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Breast Cancer in Young Women Conference - OECI

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ESO INSIDE TRACK CONFERENCE<br />

<strong>Breast</strong> <strong>Cancer</strong> <strong>in</strong><br />

<strong>Young</strong> <strong>Women</strong><br />

<strong>Conference</strong><br />

8-10 November 2012<br />

Dubl<strong>in</strong>, Ireland<br />

In collaboration with<br />

Chairs:<br />

F. Cardoso, PT - B. Kaufman, IL<br />

A. Partridge, US<br />

Host-Chair: J. Geraghty, IE<br />

Scientific Committee: S. Aebi, CH - H.A. Azim Jr, BE<br />

G. Freilich, UK - M.C. K<strong>in</strong>g, US<br />

F.A. Peccatori, IT<br />

In association with<br />

SECOND ANNOUNCEMENT


FOREWORD<br />

<strong>Breast</strong> cancer <strong>in</strong> young women is a devastat<strong>in</strong>g and<br />

complex disease. <strong>Breast</strong> cancer <strong>in</strong> women under 40<br />

strikes when these women are at the peak of their<br />

reproductive years, family life and careers and still have<br />

many years ahead of them to suffer the long-term effects<br />

of treatment or the consequences of recurrent disease.<br />

The etiology of breast cancer <strong>in</strong> this population is poorly<br />

understood and most cl<strong>in</strong>ical trials focus on women who<br />

are over the age of 40, thus little evidence-based data<br />

is available about the optimal management of these<br />

patients. Further research is much needed <strong>in</strong> this field.<br />

This conference is an opportunity for the latest updates<br />

on this field and a platform for generat<strong>in</strong>g future research<br />

concepts and collaborations. It will cover epidemiology,<br />

molecular biology, genetics, pathology, surgery,<br />

radiotherapy, systemic therapy and fertility preservation <strong>in</strong><br />

young women with breast cancer.<br />

We hope that you will jo<strong>in</strong> us and contribute to further<br />

develop the understand<strong>in</strong>g and treatment of this disease.<br />

On behalf of the Chairs and Scientific Committee<br />

Members<br />

Bella Kaufman<br />

:: 2 ::


LEARNING OBJECTIVES<br />

In depth learn<strong>in</strong>g of various aspects of breast cancer <strong>in</strong> young women<br />

Importance of multi-discipl<strong>in</strong>ary management<br />

Management of difficult cl<strong>in</strong>ical cases<br />

MAIN TOPICS<br />

Hereditary breast cancer<br />

Diagnostic tools <strong>in</strong> young women<br />

Local therapy<br />

Systemic therapy<br />

Pregnancy and breast cancer<br />

Fertility preservation<br />

Psychosocial aspects<br />

Management of side effects<br />

Case discussions<br />

PARTICIPANT’S PROFILE<br />

Medical oncologists<br />

Surgeons<br />

Gynaecologists<br />

Radiation oncologists<br />

Onco-geneticists<br />

Pathologists<br />

Nurses<br />

Patient advocates<br />

:: 3 ::


FACULTY<br />

O. Abulkhair, K<strong>in</strong>g Abdulaziz Medical City for National Guard, Riyadh, SA<br />

S. Aebi, Luzerner Kantonsspital, Lucerne, CH<br />

F. Amant, U.Z Gasthuisberg, Leuven, BE<br />

C. Anders, UNC L<strong>in</strong>enberger Comprehensive <strong>Cancer</strong> Center, Chapel Hill, US<br />

J. Armstrong, St. Luke’s Institute of <strong>Cancer</strong> Research, Dubl<strong>in</strong>, IE<br />

A.G. Arnold, Memorial Sloan-Ketter<strong>in</strong>g <strong>Cancer</strong> Center, New York, US<br />

