Every December, people who care about improving breast cancer treatment head to Texas for a week of learning, sharing, and discovery. The San Antonio Breast Cancer Symposium (SABCS) brings together researchers, oncologists, and patient advocates from around the world. It’s often the first place we hear about studies that may shape future treatment, long before they make their way into everyday clinic conversations. This year’s SABCS had a lot to offer for anyone facing early-stage breast cancer. New treatment ideas, smarter ways to tailor care, and encouraging steps forward in life after treatment. We pulled out 12 highlights that we think matter most for patients right now.
1) A new pill (giredestrant) that blocks estrogen more completely in HR-positive early breast cancer
For people with hormone-positive early breast cancer, data shared at SABCS showed the first new hormone-blocking pill in 20+ years seems to work better than our current standards. It isn’t approved for use in early-stage patients yet, but if it is, it could become another option to talk about when we’re choosing long-term endocrine therapy.
A large trial called lidERA tested a new once-daily pill, giredestrant, against the usual hormone pills (tamoxifen or aromatase inhibitors) after surgery for HR-positive / HER2-negative early breast cancer. At about 3 years of follow-up, women on giredestrant had fewer recurrences (about a 30% lower risk of the cancer coming back in or outside the breast).
2) Enhertu (T-DXd) after chemo may become the new “strongest” option in HER2+ early breast cancer
For people with HER2-positive early breast cancer who still had cancer remaining at surgery after their pre-surgery chemotherapy and HER2-targeted treatment, a major trial called DESTINY-Breast05 compared Enhertu (T-DXd) with Kadcyla (T-DM1), the current standard “extra insurance” treatment. The study showed that Enhertu reduced the risk of recurrence or death by about half and increased the percentage of people who were free of invasive breast cancer at three years from about 84% to 92%.
3) Can Enhertu make an impact even before surgery?
Early results from the DESTINY-Breast11 trial suggest that it might. People with high-risk HER2-positive breast cancer were more likely to have no cancer left at the time of surgery when Enhertu was part of their pre-surgery treatment. It’s not something doctors use routinely yet, but it’s definitely on the horizon.
4) Triple-negative early breast cancer (TNBC): chemo “recipes” keep evolving
In the CITRINE study, researchers added carboplatin after surgery for people with higher-risk triple-negative breast cancer to see if it could give them a stronger safety net and it worked! About 7 to 10 percent more patients stayed free of recurrence or serious complications compared with those who received the usual treatment. Pooled data and new analyses show that in higher-risk patients adding carboplatin to standard pre-surgery chemo in TNBC can improve the chance of a complete response and may improve long-term outcomes.
5) Doing less surgery and fewer extra tests when it’s safe
One of the best ‘wins’ is that in the right situations, you may safely avoid more aggressive underarm surgery and sometimes avoid extra MRI scans that don’t actually help outcomes but can push people towards bigger procedures chasing “incidentalomas“.
- Less underarm (axillary) surgery after chemo
Some people can safely avoid a full lymph node dissection. If the lymph nodes were positive before chemo but ended up clear afterward, taking only a few targeted or sentinel nodes worked just as well and caused far fewer side effects like swelling or arm discomfort.
- Pre-surgery MRI doesn’t improve outcomes for everyone
Another trial showed that routine preoperative MRI in early breast cancer did not improve local control or survival but tended to lead to more extensive surgery (like mastectomy) and additional procedures to rule out concerns of unexpected (but often benign) findings.
6) ctDNA / “liquid biopsy” to detect microscopic cancer
Several blood tests are getting very good at picking up tiny amounts of cancer DNA after treatment. They’re still mostly used in clinical trials, but the goal is to know earlier whose cancer is truly gone and who might benefit from extra treatment or closer follow-up. ctDNA is a blood test looking for tiny fragments of tumor DNA in the bloodstream. At SABCS, multiple companies (Guardant, Natera, SAGA and others) presented data that ctDNA tests can detect minimal residual disease (MRD) after treatment and predict who is more likely to have a recurrence, sometimes well before scans.
