Breast Cancer

As breast cancer survival rates continue to improve due to advances in treatment and multidisciplinary care, a new frontier of care has emerged—long-term survivorship. Breast cancer survivorship is not a singular phase but a dynamic continuum that spans years, often decades, after initial diagnosis and therapy. With survival comes the reality of persistent or late-emerging effects of treatment. The psychosocial aspect of survivorship is another major theme. Many breast cancer survivors experience anxiety, depression, fear of recurrence, and challenges related to body image, sexuality, and identity Returning to work, rebuilding relationships, and managing the expectations of others can create stress and uncertainty. Presenters will discuss strategies to support patients through these transitions, particularly for women who are caregivers themselves or who face cultural stigmas around cancer survivorship. Presentations will cover the impact of physical activity, diet, weight management, and alcohol consumption on survivorship outcomes. Clinical guidelines for healthy living after breast cancer will be shared, along with practical models for integrating lifestyle counseling into follow-up care. 

Triple-Negative Breast Cancer (TNBC) represents one of the most aggressive and clinically challenging subtypes of breast cancer, accounting for approximately 15–20% of all breast cancer diagnoses. Characterized by the absence of estrogen receptors (ER), progesterone receptors (PR), and HER2 amplification, TNBC does not respond to most endocrine or HER2-targeted therapies, leaving chemotherapy and newer systemic treatments as the main therapeutic approaches. TNBC is highly diverse at the molecular level. Researchers will present updates on intrinsic subtypes such as basal-like, mesenchymal, and luminal androgen receptor (LAR), each with distinct genetic and signalling features. Understanding these subtypes has major implications for prognosis and targeted treatment. The use of PARP inhibitors for patients with BRCA1/2 mutations will also be covered. These agents exploit defects in DNA repair mechanisms to selectively kill cancer cells, offering a more targeted approach for genetically defined TNBC populations. Current strategies combining PARP inhibitors with chemotherapy or immunotherapy will be evaluated, along with discussions on resistance mechanisms and sequencing options. 

Immunotherapy is revolutionizing the landscape of cancer treatment, and its application in breast cancer is rapidly evolving. Although traditionally considered less immunogenic than other tumor types, certain subtypes of breast cancer—most notably triple-negative breast cancer (TNBC)—have shown responsiveness to immune-based therapies. Combination strategies represent a major focus in current research. The synergy between immunotherapy and chemotherapy, targeted therapy, and radiation is under intense investigation. Experts will share insights from recent trials exploring these combinations, aiming to enhance immune system activation while overcoming resistance mechanisms. Checkpoint blockade has emerged as the most promising immunotherapy strategy in breast cancer. Inhibitors targeting programmed death-1 (PD-1), programmed death-ligand 1 (PD-L1), and CTLA-4 are being actively studied and utilized. Combination strategies represent a major focus in current research. The synergy between immunotherapy and chemotherapy, targeted therapy, and radiation is under intense investigation. Emerging topics will also include the role of the gut microbiome in modulating immune responses and treatment outcomes. Early research suggests that gut flora diversity and composition can influence the efficacy of immunotherapy and may serve as a modifiable factor in patient outcomes.

HER2-positive breast cancer, defined by the overexpression or amplification of the human epidermal growth factor receptor 2 (HER2), accounts for approximately 15–20% of all breast cancer cases. Once associated with a poor prognosis, HER2-positive breast cancer has become one of the most treatable subtypes due to the development of highly effective targeted therapies. By understanding the molecular underpinnings of HER2-positive disease, participants will gain insight into why this subtype responds so well to targeted therapies. HER2-directed therapies that have transformed patient outcomes. Landmark agents such as trastuzumab and pertuzumab remain the backbone of treatment, especially in early and metastatic settings. Presenters will discuss optimal combinations, duration of therapy, and updates from pivotal trials like CLEOPATRA, APHINITY, and KATHERINE.. These innovative agents combine the precision of monoclonal antibodies with the potency of cytotoxic chemotherapy, offering substantial improvements in progression-free and overall survival. Emerging HER2-targeted therapies will be reviewed, including tyrosine kinase inhibitors (TKIs) like lapatinib, neratinib, and tucatinib. 

