The opening day of the European Breast Cancer Conference (EBCC15) reflected a clear shift in modern breast cancer care: less overtreatment, more precision, and deeper attention to what truly matters to patients. EBCC15 Day One highlighted how the field is evolving, from radiotherapy de-escalation to molecular diagnostics and patient-centered care models, demonstrating that oncology is steadily moving beyond one-size-fits-all strategies.
Can Radiotherapy Be Safely Reduced After Chemotherapy?
One of the most practice-relevant presentations came from Dr Fleur Mauritz, who presented long-term results from the RAPCHEM study, exploring whether radiotherapy can be tailored based on response to systemic treatment.
The study followed 848 patients in the Netherlands over 10 years, applying a risk-adapted approach to radiotherapy after chemotherapy and surgery. Treatment decisions were guided by whether cancer persisted in the lymph nodes following therapy.
This approach allowed low-risk patients to receive minimal or even no radiotherapy, while higher-risk patients continued to receive more intensive treatment.
After a decade of follow-up, the results were striking. Only 2.9% of patients experienced local or regional recurrence, with similarly low recurrence rates observed across low-, intermediate-, and high-risk groups.
These findings suggest that response-adapted radiotherapy may safely reduce overtreatment without compromising disease control. In an era where long-term toxicity and quality of life are increasingly important, such strategies could significantly reshape standard practice.
However, caution remains. As highlighted during the presentation, final confirmation will require randomized evidence, with results from an ongoing U.S. trial expected within the next three years.
What Does Person-Centred Care Mean for BRCA Mutation Carriers?
While treatment de-escalation addresses clinical outcomes, another session at EBCC15 focused on something equally important: what patients themselves value in care.
Leonie Witte presented a mixed-methods Q-study examining perspectives of women living with inherited breast cancer risk due to BRCA mutations.
The study included 23 cancer-unaffected BRCA mutation carriers in the Netherlands, combining ranking exercises with in-depth interviews to explore patient priorities.
Three distinct viewpoints emerged:
The first emphasized the importance of clear, comprehensive information to support informed decision-making, described as “The Informed Journey.” These patients prioritized understanding their risk, options, and outcomes in detail.
The second focused on the value of empathic and respectful relationships with clinicians, captured as “Care Rooted in Compassion.” For these women, how care is delivered mattered as much as what care is provided.
The third highlighted often under-discussed aspects of genetic risk, including fertility, intimacy, body image, and the emotional impact of preventive interventions, described as “Acknowledging Intimacy and Loss.”
Together, these perspectives explained 51% of the variance in patient preferences, underscoring that BRCA carriers are not a homogeneous group. The findings reinforce the need for tailored communication and individualized counselling, ensuring that care aligns with each patient’s priorities and life context.
Can Molecular Tools Improve How We Classify Second Breast Cancers?
Precision medicine was another key theme, highlighted by work presented by Tess Snellen from the Netherlands Cancer Institute.
This retrospective study explored the use of molecular clonality analysis (MCA) to distinguish between true recurrence and second primary breast cancer in patients with a second ipsilateral tumor, a distinction that has important implications for both prognosis and treatment.
The analysis included 99 molecular assessments in 85 patients, spanning more than two decades (2000–2024). Over time, diagnostic techniques evolved from traditional loss of heterozygosity analysis to more advanced approaches, including targeted next-generation sequencing (NGS) and copy number variation (CNV) analysis.
The results showed that NGS and CNV approaches provided higher success rates and more conclusive classifications compared with earlier methods. Importantly, molecular findings often disagreed with traditional clinicopathological assessment, particularly the Jobsen Morphology method, which demonstrated limited predictive accuracy for clonal relatedness.
These findings support integrating molecular clonality testing, especially NGS and CNV-based methods, into routine clinical practice, particularly in cases where distinguishing recurrence from a new primary tumor could alter treatment decisions.
A Broader Message from Day One
Across these presentations, a consistent message emerged: breast cancer care is becoming more individualized at every level.
Radiotherapy can be tailored based on treatment response. Patient care must be shaped by individual values and lived experiences. Diagnosis itself can be refined through molecular tools rather than morphology alone.
EBCC15 Day One made it clear that the future of breast oncology lies in precision not only in treatment, but also in decision-making, communication, and diagnosis.
As more data continues to emerge from the conference, this balance between clinical innovation and patient-centered care will remain central to advancing outcomes in breast cancer.