Breast Cancer in Young Women Conference - OECI
Breast Cancer in Young Women Conference - OECI
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