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Article History

Received: 29 November 2025

Accepted: 29 March 2026

First Online: 11 April 2026

Competing interests

: M.H. received research support from Helsinn Healthcare SA, honoraria from Lilly Deutschland GmbH, Thieme and travel support from Novartis, Lilly Deutschland GmbH, and AstraZeneca. A.H. received grants or contracts from ExactScience, Veracyte, consulting fees from Roche, Novartis, MSD, Agendia, AstraZeneca, GSK, ExactScience, Riemser, Teva, Onkowissen, Lilly, Gilead, Menarini Stemline, Pfizer, Amgen, Pierre Fabre, DaichiiSankyo, and payment or honoraria for lectures, presentations, speakers bureaus from Roche, Novartis, Lilly, MSD, AstraZeneca, Agendia, Seagen, GSK, ExactScience, Riemser, Teva, Onkowissen, Gilead, Menarini Stemline, Pfizer, Amgen, Pierre Fabre, Eisai, DaichiiSankyo, Thieme, Veracyte, Springer, support for attending meetings from Roche, Novartis, Lilly, AstraZeneca, GSK, ExactScience, Gilead, Menarini Stemline, Pfizer, DaichiiSankyo and Participation on Advisory Board from Novartis, Roche, Agendia, Lilly, Gilead, AstraZeneca, Pfizer, MSD, Daiichi Sankyo, GSK, Menarini Stemline, ExactScience, Eisai, Sandoz/Hexal. N.A. received honoraria for lectures and participation in advisory boards: Gilead, Pfizer, Novartis, and received support for attending meetings from AstraZeneca, Novartis. A.K. received lecture fees from Gilead and Novartis, honoria for written scientific work from Thieme as well as support for attending meetings from Lilly; T.L. received Consulting fees from Roche, Lilly, MSD, honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Amgen, Roche, MSD, Novartis, Pfizer, Lilly, GSK, Gilead, AstraZeneca, Daiichi Sankyo, Stemline, Seagen, Support for attending meetings and/or travel from Pfizer, AstraZeneca, Gilead, Daiichi Sankyo, Stemline, Seagen, MSD, advisory board honoraria from MSD, Roche, Pfizer, Lilly, Myriad, Esai, GSK, Gilead, Daiichi Sankyo, Roche, AstraZeneca; A.E. received lecture honoraria from AstraZeneca. H.S. received honoraria from Pfizer, Novartis, GILEAD, Lilly, Daiichi, Eickeler Veranstaltungen, Novartis, GILEAD. N.T. received honoraria for lectures and advisory boards: Novartis, Exact Sciences, Pfizer, Thieme, AstraZeneca, Grants or contracts from: Novartis, Travel expenses: Novartis, Daiichi sankyo, AstraZeneca, Participation on a Data safety Monitoring Board or Advisory Board from Novartis, Thieme, C.G. received speaker honoraria from Novartis Pharma GmbH and ClinSol GmbH & Co. KG. C.M.T. received honoraria from AstraZeneca and is a shareholder in Curevac N.V. and BioNTech SE. M.B.-P. received grants or contracts from Korean Breast Cancer Society, Eugen & Irmgard Hahn Stiftung, EndoMag, Mammotome, MeritMedical, Sirius Medical, Gilead, Hologic, Exact Sciences, Claudia von Schilling Stiftung, Dampft Stiftung, Ehmann Stiftung, Savognin, payment for honoraria or lectures from Roche, Novartis, Pfizer, Pfm, Eli Lilly, Onkowissen, Seagen, AstraZeneca, Eisai, Amgen, Samsung, Canon, MSD, GSK, Daiichi Sankyo, Gilead, Sirius Medical, Syantra, Resitu, Pierre Fabre, Exact Sciences, Aurikamed, Stemline, support for attending meetings from Eli Lilly, Exact Sciences, Pierre Fabre, Pfizer, Daiichi Sankyo, Roche, Stemline. S.Y.B. received institutional grants from Pfizer, Seagen, Daiichi-Sankyo, Gilead, Berlin-Chemie AG, AstraZeneca, Helsinn Healthcare S.A. and personal honoraria for