Hormone receptor-positive (HR+) breast cancers represent the most prevalent subtype, accounting for approximately 70% of all breast cancer diagnoses. These tumors express estrogen receptors (ER), progesterone receptors (PR), or both, and are typically characterized by slower growth and a more favorable prognosis compared to other subtypes. However, despite the initial responsiveness to endocrine therapies, recurrence and treatment resistance remain significant challenges. These insights form the basis for tailoring treatment approaches and predicting outcomes.The main focus will be on endocrine therapy, which remains the cornerstone of treatment for HR+ breast cancer. Speakers will examine the use of selective estrogen receptor modulators (SERMs) such as tamoxifen, aromatase inhibitors (AIs), and selective estrogen receptor degraders (SERDs), highlighting indications, efficacy, and adverse effect profiles. Recent updates to guidelines regarding extended adjuvant endocrine therapy duration, especially in high-risk patients, will be presented along with patient selection criteria. 

The identification and application of biomarkers have revolutionized the diagnosis, treatment planning, and prognosis of breast cancer. Breast cancer is a highly heterogeneous disease with varying clinical behaviors and treatment responses. Biomarkers serve as measurable indicators of the biological state of a tumor and can be used to classify breast cancer into subtypes, assess aggressiveness, forecast likely clinical outcomes, and predict responsiveness to specific therapies. Beyond these classical markers, attention will turn to proliferation markers such as Ki-67, which provide insights into tumours growth rate and have implications for treatment intensity. Experts will discuss the challenges and variability in Ki-67 assessment, and its evolving utility in distinguishing luminal A from luminal B tumors, and its role in neoadjuvant settings. These tests analyze the expression of multiple genes within a tumor to provide prognostic scores and treatment recommendations. For example, Oncotype DX is frequently used to determine whether a patient with early-stage, HR-positive, HER2-negative breast cancer will benefit from chemotherapy in addition to hormonal therapy. 

Radiation oncology plays a pivotal role in the multidisciplinary treatment of breast cancer, significantly improving local control and overall survival across various stages of the disease. Hypofractionated whole-breast irradiation (WBI) has been validated through major trials (such as START and FAST-Forward) to be equally effective and safe as conventional fractionation, with added convenience for patients. The session will compare standard and hypofractionated regimens, highlighting patient selection, toxicity profiles, and long-term cosmetic outcomes. The advantages, limitations, and patient eligibility criteria for PBI using techniques such as brachytherapy, external beam radiation, and intraoperative RT will be examined.For locally advanced breast cancer, post-mastectomy radiation therapy (PMRT) remains a critical component of treatment. The session will review evidence supporting PMRT in patients with positive lymph nodes or large tumors, focusing on optimal targeting of chest wall and regional nodes (axillary, supraclavicular, internal mammary). 

Surgery remains a foundational component in the treatment of breast cancer, offering both curative and palliative options. Over the past few decades, significant innovations in surgical techniques have reshaped the landscape of breast cancer care—shifting from radical approaches to more precise, personalized, and aesthetically mindful procedures. Tools such as intraoperative ultrasound, cavity-shave margins, and emerging margin assessment technologies (like optical spectroscopy and micro-CT) will be reviewed for their impact on re-excision rates and local recurrence. Oncoplastic surgery, a transformative approach that combines oncologic resection with plastic surgery techniques, will also be thoroughly discussed. Oncoplastic surgery allows for wider excisions without compromising aesthetic appearance, expanding BCS eligibility for patients with larger tumors or unfavorable tumor-to-breast size ratios. 

Neoadjuvant and adjuvant therapies have become essential pillars in the comprehensive treatment of breast cancer, significantly improving survival rates and enabling tailored, stage-appropriate care. Neoadjuvant therapy, which involves administering systemic treatments prior to surgery, has gained prominence, especially in patients with triple-negative, HER2-positive, or locally advanced disease. Its primary goals are to reduce tumor size, increase the likelihood of breast-conserving surgery, assess treatment response in vivo, and provide early systemic control. Adjuvant therapy, given after primary surgery, remains a cornerstone in early-stage breast cancer management. It encompasses a range of treatment modalities, including chemotherapy, hormonal therapy, targeted therapy, and radiation therapy, designed to eradicate microscopic residual disease and reduce recurrence risk. . Presenters will offer insights into evidence-based treatment algorithms based on tumor subtype, nodal involvement, molecular profiling, and risk assessment tools such as Oncotype DX and MammaPrint.

