SABCS 2025: Why We Attended What We Attended — And What the Science Is Saying

For the seventh year, SurvivingBreastCancer.org (SBC) attended the San Antonio Breast Cancer Symposium (SABCS)—and for the second year, we proudly brought patient advocates through our Educational Scholars Program.

SABCS is one of the most influential global meetings in breast cancer research. But for those of us living with breast cancer, the question isn’t just what’s new?—it’s what does this mean for patients right now and in the future?

Below, our SBC advocates share why they chose specific sessions, followed by what the evidence presented at SABCS 2025 suggests so far.

Young-Onset Breast Cancer

Laura Carfang, EdD – Founder & CEO, SurvivingBreastCancer.org

Why I Attended

I attended the session on young-onset breast cancer because I was diagnosed with stage IIB triple-positive (HR+/HER2+) breast cancer at age 34—after my concerns were initially dismissed by primary care providers. I had no family history, no known genetic mutation, and lived a healthy vegan and active lifestyle.

As breast cancer rates continue to rise among people under 45, I wanted to hear what the data says about how age impacts diagnosis, treatment decisions, fertility, relationships, and long-term survivorship.

What the Science Says (SABCS 2025)

• Young-onset breast cancer continues to be recognized as biologically and psychosocially distinct from postmenopausal disease.

• Prior SABCS meetings and published literature consistently show:

  • Higher rates of aggressive subtypes (HER2+ and TNBC)

  • Increased fertility-related decision-making pressure

  • Greater psychosocial burden (career disruption, parenting, intimacy, financial toxicity)

Metastatic & Advanced Disease: What Could Shift Standards of Care

William – Founder & VP, Business Development, SBC

Why This Matters

Because no one attendee can be everywhere at once, I focused on late-stage and translational science that could impact current and near-term standards of care.

Evidence-Based Highlights from SABCS 2025

HER2-Positive Disease

• HER2CLIMB-05 (Phase 3)

  • Tucatinib + trastuzumab/pertuzumab maintenance improved progression-free survival compared with HP alone in advanced HER2+ breast cancer.

  • Suggests an emerging oral maintenance strategy that may reduce chemotherapy exposure.

• PHILA Trial (Pyrotinib + trastuzumab + docetaxel)

  • Five-year follow-up showed durable PFS and OS benefits vs trastuzumab-docetaxel alone.

  • Reinforces intensified HER2 blockade as a long-term strategy.

HR+/HER2− Disease

• lidERA / giredestrant (oral SERD)

  • Pivotal data support next-generation SERDs as alternatives to traditional endocrine therapy in higher-risk early-stage disease.

• VIKTORIA-1 (gedatolisib)

  • Showed promising PFS and patient-reported outcomes in PIK3CA–wild-type disease when combined with fulvestrant ± palbociclib.

  • Important because it expands options beyond PI3K-mutant tumors.

Neoadjuvant & Local Therapy

• DESTINY-Breast11

  • Neoadjuvant trastuzumab deruxtecan regimens achieved high pCR rates in high-risk HER2+ disease.

  • Raises the possibility of chemotherapy de-escalation in select patients.

• INVINCIBLE-4 (INT230-6, intratumoral therapy)

  • Early TNBC data showed favorable toxicity compared to standard neoadjuvant chemo.

  • Still investigational; phase 3 studies needed.

Biomarkers & AI

• Circulating tumor DNA (ctDNA) and minimal residual disease (MRD) assays showed strong prognostic value in HER2+ disease.

• AI models integrating pathology, molecular data, and clinical features (including TAILORx datasets) aim to refine recurrence prediction and treatment intensity

Surgery, Survivorship & Quality of Life

Elisa Herrera– Director of Programs & Events (English & Spanish)

Why I Attended

Attending SABCS was incredibly energizing, especially hearing the ongoing debate around whether every early-stage breast cancer patient truly needs axillary staging.

