Editor’s Note: From October 17 to 19, 2024, the 18th National Breast Cancer Conference and the 19th Shanghai International Breast Cancer Symposium (SIBCS 2024) took place in Shanghai. During this period, the fourth Controversy & Consensus Consortium (3C) Summit, focusing on clinical practice in Chinese breast cancer, was successfully held. Leading breast cancer experts and patient representatives participated in discussions and voting on updates for the 2025 CBCS Guidelines “Little Red Book.”This year’s voting involved 58 topics, covering early breast cancer pathology, surgery, adjuvant and advanced breast cancer treatment, quality of life, and medical ethics. Prof. Keda Yu from Fudan University Shanghai Cancer Center led the discussions on surgical and pathological aspects, as well as quality of life and medical ethics, while Prof. Jian Zhang from Fudan University Shanghai Cancer Center guided the sessions on comprehensive treatment for adjuvant and advanced breast cancer. Following the event, Oncology Frontier conducted interviews with members of the voting panel (in alphabetical order by last name), who shared their thoughts on the most notable topics and their expectations for the upcoming updates in the 2025 guidelines.
Prof. Yiding Chen
The Second Affiliated Hospital Zhejiang University School of Medicine
For patients with 1-2 positive sentinel lymph nodes, axillary lymph node dissection may be avoided. Additionally, prophylactic contralateral surgery is not recommended for patients with BRCA mutations.
Prof. Hengyu Li
Shanghai Changhai Hospital, Naval Medical University
Under the current conditions in China, BRCA genetic testing should prioritize BRCA1 and BRCA2 while considering an additional ten or more susceptibility genes associated with hereditary breast cancer.
Prof. Man Li
The Second Affiliated Hospital of Dalian Medical University
For HR+/HER2- advanced breast cancer, in the post-CDK4/6 inhibitor era, precision testing and careful drug selection are equally essential.
Prof. Shu Liu
The Affiliated Hospital of Guizhou Medical University
The focus on step-down treatment for lymph node-positive breast cancer patients and HER2 ultra-low expression has sparked debate. The 2025 CBCS guidelines will introduce new therapeutic agents and models, with increased emphasis on patient experience and quality of life.
Prof. Yongsheng Wang
Shandong Cancer Hospital
Regional lymph node management has become a key topic in breast cancer, with certain patients potentially eligible for exemption from axillary lymph node dissection. Based on the latest research, the 2025 guidelines will update recommendations on suitable populations for sentinel lymph node biopsy and adjuvant endocrine therapy, placing greater emphasis on individualized care and quality of life.
Prof. Jian Zhang
Fudan University Shanghai Cancer Center
For HR-positive metastatic breast cancer patients, whether to incorporate HER2 ultra-low expression in assessment frameworks remains a topic for further discussion. For treating various subtypes of metastatic breast cancer, more evidence-based research is needed. Whether these considerations will ultimately shape the guidelines remains to be seen.
Anticipated Updates for the 2025 CBCS Guidelines
The 2025 edition of the CBCS “Little Red Book” promises significant updates. However, final recommendations are still under review by the guideline committee and expert advisory group. The official release of the updated guidelines will take place at the CBCS 2025 launch event on December 21, 2024, in Shanghai. Stay tuned for further details!