H.A. Azim Jr., Jules Bordet Institute, Brussels, BE<br />

F.A. Calvo, Hospital General Universitario Gregorio Marañon, Madrid, ES<br />

F. Cardoso, Champalimaud <strong>Cancer</strong> Center, Lisbon, PT<br />

A.M. Cluxton, <strong>Young</strong> Survival Coalition, Columbus, US<br />

R.E. Coleman, Weston Park Hospital, Sheffield, UK<br />

M. Colleoni, European Institute of Oncology, Milan, IT<br />

E. Connolly, St. James Hospital, Dubl<strong>in</strong>, IE<br />

A. Costa, European School of Oncology, Milan, IT<br />

J. Crown, NICB Dubl<strong>in</strong> City University, Dubl<strong>in</strong>, IE<br />

S. Delaloge, Institut Gustave Roussy, Villejuif, FR<br />

J. Dix, Adoption Consultant, Isle of Wight, UK<br />

G. Freilich, Europa Donna, London, UK<br />

E. Furlong, University College Dubl<strong>in</strong>, Dubl<strong>in</strong>, IE<br />

T. Gagliardi, Aberdeen Royal Infirmary, Foresterhill Aberdeen, UK<br />

J. Garber, Dana Farber <strong>Cancer</strong> Institute, Boston, US<br />

O.D. Gentil<strong>in</strong>i, European Institute of Oncology, Milan, IT<br />

J. Geraghty, St V<strong>in</strong>cent’s Hospital, Dubl<strong>in</strong>, IE<br />

A. Graziott<strong>in</strong>, Sa<strong>in</strong>t Raffaele Resnati Hospital, Milan, IT<br />

A. Green, School of Medic<strong>in</strong>e & Medical Science, Dubl<strong>in</strong>, IE<br />

N. Harbeck, <strong>Breast</strong> Center, University of Munich, DE<br />

B. Kaufman, Sheba Medical Center, Tel Hashomer, IL<br />

M. Kell, University College Dubl<strong>in</strong>, Dubl<strong>in</strong>, IE<br />

C. Kelly, Mater Misericordiae Hospital, Dubl<strong>in</strong>, IE<br />

J. K<strong>in</strong>g, Royal Free Hampstead NHS Trust, London, UK<br />

M.C. K<strong>in</strong>g, University of Wash<strong>in</strong>gton - School of Medic<strong>in</strong>e, Seattle, US<br />

C.K. Kuhl, Aachen University Cl<strong>in</strong>ic, Aachen, DE<br />

S. Loibl, German <strong>Breast</strong> Group, Neu-Isenburg, DE<br />

E.W. McDermott, St. V<strong>in</strong>cent Hospital, Dubl<strong>in</strong>, IE<br />

D. Meirow, Sheba Medical Center, Tel Aviv, IL<br />

E. Mocanu, Rotunda Maternity Hospital, Dubl<strong>in</strong>, IE<br />

A. O’Doherty, National <strong>Cancer</strong> Screen<strong>in</strong>g Service, Dubl<strong>in</strong>, IE<br />

G. O’Dowd, Irish <strong>Cancer</strong> Society, Dubl<strong>in</strong>, IE<br />

O. Pagani, Oncology Institute of Southern Switzerland (IOSI), Bell<strong>in</strong>zona, CH<br />

S. Paluch-Shimon, Sheba Medical Center, Tel Hashomer, IL<br />

A.H. Partridge, Dana-Farber <strong>Cancer</strong> Institute, Boston, US<br />

F.A. Peccatori, European Institute of Oncology, Milan, IT<br />

I. Smith, Royal Marsden Hospital, Sutton Surrey-London, UK<br />

A. Tutt, K<strong>in</strong>gs College London School of Medic<strong>in</strong>e, Guy’s Hospital Camp, London, UK<br />

:: 4 ::


PROGRAMME<br />

THURSDAY, 8 NOVEMBER<br />

13:30 Christ<strong>in</strong>e Murphy Whyte memorial lecture Chair: J. Geraghty, IE<br />

13:40 Presentation for a <strong>Young</strong> Irish Patient G. O’Dowd, IE<br />

13:55 Presentation from the <strong>Young</strong> Survival Coalition A. Cluxton, US<br />

