Faculty. Silvia Allende, MD Paulina Núñez, MD Raúl Ramírez, MD Gabriel Santiago, MD Nidia Zapata, MD

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Justification Breast cancer stands out as the primary cause of death due to tumors in emerging countries where most cases are diagnosed in advanced stages, hindering their successful treatment.

2 Justification Breast cancer stands out as the primary cause of death due to tumors in emerging countries where most cases are diagnosed in advanced stages, hindering their successful treatment. In Mexico, breast cancer represents the first cause of death due to cancer in women, with an incidence of 35.4 cases per 100,000 women. The median age at diagnosis is 51 years, age where women are productive personal and economically. Mortality from breast cancer has increased in recent years in Mexico and the world, having a significant social impact. This trend will rise in future years due to the high incidence of the disease, the aging population, the challenges in timely diagnosis and the inadequate response capacity of the health systems of underdeveloped countries. The objective of this seminar is to contribute to the improvement of timely detection, and correct treatment through continuing medical education focused on the patient, as this affects society, the family, work life and the economy. 2

Faculty UNITED STATES Memorial Sloan Kettering Cancer Center Diana Lake, MD MEXICO Instituto Nacional de Cancerología Lesvia Aguilar, MD Paulina Cabrera, MD Fany Porras, MD Daniel Rivera, MD Robin

3 Faculty UNITED STATES Memorial Sloan Kettering Cancer Center Diana Lake, MD MEXICO Instituto Nacional de Cancerología Lesvia Aguilar, MD Paulina Cabrera, MD Fany Porras, MD Daniel Rivera, MD Robin Shaw, MD Elvis Cabrera MD, ISSSTE Jaime Corona MD, Centro Oncológico Guadalajara Leopoldo Lugo MD, Hospital Materno Celaya Fernando Mainero MD, IMSS Gineco 4, CDMX Carlos Navarro MD, Centro Médico ABC Milagros Pérez Quintanilla MD, Instituto Nacional de Perinatología Javier Picó, Lifesciences Consultants Silvia Allende, MD Paulina Núñez, MD Raúl Ramírez, MD Gabriel Santiago, MD Nidia Zapata, MD 3

Faculty and Authorities Diana Lake Seminar s Director Sitting from left to right: Diana Lake, Becky Sáenz, Enrique Bargalló, Milagros Pérez and Robin Shaw Standing from left to right: Leopoldo

4 Faculty and Authorities Diana Lake Seminar s Director Sitting from left to right: Diana Lake, Becky Sáenz, Enrique Bargalló, Milagros Pérez and Robin Shaw Standing from left to right: Leopoldo Lugo, Elvis Cabrera, Fernando Mainero, Carlos Navarro, Abelardo Meneses (CEO), Ángel Herrera (CMO), Jaime Corona, Martín Granados (Mexican Council of Oncology), Raúl Ramírez and Gabriel Santiago 4

5 Academic Program Monday, June 11th 8:00 AM 8:30 AM Registration AMSA 8:30 AM - 9:00 AM Pre-test AMSA Diagnosis 9:00 AM-9:20 AM Diagnostic approach and important changes in the TNM 2018 Dra. Robin Shaw Diagnosis 9:20 AM- 9:40 AM Less tissue more precision Dra. Fany Porras Diagnosis 9:40 AM- 10:00 AM Discussion Panel with clinical case Dra. Fany Porras Dra. Robin Shaw 10:00 AM 10:30 AM Inauguration AMSA Clinical Cases 10:30 AM - 11:30 AM 5 Clinical cases presentation Moderator Dr. Jaime Corona 11:30 AM- 11:45 AM Break Treatment 11:45 AM- 12:00 PM Is less surgery safe? Dr. Fernando Mainero Dr. Jaime Corona Treatment 12:00 PM 12:15PM Is it possible to de-escalate systemic treatment in the neoadjuvant setting? Dra. Diana Lake Treatment 12:15 PM 12:25 PM Is it possible to offer less systemic treatment in Her2 positive? Dr. Raúl Ramírez Treatment 12:25 PM- 12: 35 PM Is it safe to omit chemotherapy in patients HR + / her2-? Dr. Elvis Cabrera Treatment 12:35 PM- 12:45 PM Pros and cons of extended adjuvant endocrine therapy Dr. Leopoldo Lugo Treatment 12:45 PM 12:55 PM Is it safe to use hypofractionation? Dr. Gabriel Santiago Treatment 12:55 PM- 13:05 PM What do we know about the intensity modulated in Breast Cancer? Dr. Daniel Rivera Treatment 13:05 PM 13:25 PM Debate about treatment with 3 clinical cases of the attendees Dra. Paula Cabrera (moderator) Dr. Fernando Mainero Dr. Jaime Corona Dra. Diana Lake Dr. Leopoldo Lugo, Dr. Raúl Ramírez Dr. Elvis Cabrera Dr. Gabriel Santiago Dr. Daniel Rivera 13:25 PM 14:00 PM Meet the experts AMSA 14:00 PM 15:00 PM Lunch 5

