Editor's Note: The “YBCSG 2025 Mid-Year Breast Cancer Collaboration Meeting and Post-ASCO Symposium,” held recently in Shanghai, gathered experts to discuss clinical updates in breast cancer treatment. At the event, Prof. Hengyu Li—Secretary General of the Yangtze River Breast Cancer Study Group (YBCSG) and a leading expert at Shanghai Changhai Hospital, Naval Medical University—delivered a comprehensive presentation titled “Treatment Challenges of Breast Cancer Liver Metastases in 2025.” In an exclusive interview with Oncology Frontier, Prof. Li elaborated on YBCSG’s major achievements in the first half of 2025 and highlighted key challenges in managing liver metastases in breast cancer.Oncology Frontier: As Secretary General of YBCSG, could you share the group’s key initiatives and accomplishments in the first half of 2025?
Prof. Hengyu Li: I’m honored to share our progress with you. So far in 2025, YBCSG has carried out several major activities:
- Clinical Research: We focused on tackling unresolved clinical challenges in breast cancer treatment. Some related studies are ongoing, and we look forward to sharing results in due time.
- Academic Dissemination and Meeting Highlights: Our team reviewed and shared highlights from major conferences, including SABCS 2024, SGBCC 2025, and ASCO 2025, facilitating learning and professional exchange.
- Brand Events and Regional Engagement: We hosted signature YBCSG events such as “Double City Dialogue” and “Face-to-Face with the Yangtze”, along with various regional academic forums.
- “YBCSG Online” WeChat Platform: Every day, we publish literature digests with expert commentary from domestic early- and mid-career clinicians. The initiative has received very positive feedback from front-line doctors.
- Clinical Medication Handbooks: In the first half of the year, we published 26 drug handbooks covering commonly used treatments in breast cancer. We plan to expand this to include more essential agents like carboplatin, cisplatin, and capecitabine.
- “Yangtze Intelligence Brief” Column: This new column features weekly updates on the application of artificial intelligence in breast cancer and broader medical contexts.
- Timely Academic Updates: We promptly summarize and share highlights from both domestic and international conferences and key publications, keeping the community informed of the latest research developments.
Oncology Frontier: Liver is a common site of metastasis in breast cancer. In your presentation titled “2025 Treatment Challenges in Breast Cancer Liver Metastases”, what are the key difficulties currently encountered in managing this condition?
Prof. Hengyu Li: Liver metastasis remains one of the most difficult challenges in breast cancer management. Treatment of breast cancer involves both the primary lesion and the tumor microenvironment. Once metastasis occurs in the liver, its microenvironment changes significantly, requiring adapted strategies. At this meeting, we explored treatment challenges and recent progress in managing metastases to the brain, liver, and bone.
When visceral metastases occur, therapeutic efficacy tends to decline. The liver, as a vital visceral organ, presents specific challenges, and we still lack robust prospective studies focused on breast cancer liver metastases. However, one promising development comes from a randomized, controlled, multicenter trial (RC48-C006), which assessed the efficacy and safety of the domestic ADC drug disitamab vedotin (RC48) versus lapatinib plus capecitabine in HER2-positive advanced breast cancer patients with liver metastases. Based on this trial’s positive results, RC48 has been approved for patients who have received prior trastuzumab (or a biosimilar) and taxane-based therapy and who are HER2-positive (IHC 3+ or IHC 2+ with FISH+), including those with liver metastases.
Additionally, several high-profile studies presented at ASCO 2025 reported subgroup analyses on liver metastases. For HER2-positive and HR-positive patients, early and optimized use of novel agents can lead to favorable outcomes. This reinforces the importance of treatment planning and therapeutic evaluation in patients with liver involvement. For high-risk patients, systemic therapy should be prioritized. For those with low-risk or oligometastatic disease who respond well to systemic treatment, local interventions should be actively considered.
In 2024, I published a review in Chinese Journal of General Surgery titled “Advances in Surgical Treatment of Breast Cancer Liver Metastases”, which systematically analyzed local treatment strategies. Evidence shows that liver metastasis patients with favorable systemic response, limited tumor burden, and fewer lesions often experience prolonged PFS or even achieve complete remission (CR). Nonetheless, further evidence from prospective studies is essential. We look forward to collaborative efforts from experts to turn liver metastasis from a clinical dilemma into a condition with distinct and effective treatment approaches.
Oncology Frontier: The treatment of breast cancer liver metastases often requires multidisciplinary collaboration. In your opinion, how can multidisciplinary teamwork be optimized to improve outcomes for these patients? What are the specific roles and contributions of each specialty?
Prof. Hengyu Li: It’s unrealistic to rely solely on breast medical oncologists in the treatment of liver metastases. For example, a medical oncologist without surgical training might not prioritize surgical options. Conversely, a breast surgeon who is focused primarily on surgery might overly favor surgical intervention while neglecting systemic treatment or high-risk patient factors. Both extremes exist in current practice across China.
This is why multidisciplinary team (MDT) collaboration is essential. While MDT clinics have been established in many hospitals, some remain superficial in execution—meeting formal requirements without delivering substantive or high-quality input. Many clinicians lack comprehensive knowledge or a solid grasp of evidence-based medicine. Our aim with the YBCSG 2025 Mid-Year Meeting was precisely to advocate for better individualized and standardized care—especially in managing liver metastases.
An effective MDT clinic should involve multiple disciplines, each contributing in the following ways:
- Pathology: When breast cancer metastasizes to other organs, pathological biopsy is essential. Multiple biopsies may be required to evaluate metastatic lesions, alongside PD-L1 testing and molecular subtyping.
- Medical Oncology: Collaborating with medical oncologists ensures effective systemic therapy targeting liver lesions. When systemic therapy achieves good control, coordination with interventional radiology and hepatobiliary surgery becomes viable.
- Hepatobiliary Surgery: Retrospective data suggest that liver resection can be beneficial in selected patients with liver metastases. Although current evidence is primarily retrospective, further prospective studies are eagerly awaited.
- Infectious Disease/Hepatology: Specialists in infectious diseases or liver function management play a crucial role in managing hepatic impairment within the MDT.
- Traditional Chinese Medicine (TCM): TCM can contribute to maintenance therapy and improve overall patient well-being.
Through this multidisciplinary framework, we hope patients with breast cancer liver metastases can achieve longer survival and better quality of life—and for some, even the possibility of cure. We encourage more clinicians to actively engage in multidisciplinary collaboration and clinical research while offering dedicated, patient-centered care.
Prof. Hengyu Li Associate Professor, Associate Chief Physician, Master’s Supervisor Director, Department of Thyroid and Breast Surgery, Changhai Hospital, Naval Medical University