14:10 <strong>Breast</strong> <strong>Cancer</strong> <strong>in</strong> <strong>Young</strong> <strong>Women</strong>:<br />

the magnitude of the problem<br />

B. Kaufman, IL<br />

14:25 SESSION I:<br />

Debate: The biology of breast cancer <strong>in</strong> young women is unique<br />

14:25 Introduction by Chair J. Garber, US<br />

14:30 In favour M. Colleoni, IT<br />

14:50 Aga<strong>in</strong>st C. Anders, US<br />

15:10 Coffee break<br />

15:40 SESSION II: Familial and hereditary breast cancer Chair: A. Green, IE<br />

15:40 Biology of BRCA - associated breast cancer A. Tutt, UK<br />

16:00 Genetic counsell<strong>in</strong>g and test<strong>in</strong>g A.G. Arnold, US<br />

16:20 <strong>Cancer</strong> risk-reduc<strong>in</strong>g measures for high risk women J. Garber, US<br />

16:45 The woman’s perspective G. Freilich, UK<br />

17:00 Best Abstracs presentations Chairs: E. Connolly, IE<br />

and M. Kell, IE<br />

17:30 Case discussion session 1 Moderators: B. Kaufman, IL<br />

Panel: Speakers and Chairs<br />

and S. Paluch-Shimon, IL<br />

18:10-19:10 Satellite symposium<br />

:: 5 ::


FRIDAY, 9 NOVEMBER<br />

9:00 SESSION III: Stag<strong>in</strong>g of breast cancer <strong>in</strong> young women Chair: A. O’Doherty, IE<br />

9:00 How to best use available techniques C.K. Kuhl, DE<br />

9:20 Emerg<strong>in</strong>g technologies T. Gagliardi, UK<br />

9:40 SESSION IV:<br />

Loco-regional therapy. What should be different<br />

<strong>in</strong> young women<br />

Chairs: A. Costa, IT<br />

and J. Armstrong, IE<br />

9:40 Surgery O.D. Gentil<strong>in</strong>i, IT<br />

10:00 Radiotherapy F.A. Calvo, ES<br />

10:20 Coffee break<br />

11:00 SESSION V: Adjuvant systemic therapy Chairs: N. Harbeck, DE<br />

and A.H. Partridge, US<br />

11:00 Endocr<strong>in</strong>e therapy for early breast cancer: standards<br />

and controversies<br />

O. Pagani, CH<br />

11:25 Debate: All young early breast cancer patients should<br />

receive adjuvant chemotherapy<br />

11:25 Introduction by Chair S. Aebi, CH<br />

11:30 In favour F.A. Peccatori, IT<br />

11:50 Aga<strong>in</strong>st S. Delaloge, FR<br />

12:10 Adjuvant bisphosphonates for young early<br />

breast cancer patients<br />

12:10 Bisphosphonates <strong>in</strong> the adjuvant sett<strong>in</strong>g:<br />

ready for prime time?<br />

12:35 RANKL signall<strong>in</strong>g: bone metastasis<br />

and beyond<br />

Chair: J. Crown, IE<br />

I. Smith, UK<br />

R.E. Coleman, UK<br />

13:00 Lunch and poster session<br />

:: 6 ::


14:30 SESSION VI: Advanced breast cancer Chair: S. Aebi, CH<br />

14:30 Advanced breast cancer <strong>in</strong> young women:<br />

what should be different<br />

F. Cardoso, PT<br />

14:55 Advances <strong>in</strong> targeted therapy N. Harbeck, DE<br />

15:15 Case discussion session II Moderators: A.H. Partridge, US<br />

Panel: Speakers from and Chairs from sessions V and VI<br />

and O. Abulkhair, SA<br />

16:00 Coffee break<br />

16:30 SESSION VII: Fertility and adoption Chairs: E.W. McDermott, IE<br />

and E. Mocanu, IE<br />

16:30 Fertility preservation D. Meirow, IL<br />

16:55 Can I adopt a child? J. Dix, UK<br />

17:10-18:40 Satellite symposium<br />

:: 7 ::


