Sun Valley summary. Consensus and action items Expedition Inspiration meeting 2000

The fourth Expedition Inspiration conference was held March 21-23, 2000. While there are other conferences that concentrate on a particular facet of breast cancer, the design and goals of this conference are unusual. In order to maximize interaction of investigators and clinicians the meetings are small, invited, and private. The participants include both senior and junior physicians and scientists involved in clinical and basic research as well as clinical practice. The meetings serve four purposes: (i) Active discussion among participants who do not usually interact, (ii) Develop consensus as to the state of our knowledge as well as an action plan to stimulate future studies, (iii) Develop collaborative projects among the meeting participants, (iv) Foster new investigations by participants as well as others. This year immunology and the role of lymph nodes in breast cancer were the subject of the discussion. Investigators studying breast cancer biology, tumor immunity, potential cancer vaccines, and immunotherapy discussed potential therapeutic manipulation of the immune response to alter the natural history of breast cancer. Regional lymph nodes, the site of the immune response, are often affected early in the spread of breast cancer. For clinicians this involvement is central to planning effective treatment. The paradox that despite the involvement of these lymph nodes in mounting an immune response they are frequently the first site of breast cancer spread stimulated a great deal of discussion and some potentially interesting studies. The following consensus statement is the product of those discussions.