@dr_yakupergun Is ALND always indicated in cN2 at presentation? And always ALND for any SN+ after NAC? Feels like a conservative position given current data!
Updated Results of the POSITIVE (Pregnancy Outcome and Safety of Interrupting Therapy for Women with Endocrine Responsive Breast Cancer) Trial
https://t.co/x4vT9HZXOf
Breast cancer surgery is entering its de-escalation era.
AGO 2026 just pushed the field another step forward:
🔹 Omit SLNB in selected low-risk cN0 patients
🔹 Prefer TAD over ALND after NACT
🔹 Reserve full axillary dissection mainly for residual macrometastatic disease
The axilla is no longer “one-size-fits-all.”
Biggest shift?
Patients converting from cN+ → ycN0 after neoadjuvant therapy may avoid the morbidity of ALND without compromising regional control.
Less lymphedema.
Less neuropathy.
Less long-term toxicity.
More precision. More personalization.
The modern breast surgeon is no longer just removing disease.
They are actively preserving quality of life.
📖 Full paper in comment ⬇️
#OncoTwitter #MedTwitter #BreastCancer #BreastSurgery @OncoAlert@myesmo@esmo_open@ASCO
What is the cost and morbidity of SLNB/ALND in SOUND/SENOMAC populations to identify node-positive disease for adjuvant CDK4/6i?
Very high numbers needed to diagnose/treat to prevent an IDFS or OS event. A timely discussion on balancing benefit vs surgical morbidity, toxicity, and cost in the de-escalation era.
#ESMOBreast26 presented by Pfob et al. simultaneously published in @TheLancet:
@muschollings
Two decades of synthetic lethality in cancer with PARP inhibitors. Still one of the most fascinating mechanisms of actions for a targeted anticancer therapy. Reviewed by those that developed/unveiled it. https://t.co/6rDRtikQz8
#ESMOBreast26
ER-low breast cancer remains biologically messy.
Prior NCDB data suggested worse OS with omission of adjuvant ET in ER-low disease, especially ER 6–10% / residual disease.
But the Quebec/Canada cohort does not clearly reproduce this signal.
My take: ER-low should not be treated as a single entity.
When possible, intrinsic subtype should guide decisions.
Otherwise, separating ER 1–5% from ER 6–10% and individualizing by residual disease/risk may be more rational than a binary ER+ vs ER− approach.
Genetic testing in cancer care is underused, especially in underserved populations
This paper @JCOOA_ASCO offers a practical, tumor-based roadmap to identify patients who should be referred for germline evaluation
https://t.co/Kz0FJdJUZK
💬 Viewpoint: Breast density increases cancer risk and reduces #Mammography sensitivity, but access to supplemental screening like #MRI and ultrasonography remains limited, creating disparities in early #BreastCancer detection.
https://t.co/D8RSn14jYe
📌 High-Yield Oncology Concept Every Oncologist Must Know
**Histological Transformation in Cancers** – The dynamic biology that changes everything under therapy pressure.
From EGFR-mutant NSCLC → SCLC to Prostate adenocarcinoma → NEPC to Richter transformation — this one infographic covers:
✅ Definition & Pathogenesis
✅ Classic Clinical Examples
✅ When to suspect (and re-biopsy!)
✅ Diagnostic approach (tissue + NGS + IHC)
✅ Management shift & poor prognosis pearls
Perfect for DM/MCh/DNB viva, theory exams & day-to-day practice.
“Cancer is not static — it evolves under treatment pressure.”
Save it. Share it. Teach it.
Next topic dropping soon: Types of Neck Dissection
Dr Rupam Manna MD
@DrRupamOncology
#Oncology #HistologicalTransformation #NSCLC #SCLC #ProstateCancer #MedicalEducation #VivaPrep #OncoViva #CancerBiology
Incredible opportunity to spend a day with the best breast cancer program in the country, either in person on our campus, or online. Registration required, but course is free! Be fully up to speed on the latest in breast med onc, rad onc, and surgery.
¿Escritura académica asistida por IA? Sí, pero bajo ciertas condiciones. En este artículo open access de Cheng, Calhoun & Reedy analizan el tema y proponen una serie de recomendaciones y pautas. Hemos hecho una infografía de un Decálogo de uso ético de IA basándonos en su propuesta.