Targeted therapy has transformed the landscape of breast cancer treatment by shifting the focus from non-specific cytotoxic agents to precise, molecularly directed interventions. Unlike traditional chemotherapy, targeted therapies are designed to interfere with specific molecular pathways that drive tumor growth and survival. This session will begin by exploring the key molecular targets in breast cancer—such as HER2, CDK4/6, PI3K, and PARP—and the mechanisms through which these targets are manipulated to achieve therapeutic benefit. The success of HER2-directed therapies (trastuzumab, pertuzumab, T-DM1) in altering the course of HER2-positive breast cancer will be discussed as a foundational model of targeted treatment. Clinical trial data supporting their use in both metastatic and early-stage disease will be presented, along with discussions on resistance mechanisms, adverse effect profiles, and ongoing trials aimed at overcoming therapeutic limitations. 

Though often perceived as a disease affecting only women, breast cancer in men is a rare but important clinical entity that demands greater attention in both research and practice. Accounting for less than 1% of all breast cancer cases, male breast cancer (MBC) presents unique biological, diagnostic, psychological, and therapeutic challenges that distinguish it from its female counterpart. While genetic mutations such as BRCA2 play a significant role, other contributors—including advancing age, radiation exposure, liver disease, estrogen-related conditions (e.g., Klinefelter syndrome), and family history—will be reviewed. Particular emphasis will be placed on the role of hereditary factors and the need for genetic counseling and testing in male patients, especially in the context of familial cancer syndromes. A major challenge in MBC is delayed diagnosis, often due to low public and clinical awareness, as well as social stigma. Unlike women, men are not routinely screened for breast cancer, leading many to present with more advanced disease. From a biological standpoint, MBC is predominantly hormone receptor-positive, with a large proportion of tumors expressing estrogen and progesterone receptors. 

Health equity and access will be addressed by examining disparities in outcomes across socioeconomic, racial, and geographic lines. Strategies to improve trial enrollment, outreach, and access to novel therapies for underserved populations will be emphasized. Health equity and access will be addressed by examining disparities in outcomes across socioeconomic, racial, and geographic lines. Strategies to improve trial enrollment, outreach, and access to novel therapies for underserved populations will be emphasized. From a biological standpoint, breast cancer in younger women is more likely to present as triple-negative or HER2-positive subtypes, which are typically more aggressive and associated with poorer prognosis. This session will highlight the molecular and clinical characteristics that differentiate tumors in young women from those in older patients, informing decisions about personalized treatment planning. Fertility preservation is one of the most critical concerns for younger breast cancer patients. Chemotherapy and other systemic treatments can impair ovarian function, so the session will delve into oncofertility options such as egg and embryo freezing, ovarian tissue preservation, and the use of GnRH agonists during treatment. Collaboration between oncologists and reproductive endocrinologists will be discussed as essential in maintaining quality of life and future family planning possibilities.

As breast cancer progresses to more advanced stages, its complexity increases significantly, demanding a multidisciplinary, patient-centered approach. Molecular profiling and liquid biopsy are increasingly essential in guiding individualized treatment decisions. These tools allow clinicians to identify actionable mutations and resistance patterns, enabling tailored therapies that align with tumor biology and patient needs. Central to the discussion will be novel therapeutic agents and combination strategies, including CDK4/6 inhibitors, PI3K inhibitors, PARP inhibitors, and antibody-drug conjugates. These treatments have significantly transformed the standard of care for hormone receptor-positive and HER2-positive disease, extending progression-free and overall survival in many patients. In parallel, immunotherapy and targeted treatments are becoming promising options for selected patient subsets, particularly those with triple-negative subtypes. The integration of immune checkpoint inhibitors and biomarker-driven therapies will be reviewed, along with strategies to overcome immune resistance and optimize patient selection through PD-L1 expression and tumor mutational burden assessments. 