SATURDAY, 10 NOVEMBER<br />

8:30 SESSION VIII: Quality of life issues Chairs: A. Costa, IT<br />

and J. K<strong>in</strong>g, UK<br />

8:30 Management of early menopause associated symptoms A. Partridge, US<br />

8:55 The young couple and breast cancer A. Graziott<strong>in</strong>, IT<br />

9:15 “Mommy has breast cancer”: how do the children cope? E. Furlong, IE<br />

9:30 SESSION IX: <strong>Breast</strong> cancer and pregnancy Chair: F. Cardoso, PT<br />

and C. Kelly, IE<br />

9:30 <strong>Breast</strong> cancer dur<strong>in</strong>g pregnancy:<br />

the oncologist perspective<br />

S. Loibl, DE<br />

9:50 <strong>Breast</strong> <strong>Cancer</strong> dur<strong>in</strong>g pregnancy:<br />

the obstetrician/paediatric perspective<br />

F. Amant, BE<br />

10:10 Pregnancy after breast cancer H.A. Azim Jr, BE<br />

10:25 Pregnancy registry and trial project O. Pagani, CH<br />

10:35 Coffee break<br />

11:00 Case discussion session III Moderators: F.A. Peccatori, IT<br />

Panel: Speakers, Chairs and patient representative<br />

and C. Kelly, IE<br />

11:40 SESSION X:<br />

<strong>Breast</strong> <strong>Cancer</strong> <strong>in</strong> <strong>Young</strong> <strong>Women</strong> <strong>Conference</strong> Statement<br />

Chairs: B. Kaufman, IL<br />

A.H. Partridge, US and<br />

F. Cardoso, PT<br />

Panel: S. Aebi, CH - F. Amant, BE - H.A. Azim Jr, BE - F.A. Calvo, ES - S. Delaloge, FR<br />

G. Freilich, UK - T. Gagliardi, UK - J. Garber, US - O.D. Gentil<strong>in</strong>i, IT - N. Harbeck, DE<br />

C.K. Kuhl, DE - S. Loibl, DE - D. Meirow, IL - O. Pagani, CH - F.A. Peccatori, IT<br />

13:10 Clos<strong>in</strong>g remarks J. Geraghty, IE<br />

:: 8 ::


GENERAL INFORMATION<br />

ORGANISING SECRETARIAT<br />

Francesca Marangoni - fmarangoni@eso.net<br />

Tel: +39 02 85464525<br />

Roberta Ventura - rventura@eso.net<br />

Tel: +39 02 85464532<br />

European School of Oncology<br />

Via del Bollo, 4<br />

20123 Milan, Italy<br />

Fax: +39 02 85464545<br />

VENUE<br />

O’Reilly Hall<br />

University College Dubl<strong>in</strong><br />

Belfield, Dubl<strong>in</strong> 4 - Ireland<br />

Map available here:<br />

www.ucd.ie/maps/UCD_Map_July_2011.pdf<br />

OFFICIAL LANGUAGE<br />

The official language will be English. No translation will be provided.<br />

BADGE<br />

The badge is the only official evidence of registration and should be worn at all times dur<strong>in</strong>g<br />

the conference. Loss of badge means loss of registration.<br />

INSURANCE<br />

The organizers bear no responsibility for untoward events <strong>in</strong> relation to the participation <strong>in</strong> the<br />

Convention. Participants are advised to take out their own personal and travel <strong>in</strong>surance<br />

coverage.<br />

ABSTRACT BOOK<br />

An abstract book will be published as supplement to The <strong>Breast</strong> and will conta<strong>in</strong> abstracts of<br />

the <strong>in</strong>vited lecturers and those submitted by the participants that have been accepted for oral<br />

or poster presentation or for publication only. The three best abstracts will be selected and<br />

proposed for oral presentation (Free registration will be granted to the first author of the three<br />

selected abstracts). Oral presentations will be scheduled on 8 November and poster session<br />

will be scheduled on 9 November.<br />

Onl<strong>in</strong>e submission and <strong>in</strong>formation available on www.eso.net.<br />