6 Academic Program Tuesday, June 12th 8:30 AM 9:00 AM Registration AMSA Assessment 9:00 AM 9:15 AM Imaging assessment Dra. Lesvia Aguilar Assessment 9:15 AM- 9:30 AM Genetics Dra. Paulina Núñez Assessment 9:30 AM- 9: 45 AM Discussion panel with clinical case Dra. Lesvia Aguilar Dra. Paulina Núñez Hormonal Treatment and fertility Hormonal Treatment and fertility Hormonal Treatment and fertility 9:45 AM - 10:00 AM Hormone therapy in breast cancer Dr. Milagros Pérez 10:00 AM- 10:15 AM Fertility and breast cancer Dr. Carlos Navarro 10:15 AM- 10:30 AM Discussion panel with clinical case Dr. Carlos Navarro Dr. Milagros Pérez 10: 30 AM-!0: 45 AM Break 10:45 AM- 11: 45 AM 5 Clinical Cases Presentation Moderator Dr. Jaime Corona Survivorship 11:45 AM 12:00 PM Survivorship Dra. Diana Lake Survivorship 12:00 PM - 12:15 PM Economics of breast cancer Dr. Javier Picó Survivorship 12:15 PM - 12:20 PM Discussion panel with clinical case Dra. Diana Lake Dr. Javier Picó Palliative Care 12:30 PM 12:45 PM Patient support Dra. Nidia Zapata Palliative Care 12:45 PM 1:00 PM Palliative Care Dra. Silvia Allende Palliative Care 1:00 PM - 1:15 PM Discussion panel with clinical case Dra. Silvia Allende Dra. Nidia Zapata 1:15 PM 1:45 PM Post-test AMSA 1:45 PM 2:15 PM Meet the experts AMSA 2:15 PM 3:15 PM Lunch INCAN- AMSA 3:15PM 3:30PM Group photo AMSA 3:30 PM- 4:00 PM Closing ceremony INCAN- AMSA 6

7 Participating Institutions HOSPITAL Total Instituto Mexicano del Seguro Social 18 Instituto Nacional de Cancerología 9 Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán 6 Hospital Universitario "José Eleuterio Gonzalez" 1 Consultorio privado 3 Fundación Médica Sur 1 Hospital Infantil del Estado de Sonora 1 Centro Oncólogico Internacional 1 Hospital Central Pémex 1 Hospital San Ángel Inn Sur 1 Hospital Central Militar 1 Centro Oncólogico Estatal ISSEMYM, Toluca 1 Hospital General de México 1 Hospital Regional de Alta Especialidad de Oaxaca 1 Centro Médico ABC 1 Hospital Materno de Celaya 1 Total: 48 participants

8 Participants' profile 6% 4% 4% Medical Oncologist Residents 19% Surgical Oncologists Gynecologic Oncology Residents 6% Medical Oncologists 8% 17% OB-GYN Doctors Radiation Oncologist Residents Surgical Oncologists Residents 8% Others* 11% 17% Gynecologic Oncologists General Physicians *1 Pediatric Oncolgy Surgeon, 1 Radiation Oncologist and 1 OB-GYN Resident

9 National and International Impact Latin America Colombia Guatemala Mexico 1.- Mexico City 2.- Aguascalientes 3.- Baja California 4.- Baja California Sur 5.- Jalisco 6.- Estado de México 7.- Sonora 8.- Guanajuato 9.- Nuevo León 10.- Oaxaca 11.- Tlaxcala 9

10 Best Results Will attend a Salzburg OMI Seminar in 2019 Best Post Test Roberto Iván Sánchez Reyes Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Best Clinical Cases Milagros Pérez Quintanilla Centro Médico ABC Francisco Javier Castro Alonso Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Best Participation Guillermo Gocher Damián IMSS, Centro Médico Nacional Siglo XXI 10

11 Best Results From left: Francisco Castro, Roberto Iván Sánchez, Milagros Pérez y Guillermo Gocher 11

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14 Closing Ceremony 14

15 In alliance with: 15

16 Thank you! Contact: Rebeca Aguilar Álvarez de Sáenz Alianza Médica para la Salud, A. C. Prolongación Paseo de la Reforma No Col. Paseo de las Lomas, C.P CDMX Tel (55) Follow us at: Alianza Médica para la amsa_mx 30

Inflammatory Breast Cancer

Inflammatory Breast Cancer Jaime G. de la Garza-Salazar Abelardo Meneses-Garcia Claudia Arce-Salinas Editors Inflammatory Breast Cancer Editors Jaime G. de la Garza-Salazar, M.D. Department of Clinical