Current Messages on Breast Cancer from ASCO 2025: Smart Treatments, Preventive Surgeries, and Promising Data
This year’s ASCO 2025 conference in Chicago was a critical gathering not only for the field of oncology but also for shaping the future of breast cancer treatments. At this conference, I had the opportunity to share valuable updates on the entire process, from early-stage disease to metastatic stages.
We are now in an era where breast cancer management is increasingly personalized, focusing on more effective outcomes with fewer side effects. Let’s take a look at the key developments highlighted at ASCO 2025.
The Tumor’s Genetic Map: Determining the Course of Treatment
This year’s key emphasis was: Every patient is unique, and so is their tumor.
Instead of the traditional “stage-based treatment” approach, the genetic and biological characteristics of the tumor now play a central role in treatment decisions.
In particular, multigenetic risk scores (Oncotype DX, MammaPrint, etc.) have gained greater importance in deciding whether to administer chemotherapy in early-stage hormone-positive patients.
In HER2-low patients, targeted therapies like trastuzumab deruxtecan are emerging as alternatives to chemotherapy.
Next-Generation Smart Molecules in Metastatic Disease
The most notable presentations at ASCO 2025 regarding the management of metastatic breast cancer focused on:
Antibody-drug conjugate therapies (ADCs),
PARP inhibitors,
and immunotherapy + chemotherapy combinations.
The impact of PARP inhibitors on survival was particularly emphasized in patients with BRCA mutations. In triple-negative tumors, immunotherapies continue to show promising results in PD-L1-positive patients.
Surgical Approach: Protective, Functional, and Individualized
In breast surgery, the focus is no longer solely on tumor removal but also on the patient's quality of life, aesthetic appearance, and functional integrity.
Breast-conserving surgeries are now much more common.
Sentinel node biopsy is replacing axillary dissection.
Thanks to oncoplastic surgeries, both aesthetic and oncological success is now possible.
It was once again emphasized that surgeons must make decisions in collaboration with medical oncologists and radiation therapists.
Strategy Changes in Adjuvant and Neoadjuvant Treatments
With the data shared at ASCO 2025, neoadjuvant treatment (systemic treatment before surgery) has become almost standard in some subtypes.
In HER2-positive and triple-negative patients, less extensive surgeries are being considered in cases where a complete pathological response (pCR) is achieved.
In cases where residual disease is detected after neoadjuvant therapy, adjuvant treatment options such as T-DM1 and capecitabine are increasing survival rates.
Quality of Life and Supportive Approaches Beyond Treatment
Cancer treatment is not just about targeting the tumor; it also means enhancing the patient's quality of life, psychological resilience, and social support.
At ASCO 2025:
- Managing treatment-related fatigue,
- Nutritional support,
- Psychological support programs,
- were key agenda items.
Additionally, digital monitoring applications enable closer tracking of side effects and early intervention when necessary.
Conclusion: Science is Advancing, Hope is Growing
ASCO 2025 once again demonstrated that breast cancer is no longer defined solely by stage but has become a multifaceted disease shaped by the patient’s genetic makeup, treatment response, and life expectancy.
Each year, higher success rates with fewer side effects are becoming possible. From surgery to systemic treatment, from follow-up to supportive care, all processes now prioritize more conscious, individualized, and patient-specific approaches.
I can confidently say that all these developments are empowering both us as physicians and our patients.
With love and health,
Prof. Dr. Bülent Çitgez