CME ACCREDITATION AND CERTIFICATES<br />

Participants will be issued a certificate of attendance.<br />

Application for CME recognition has been submitted to ESMO for ESMO-MORA accreditation,<br />

to the Accreditation Council of Oncology <strong>in</strong> Europe (ACOE) and to the European Accreditation<br />

Council for Cont<strong>in</strong>u<strong>in</strong>g Medical Education (EACCME), an <strong>in</strong>stitution of the European Union of<br />

Medical Specialists (UEMS). The event was granted 12 European CME credits (ECMEC) by the<br />

European Accreditation Council for Cont<strong>in</strong>u<strong>in</strong>g Medical Education (EACCME).<br />

EACCME credits are recognized by the American Medical Association towards the Physician’s<br />

Recognition Award (PRA).<br />

The programme was furthermore awarded with 14 cat. 1 ESMO-MORA po<strong>in</strong>ts.<br />

:: 9 ::


GENERAL INFORMATION<br />

NURSES AND PATIENT ADVOCATES<br />

Nurses and representatives of cancer patient advocacy non-profit organizations are eligible for<br />

a discounted registration fee:<br />

EUR 180 by 5 August, EUR 230 by 14 October, EUR 280 after 14 October and onsite.<br />

Interested nurses and patient advocates should contact Roberta Ventura (rventura@eso.net)<br />

<strong>in</strong> order to register to the conference.<br />

TRAVEL GRANTS<br />

Thanks to the generosity of BCY1 sponsors travel grants are made available on a competitive<br />

basis to:<br />

n Physicians from middle- and low-<strong>in</strong>come countries as def<strong>in</strong>ed by The World Bank;<br />

n Physicians under the age of 40;<br />

n Nurses;<br />

n Patient Advocates.<br />

Full applications should be submitted by 1 July to Roberta Ventura (rventura@eso.net) and<br />

<strong>in</strong>clude:<br />

n Curriculum vitae <strong>in</strong>clud<strong>in</strong>g full affiliation, contact details and date of birth;<br />

n Letter describ<strong>in</strong>g motivation for attend<strong>in</strong>g;<br />

n Physicians and nurses are furthermore asked to submit a letter of endorsement by the<br />

Institute/Department director or head nurse;<br />

n The successful submission of an abstract (deadl<strong>in</strong>e 1 July) is not mandatory but would be<br />

considered <strong>in</strong> the selection process.<br />

Travel grant recipients will receive a set amount to contribute to their travel and<br />

accommodation expenses, whilst registration will be processed directly by ESO free of charge.<br />

The follow<strong>in</strong>g amounts will be refunded by bank transfer after the conference: EUR 500 for<br />

participants com<strong>in</strong>g from Europe, Middle-East and North-Africa; EUR 1.000 for participants<br />

com<strong>in</strong>g from other regions and overseas. The outcome of the application will be notified by<br />

27 July.<br />

PASSPORT AND VISA<br />

A valid passport and/or identity card is required for entry <strong>in</strong>to Dubl<strong>in</strong>. A visa may be required<br />

for some countries. For specific <strong>in</strong>formation, please visit the department of Foreign affairs and<br />

Trade website at www.dfa.ie.<br />

SPONSORSHIP OPPORTUNITIES<br />

The Invitation to Sponsors can be downloaded at www.eso.net. For further <strong>in</strong>formation, please<br />

contact Francesca Marangoni (fmarangoni@eso.net)<br />

:: 10 ::


