Guideline statement	LoE/GoR	Consensus
Visceral crisis is defined as severe organ dysfunction as assessed by signs and symptoms, laboratory studies and rapid progression of disease. Visceral crisis is not the mere presence of visceral metastases but implies important visceral compromise leading to a clinical indication for a more rapidly efficacious therapy, particularly since another treatment option at progression will probably not be possible.	Expert opinion/n/a	95%
Primary endocrine resistance is defined as relapse while on the first 2 years of adjuvant ET, or PD within first 6 months of first-line ET for ABC, while on ET.	Expert opinion/n/a	67%
Secondary endocrine resistance is defined as relapse while on adjuvant ET but after the first 2 years, or relapse within 12 months of completing adjuvant ET, or PD ≥ 6 months after initiating ET for ABC, while on ET.	Expert opinion/n/a	67%
Oligometastatic disease is defined as low volume metastatic disease with limited number and size of metastatic lesions (up to 5 and not necessarily in the same organ), potentially amenable for local treatment, aimed at achieving a complete remission status.	Expert opinion/n/a	78%
Patients with multiple chronic conditions are defined as patients with additional comorbidities (e.g. cardiovascular, impaired renal or liver function, autoimmune disease) making it difficult to account for all of the possible extrapolations to develop specific recommendations for care.	Expert opinion/n/a	100%
Adequate OFS in the context of ABC:
Adequate OFS for ABC pre-menopausal patients can be obtained through bilateral ovariectomy, continuous use of LHRH agonists or OFA through pelvic RT (this latter is not always effective and therefore is the least preferred option).	I/A	85%
If a LHRH agonist is used in this age group, it should usually be given on a q4w basis to guarantee optimal OFS.	II/B	85%
Efficacy of OFS must be initially confirmed analytically through serial evaluations of serum oestradiol, even in the presence of amenorrhoea, especially if an AI is administered.	Expert opinion/ B	85%
As all endocrine interventions for pre-menopausal patients with endocrine-responsive ABC require indefinite OFS, choosing one method over the other requires balance of patient’s wish for potentially preserving fertility, compliance with frequent injections over a long period of time and cost.	Expert opinion/ B	85%
Maintenance therapy: in the context of ABC Guidelines, maintenance therapy refers to the continuation of anti-HER2 therapy and/or ET after discontinuation of ChT.	Expert opinion/n/a	100%
Integrative medicine: complementary and integrative medicine (CIM) represents the use of complementary treatments side by side with conventional approaches in a proper therapeutic environment.	Expert opinion/n/a	100%

In green, NEW ABC 4 statements.

ABC, advanced breast cancer; AI, aromatase inhibitor; Consensus, percentage of panel members in agreement with the statement; ChT, chemotherapy; ET, endocrine therapy; GoR, grade of recommendation; HER2, human epidermal growth factor 2; LHRH, luteinising hormone-releasing hormone; LoE, available level of evidence; OFA, ovarian function ablation; OFS, ovarian function suppression; PD, disease progression; q4w, every 4 weeks; RT, radiotherapy.