture to honour the memory of Professor Aron Goldhirsch. Ahead of the conference, BIG had the pleasure to ask him a few questions about adjuvant therapies and the role Aron had in the evolution of adjuvant therapies across time, and in the evolution of academic research. His interview will be posted on BIG’s website on Monday 15 March.

So, watch this space, but in the meantime, enjoy reading the interview with Professor Beat Thürlimann.

Interview with Professor Beat Thürlimann

Member of the conference leadership with founder Hans-Jörg Senn

For many years, Professor Beat Thürlimann was Chief Physician and Head of the Breast Centre at the Kantonsspital St. Gallen (Switzerland). He also serves as Past-President of the Swiss Group for Clinical Cancer Research (SAKK).


Since its early days, Prof Thürlimann has been involved in the establishment and organisation of the St Gallen International Breast Conference.

BIG asked Prof Thürlimann the following questions:

Prof Aron Goldhirsch was Scientific Co-Chair of the St. Gallen conference for about 30 years. A special lecture will be given in his honour. What is his main contribution to the conference and what has changed compared to 30 years ago, when the conference was launched?

Together with Dr Alan Coates and Dr Richard Gelber, Dr Aron Goldhirsch was the main driver behind the conference and the consensus. Aron, who always remained humble, had one ideal: to combine science and research with patient care. When he was urged (for example by policy-makers) to make firmer statements on treatment recommendations in the consensus paper, he said to me: “A certain uncertainty must remain!” For him room for optimal individual patient care remained a priority.

On the other hand, as a policy-maker Aron initiated the paradigm change from risk-adapted adjuvant therapy to tailored treatment in 2003; but it was only in 2005 that the panel would follow him. Indeed, 2005 was an extraordinary year of progress that significantly changed the landscape in adjuvant breast cancer therapy. The panel recommended a fundamental change in the criteria for selection of adjuvant systemic therapy, giving prime attention to endocrine responsiveness.

Today, the debate on endocrine responsiveness, proliferation, and benefit of chemotherapy continues. Nevertheless, considerable improvements have been made, with new tools and new data emerging from clinical research.

How do you expect the St Gallen International Breast Conference to evolve in the next decade?

Any prediction is difficult, especially when it comes to the future. The conference will adapt to the new technologies, regulations, and travel behaviours. Virtual access will allow for a larger attendance and, importantly, from low- and middle-income countries in particular. I continue to acknowledge the value of personal interactions through face-to-face meetings during and after the conference, both for clinicians and researchers. However, it remains a challenge to find the best ways to accommodate all these different needs.

What are the most burning questions that still need to be answered and standardised in early disease?

Obviously, we have to pursue the ultimate goal of personalised medicine, which is still a long and winding road to go. The path we follow not only consists of escalating breast cancer therapies for a small but important group of patients, but also, to a greater extent, of de-escalating treatment for the majority of patients with good prognosis. The vast majority of these patients may be cured without maximal adjuvant therapy.

Furthermore, because the current surgical approach is unsatisfactory, the management of patients with high risk of developing breast cancer needs to be improved. Additional information may help to individualise the approach: polygenic risk-scores are one of the promising tools available. The approach to the axilla (axillary dissection versus no axillary dissection) was put on the agenda by Aron (and others) more than a decade ago, and it will remain for many conferences to come.

Finally, the lack of access to innovation, in particular to new tests and drugs, remains an issue to address: innovative drugs and technology are ineffective if patients don’t have access to them.

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