GENERAL INFORMATION<br />

MEDIA REGISTRATION<br />

The congress is open to representatives of pr<strong>in</strong>t and electronic media. Registration is free of<br />

charge to journalists who are <strong>in</strong> possession of a valid, recognised press card. Freelance journalists<br />

must present a commission<strong>in</strong>g letter on headed paper from a recognised news organisation or<br />

publication. Representatives of advertis<strong>in</strong>g, market<strong>in</strong>g and public relations companies are not<br />

eligible for free media registration. A copy of the Press Card or of the commission<strong>in</strong>g letter should<br />

be sent, together with the media registration form, to<br />

Roberta Ventura (rventura@eso.net).<br />

CANCELLATION OF REGISTRATION OR REPLACEMENT<br />

Cancellation should be notified to ESO <strong>in</strong> writ<strong>in</strong>g. In case of cancellation without replacement,<br />

the fee less handl<strong>in</strong>g charges of EUR 100 will be refunded after the event, provided that the<br />

cancellation is received by ESO before 7 October.<br />

Replacements will be possible till 14 October 2012.<br />

CONFIRMATION OF REGISTRATION<br />

Registration will be confirmed by e-mail, by fax or by mail.<br />

ACKNOWLEDGEMENTS<br />

ESO would like to gratefully acknowledge the support and assistance from Fáilte Ireland.<br />

Fáilte Ireland acts as a corporate resource for tourism professionals and service providers at<br />

local, regional and national levels.<br />

Aer L<strong>in</strong>gus is delighted to assist delegates attend<strong>in</strong>g the BCY1 - <strong>Breast</strong> <strong>Cancer</strong> <strong>in</strong> <strong>Young</strong> <strong>Women</strong><br />

<strong>Conference</strong>.<br />

Please go to www.aerl<strong>in</strong>gus.com/conference/bcy for more <strong>in</strong>formation on group book<strong>in</strong>gs, direct flights,<br />

connect<strong>in</strong>g flights, fares and availability.<br />

DEADLINES<br />

Abstracts: 1 July 2012<br />

Travel grants: 1 July 2012<br />

Early registration: by 5 August 2012<br />

Late registration: by 14 October 2012<br />

On-site registration: after 14 October 2012<br />

:: 11 ::


ACCOMMODATION FORM<br />

BCY1 - BREAST CANCER IN YOUNG WOMEN CONFERENCE - 8-10 November 2012, Dubl<strong>in</strong>, Ireland<br />

Please fill <strong>in</strong> this form us<strong>in</strong>g BLOCK Capitals and send to Leah Perrot at MCI Dubl<strong>in</strong> by email or fax to<br />

esodubl<strong>in</strong>@mci-group.com - Fax +353 1 2805405<br />

MCI Dubl<strong>in</strong> - 1 Clar<strong>in</strong>da North, Dun Laoghaire, Co.Dubl<strong>in</strong>, Ireland - Tel +353 1 2802641<br />

For onl<strong>in</strong>e accommodation book<strong>in</strong>g and for more <strong>in</strong>formation on the hotels please go to www.eso.net<br />

PARTICIPANT INFORMATION<br />

Dr. Prof. Mr. Ms.<br />

First name<br />

Organisation<br />

Address<br />

City<br />

State/County<br />

Tel<br />

(<strong>in</strong>clud<strong>in</strong>g country code)<br />

Surname<br />

Postcode/Zipcode<br />

Country<br />

Fax<br />

(<strong>in</strong>clud<strong>in</strong>g country code)<br />

BOOKING<br />

All rates are quoted <strong>in</strong> Euro, per night <strong>in</strong>clud<strong>in</strong>g breakfast and VAT.<br />

Please choose your hotel below<br />

S<strong>in</strong>gle room Double room Tw<strong>in</strong> room<br />

Stillorgan Park Hotel ( ) EUR 99 EUR 109 EUR 109<br />

Ballsbridge Inn ( ) EUR 75 EUR 90 EUR 90<br />

D4 Berkeley ( ) EUR 100 EUR 115 EUR 115<br />

Check <strong>in</strong> date<br />

Check out date<br />

Shar<strong>in</strong>g with<br />

TERMS AND CONDITONS<br />

Please see the onl<strong>in</strong>e book<strong>in</strong>g system on www.eso.net<br />