One of the most compelling conversations centered on balancing clinical necessity vs. quality of life. As treatments become more personalized and systemic therapies more effective, experts are increasingly questioning whether routine axillary staging always changes management—or if, in some cases, it adds unnecessary intervention and long-term side effects.

What stood out to me most was the shared acknowledgment that “one-size-fits-all” no longer applies in early-stage breast cancer care. The future clearly points toward risk-adapted, patient-centered decision-making, where staging, imaging, and surgery are tailored—not automatic.

Evidence-Based Findings

Axillary Staging

• SABCS discussions emphasized that as systemic therapies improve, axillary staging may not always change management.

• The field is moving toward risk-adapted surgical decision-making, though no universal practice change was announced.

Estrogen Use in Survivors This was one of the most evidence-rich discussions reported:

• Two large observational studies (N≈45,000 and N≈54,000) and a meta-analysis showed:

  • No increased breast cancer recurrence risk with low-dose vaginal estrogen

  • Pooled recurrence risk: 0.87 (95% CI: 0.67–1.11)

• Vaginal estrogen users showed reduced all-cause mortality

• Benefits included improved GSM symptoms via:

  • Lower vaginal pH

  • Improved elasticity and epithelial thickness

• Consensus:

  • Non-hormonal options remain first-line

  • Low-dose vaginal estrogen or DHEA can be considered, particularly for:

    • HR− disease

    • Patients on tamoxifen

    • Those with lower recurrence risk

This session directly challenged fear-based avoidance and reinforced evidence-based survivorship care.

Emerging Topics: GLP-1s, Cold Capping, and Beyond

Julie Cottrill – SBC Volunteer

I enjoyed the networking with other survivors & thrivers. It always seems to energize me and give me new motivation. It’s a new sense of hope that we can continue to improve the quality of life for all breast cancer patients. 

A session I missed but hope to catch virtually is the expanding role of GLP-1 receptor agonists beyond weight management, focusing on their potential to improve breast cancer treatment outcomes and mitigate side effects. 

New studies suggest it may help reduce certain chemo related side effects such as fatigue, anemia, neuropathy, and nausea and vomiting.

Another exciting update was New York is the first state to require large private insurers to cover cold capping effective January 2026. 

Genetics & Risk Prediction

Carol – SBC Volunteer

Breast Cancer Family Registry (BCFR)

I attended The Breast Cancer Family Registry: Past, Present, Future Session.  As someone that did not know a thing about breast cancer at the time of my diagnosis, not only did I have to learn everything about my diagnosis but I had to do a deep dive into my family health history.  

This session highlighted the evolution and ongoing impact of the BCFR.  This organization has been collecting data for 30 years!  Researchers with this study have been following a cohort of families at risk of breast cancer & created a new personal risk prediction model for people with BRCA1 and BRCA2 mutations. It incorporates family members’ age of cancer onset, which can change risk calculations and is something that other models don’t do. The risk calculator also can also predict how preventative mastectomy and salpingo-oophorectomy at various ages affect cancer risk. This could help people decide if and when to have these procedures.  As we all know, the decisions we have to make after a breast cancer diagnosis are so overwhelming.   My hope is this study continues to help develop better standards of practice for patients faced with BRCA1 and BRCA2 mutations.

I found it very interesting that not only do they follow breast cancer patients but also a close family member (ie: mother, sister) as a control.  

One session I didn’t get to attend but am very excited to review the recap for is about Acupuncture helping with Chemo Brain.  

Overall, the experience of SABCS is hard to put into words.  It was great to meet others diagnosed with breast cancer and see all of the amazing patient advocates together proving that we have a voice worth listening too.  I made so many new connections and can’t wait to see what the next year of science brings to those diagnosed with breast cancer.       

Evidence-Based Contributions

• 30-year longitudinal registry

• New BRCA1/2 risk prediction model:

  • Incorporates age of onset in family members

  • Models impact of prophylactic mastectomy and salpingo-oophorectomy at different ages

• Includes unaffected relatives as controls—strengthening risk modeling

This work supports more personalized, informed surgical decision-making.