7) Genetics & screening (WISDOM trial and polygenic risk scores)
The WISDOM trial is exploring a more personalized way to approach breast cancer screening by looking at a wider set of genetic risks, not just BRCA. The idea is to tailor when you start screening, how often you go, and whether you need any additional imaging. This kind of information can also help guide screening for your family members. At SABCS, researchers highlighted how these newer tools could help us find cancers earlier and reduce unnecessary testing, all while making sure the approach works well for women of different ages, backgrounds, and risk levels.
8) Pre-surgery radiation + immunotherapy (P-RAD)
Early findings from the P-RAD trial suggested that giving a small dose of radiation before surgery might help “wake up” the immune system when it’s paired with immunotherapy and chemotherapy. This even showed promise in some hormone-positive cancers, which don’t always respond as strongly to immune-based treatments. It’s part of a bigger movement in breast cancer research to find smart combinations that help the body recognize and fight cancer more effectively, with the hope of giving people better long-term protection.
9) “Chemo brain” and acupuncture (ENHANCE trial)
If you’re one of the many struggling with memory, focus, or sleep after treatment, acupuncture is emerging as one evidence-supported option to consider alongside things like exercise, sleep strategies, and cognitive rehab. The ENHANCE randomized trial compared acupuncture vs sham acupuncture (fake acupuncture used in clinical trials) vs usual care for breast cancer survivors with cognitive complaints and insomnia. It’s one of the top-watched survivorship abstracts this year and suggests acupuncture can modestly improve cancer-related cognitive difficulties and sleep compared with usual care.
10) Alcohol, weight, GLP-1s, and recurrence risk
We can’t control everything, but sessions at SABCS reinforced that cutting back alcohol, staying active, and managing weight really do matter for long-term breast cancer risk, especially for hormone-positive disease. GLP-1s are being studied, but right now they should be used for clear medical reasons, not as a “breast cancer prevention” drug.
A Living Beyond Breast Cancer SABCS recap pulls together data on how alcohol, obesity, and treatment-related menopause affect both the risk of getting breast cancer and the risk of it coming back.
There is no truly “safe” level of alcohol for breast cancer risk; more drinking means higher risk.
Obesity is clearly linked to higher risk of especially ER-positive breast cancer; being active and keeping a healthy weight helps.
Early data are exploring whether diabetes drugs (metformin) or GLP-1 drugs (like semaglutide/Ozempic) might reduce risk in people with obesity, but this is not yet standard of care.
11) TNBC vaccine update
Researchers shared final results from a Phase I trial of an experimental vaccine designed to prevent triple-negative breast cancer from coming back. The vaccine targets alpha-lactalbumin, a protein commonly found in TNBC tumors but not in normal breast tissue. 74% of participants developed a measurable immune response, and there were no serious side effects, with mild injection-site reactions like redness or swelling being the most common. The data were presented by investigators from the Cleveland Clinic, in collaboration with Anixa Biosciences, and based on these encouraging results, a larger Phase II trial at multiple sites across the U.S. is planned!
12) Menopause, sexual health, and long-term endocrine side effects
For many people with early-stage breast cancer, treatment can cause sudden menopause and long-lasting side effects that affect daily life, relationships, and overall well-being. At SABCS, multiple sessions focused on managing treatment-induced menopause, sexual health changes, and the long-term side effects of endocrine therapy, including hot flashes, joint pain, fatigue, vaginal dryness, and cognitive changes. The takeaway was that these symptoms are common, manageable, and should be addressed proactively as part of cancer care, not left for patients to raise on their own.
SABCS 2025 reminded us that progress in early-stage breast cancer is real and ongoing. Care is becoming more personalized, and patients have more information and more of a voice in their care. Outcomes4Me is here to help you stay informed, understand your options, and feel supported as you navigate what comes next.