Prevention remains one of the most powerful tools in reducing the global burden of breast cancer. As the incidence of breast cancer continues to rise across both developed and developing nations, the implementation of effective, evidence-based prevention strategies has become a global priority. These include lifestyle elements such as diet, physical activity, alcohol consumption, obesity, reproductive choices, and exposure to environmental carcinogens. Scientific evidence has consistently shown that regular physical activity, a healthy weight, and reduced alcohol intake can significantly lower breast cancer risk. Genetic counseling and risk-reducing strategies are also key components of personalized prevention. Individuals with a strong family history or known mutations in genes like BRCA1, BRCA2, TP53, or PALB2 may benefit from tailored risk-reducing options. The importance of breast self-awareness and clinical vigilance will be highlighted as part of broader early risk identification efforts. While not a substitute for screening, understanding changes in breast tissue and being aware of family history or symptom development plays a critical role in self-initiated healthcare-seeking behavior.

Breast cancer affects far more than just the body — it significantly impacts emotional, psychological, social, and spiritual well-being. From the moment of diagnosis, patients often experience a range of intense emotions, including shock, fear, sadness, anxiety, and uncertainty. These psychological reactions can affect treatment decisions, adherence to therapy, and quality of life. One major focus will be the mental health burden associated with breast cancer. Anxiety, depression, and post-traumatic stress symptoms are common among patients and survivors. These changes can lead to a loss of confidence and impact intimate relationships. Social support networks—including family, friends, caregivers, and peer groups—play a vital role in emotional resilience. Different cultural beliefs about illness, stigma, and healing can influence how individuals perceive their disease and access care. Socioeconomic barriers, such as financial toxicity and lack of access to psychosocial services, further compound distress for many patients. 

Breast reconstruction and cosmetic surgery play a vital role in the holistic treatment and recovery of breast cancer patients. Beyond the physical restoration of the breast, these procedures contribute significantly to psychological healing, body image, and self-esteem following a mastectomy or lumpectomy. DIEP, TRAM, and latissimus dorsi flaps). Experts will discuss indications, benefits, limitations, and post-operative outcomes of each method, providing attendees with a comprehensive understanding of how to tailor reconstruction plans based on patient needs, tumor characteristics, and treatment timelines. Timing of reconstruction—immediate versus delayed—is another key consideration. While immediate reconstruction is often preferred for its psychological and cosmetic benefits, it must be balanced against potential complications and the need for adjuvant therapies such as radiation. Timing of reconstruction—immediate versus delayed—is another key consideration. While immediate reconstruction is often preferred for its psychological and cosmetic benefits, it must be balanced against potential complications and the need for adjuvant therapies such as radiation.

The integration of Artificial Intelligence (AI) into breast imaging represents a transformative advancement in the early diagnosis, risk assessment, and management of breast cancer. As the field continues to evolve, AI technologies are increasingly proving to be invaluable tools for radiologists and clinicians, enhancing accuracy, reducing diagnostic errors, and optimizing workflows. AI, particularly machine learning (ML) and deep learning (DL) algorithms, have shown exceptional capabilities in analyzing mammograms, ultrasound images, and magnetic resonance imaging (MRI) scans with high levels of precision. These tools are now being used to automatically detect abnormalities, such as masses, calcifications, and architectural distortions, which may be early signs of breast cancer. One of the key advantages of AI is its ability to rapidly process vast datasets, enabling more consistent interpretation and supporting radiologists in making timely and informed decisions. These models learn from patterns in medical images to identify suspicious features with increasing sensitivity and specificity

Liquid biopsy and other non-invasive diagnostic techniques are revolutionizing the landscape of breast cancer detection, prognosis, and treatment monitoring. Unlike traditional biopsies that require surgical or tissue-based sampling, liquid biopsies analyze circulating biomarkers—such as cell-free DNA (cfDNA), circulating tumor cells (CTCs), and exosomes—from a simple blood sample. Liquid biopsies offer a minimally invasive alternative to tissue biopsies, allowing for frequent sampling over time and providing a dynamic view of tumor evolution. They are particularly useful in cases where tumor tissue is difficult to access or when serial monitoring is required to assess treatment response or detect recurrence. A major highlight will be the role of ctDNA in early cancer detection, prognosis, and treatment monitoring. Studies have demonstrated that specific mutations, methylation patterns, and tumor-specific alterations can be identified in ctDNA with high sensitivity. Although less abundant than ctDNA, CTCs provide unique insights into the biology of metastatic disease and can be cultured or analyzed for gene expression and protein markers, aiding in real-time phenotyping of the tumor.