CREDIT CARD DETAILS<br />

Accommodation payment and extras will be paid directly to the hotel. Please provide your credit<br />

card details <strong>in</strong> order to guarantee your book<strong>in</strong>g. With out card details it will not be possible to<br />

make a book<strong>in</strong>g.<br />

CREDIT CARD: Mastercard or Visa only<br />

Credit card number / / / Expiry date /<br />

Card holders name (<strong>in</strong> Capital letters)<br />

CVV number<br />

Card holders signature<br />

I agree to the terms and conditions and that my credit card details will be forwarded to the appropriate<br />

hotel to guarantee my book<strong>in</strong>g.<br />

Signature<br />

If you require any assistance with your book<strong>in</strong>g please do not hesitate to contact Leah Perrott at:<br />

esodubl<strong>in</strong>@mci-group.com - Tel: +353 1 2802641


REGISTRATION FORM<br />

BCY1 - BREAST CANCER IN YOUNG WOMEN CONFERENCE - 8-10 November 2012, Dubl<strong>in</strong>, Ireland<br />

Please fill <strong>in</strong> this form <strong>in</strong> BLOCK CAPITALS and send by the deadl<strong>in</strong>e to:<br />

European School of Oncology - Roberta Ventura - Via del Bollo, 4 - 20123 Milan - Italy<br />

Tel: +39 02 8546 4532 - Fax: +39 02 8546 4545 - Email: rventura@eso.net<br />

PARTICIPANT’S DETAILS<br />

ONLINE REGISTRATION IS AVAILABLE AT www.eso.net<br />

Dr. Prof.<br />

Surname<br />

Name<br />

Institute<br />

Department<br />

Street<br />

Zip Code Town Country<br />

Phone Fax Mobile<br />

Email<br />

Date of birth<br />

Birth place (town and country)<br />

Profession<br />

Specialisation<br />

Ma<strong>in</strong> field<br />

VAT number (Compulsory for all freelancers)<br />

Fiscal Code (Italian residents only)<br />

If your <strong>in</strong>voice details are different to those above, please complete the follow<strong>in</strong>g section:<br />

Invoice contact details<br />

Address<br />

Phone<br />

email<br />

VAT number (Compulsory for all freelancers)<br />

Fiscal Code (Italian residents only)<br />

REGISTRATION FEES:<br />

Registration <strong>in</strong>cludes participation <strong>in</strong> all sessions, a copy of the Programme and the Abstract Book, coffee breaks<br />

and lunches as <strong>in</strong>dicated <strong>in</strong> the programme.<br />

Payable <strong>in</strong> Euro Early rate Late rate On site rate<br />

(by 5 August) (by 14 October) (after 14 October)<br />

Registration fee EUR 350 EUR 450 EUR 550<br />

<strong>Breast</strong>CentresNetwork Members EUR 250 EUR 450 EUR 550<br />

Club ESO Members EUR 250 EUR 450 EUR 550<br />

ESMO Members EUR 250 EUR 450 EUR 550<br />

PAYMENT DETAILS:<br />

The registration is processed when payment accompanies the form (credit card details or copy of bank transfer)<br />

Visa/Mastercard Card Number / / /<br />

Expire date / CV2 code<br />

Holder’s name:<br />

and signature<br />

BANK TRANSFER with no cost to the beneficiary (please provide a copy of the bank transfer):<br />

Bank:<br />

Account holder:<br />

Number:<br />

IBAN:<br />

Reference<br />

Banca Popolare di Milano, Agenzia 24 - Milan, Italy<br />

European School of Oncology<br />

No. 16333<br />

IT96G0558401624 0000000 16333 - BIC: BPMIITM1024<br />

“BCY1” + your name<br />

I authorize the European School of Oncology to use my personal data accord<strong>in</strong>g to what is specified <strong>in</strong> Article 13 DLGS 196,<br />

available at www.eso.net or on request at fax number +39 02 8546 4545.<br />

Signature<br />

Date


European School of Oncology (ESO)<br />

Via del Bollo, 4<br />

20123 Milan, Italy<br />

Ph +39 02 8546451<br />

Fx +39 02 85464545<br />

www.eso.net<br />

is member of

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