Two Onc Docs Localized Breast Cancer 2025 UPDATE
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Oct 13, 2025 Explore the latest in localized breast cancer treatments with 2025 updates! Discover when radiation can be skipped after surgery and the role of neoadjuvant therapies. Delve into the complexities of treating triple negative disease, including chemotherapy and the use of carboplatin. Understand hormonal therapies for ER/PR positive cases, their potential side effects, and the importance of genomic testing. Plus, insights on managing breast cancer in men and during pregnancy provide a comprehensive view of contemporary care options.
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Carboplatin, Residual Disease, And BRCA
- Adding carboplatin may benefit stage II–III triple-negative, especially premenopausal patients per later data. For residual disease after neoadjuvant chemo, add capecitabine, and olaparib if BRCA-positive.
Endocrine Therapy Duration And Ovarian Suppression
- All ER/PR-positive patients need endocrine therapy for ≥5 years and consider up to 10 for high risk. Use ovarian suppression in high-risk premenopausal patients per SOFT/TEXT trials.
Genomic Tests Guide Chemo Decisions
- Use genomic assays (Oncotype DX, MammaPrint) to decide chemo for ER+/HER2− tumors with 0–3 nodes. Omit chemo in postmenopausal patients with Oncotype <26 and in premenopausal node-negative with score <16.