47. San Antonio Breast Cancer Symposium

The 47th SABCS, a highly anticipated conference for breast cancer experts, was organized with the greatest-ever participation and the presentation of extensive new information.

Great focus was placed on obesity, a factor associated with both an increased risk of breast cancer in healthy individuals and poorer outcomes in breast cancer patients, as well as the diversity and importance of molecular risk factors in identifying individuals with an elevated breast cancer risk. Tailored prevention, breast screening, individualized surgical approaches, and medical therapies not only improve outcomes but also influence quality of life and financial burden.

Further surgical de-escalation is being implemented in true early breast cancer cases but could be misleading after neoadjuvant therapies. Postoperative radiotherapy has a less detrimental effect on quality of life compared to endocrine therapies maintained for several years. Node-negative triple-negative breast cancers with high (>30%) tumor-infiltrating lymphocyte (TIL) content demonstrate excellent prognosis, while HER2-positive breast cancers vary based on their molecular co-driver status and immune sensitivity. In luminal cancers with an Oncotype DX score >30, the benefit of anthracycline-based adjuvant chemotherapy increases.

Currently, molecular diagnostics, molecular targeted agents, and immunotherapies form the foundation of oncology care. Their application is supported by emerging technologies such as TIL analysis, circulating tumor DNA, minimal residual disease (MRD) assessment, and the expertise of a multidisciplinary tumor board. A number of new targeted and immune therapy agents, as well as antibody-drug conjugates (ADCs), offer more effective and less toxic treatment options.