lectures from AstraZeneca. CC.H. received honoraria for lectures from Novartis, Roche, Pfizer, Gilead, AstraZeneca, MSD, Daiichi Sankyo, Eisai, honoraria for participation in advisory boards from Roche, Daiichi Sankyo, MSD, Novartis and support for attending meetings from Daiichi Sankyo. D.L. reports consulting fees, honoraria, payment for expert testimony or support for attending meetings from Eli Lilly, Novartis, Pfizer, Gilead, Daiichi Sankyo, GSK, Loreal, Onkowissen, high5, MSD, AstraZeneca, AbbVie, Genmab. M.P.L reports payments for participation in Advisory Boards / Advisory from Novartis, Hexal, Agendia, Endomag, Lilly, MSD, Pfizer, Exact Sciences, Daiichi-Sankyo, Gilead, Roche, Stemline/ Menari-Group, AstraZeneca, Payment for lectures from Lilly, Roche, MSD, Novartis, Pfizer, Exact Sciences, Daiichi-Sankyo, Grünenthal, GSK, Gilead, AstraZeneca and Eisai, support for attending meetings from Gilead, Daiichi-Sankyo, AstraZeneca and Pfizer, Participation on a Data Safety Monitoring Board or Advisory Board Pfizer PERFORM trial, Novartis BC-CAPTOR-trial, Novartis Caroleen trial and board membership for Deutsche Gesellschaft für Senologie e.V., Deutsche Akademie für Senologie and Participant in the Kommission Mamma der AGO e.V. and Receipt of equipment, materials, drugs, medical writing, gifts or other services from AstraZeneca Pfizer, V.M. received Speaker honoraria: AstraZeneca, arsTempi, Daiichi-Sankyo, Eisai, Pfizer, MSD, Medac, Novartis, Roche, Seagen, Onkowissen, high5 Oncology, Lilly, Medscape, Gilead, Pierre Fabre, iMED Institute, Consultancy honoraria: Roche, Pierre Fabre, PINK, ClinSol, Novartis, MSD, Daiichi-Sankyo, Eisai, Lilly, Seagen, Gilead, Stemline, Institutional research support: Novartis, Roche, Seagen, Genentech, AstraZeneca, Travel grants: Astra Zeneca, Roche, Pfizer, Daiichi Sankyo, Gilead, V.M. is an editorial board member of the journal The Breast. F.-A.T. received consulting fees from GSK, AbbVie, MSD, Payment or honoraria for lectures, presentations, speakers bureaus from AstraZeneca, Roche, Novartis and Support for attending meetings and/or travel from AbbVie. A.S. received honoraria from Amgen, AstraZeneca, Aurikamed, Bayer, Celgene, ClinSol, Clovis Oncology, coma UroGyn, Connectmedica, Daiichi Sankyo, Gilead, GSK, if-kongress, I-MED, iOMEDICO, Lilly, MCI Deutschland, med publico, Menarini Stemline, Metaplan, MSD, Mylan, NeoConnect, NanoString Technologies, Novartis, Onkowissen, Pfizer, Pierre Fabre, promedicis, Roche, Seagen, streamedup, SYNLAB, Tesaro and travel support from AstraZeneca, Celgene, Daiichi Sankyo, Gilead, Pfizer, Roche; M.B-P. received honoraria for lectures and advisory boards: Roche, Novartis, Pfizer, pfm, Eli Lilly, Onkowissen, Seagen, AstraZeneca, Eisai, Amgen, Samsung, Canon, MSD, GSK, Daiichi Sankyo, Gilead, Sirius Medical, Syantra, resitu, Pierre Fabre, ExactSciences, Aurikamed. Study support: Korean Breast Cancer Society, Eugen & Irmgard Hahn Stiftung, EndoMag, Mammotome, MeritMedical, Sirius Medical, Gilead, Hologic, ExactSciences, Claudia von Schilling Stiftung, Damp Stiftung, Ehmann Stiftung Savognin. Travel expenses: Eli Lilly, ExactSciences, Pierre Fabre, Pfizer, Daiichi Sankyo, Roche, Stemline. A.R. received honoraria for lectures: Roche, Pfizer, Novartis, Celgen, LEO Pharma, Novartis, ExactSciences, Pierre Fabre, Lilly, Seagen, Targos and honoraria for Participation on a Data Safety Monitoring Board or Advisory Board from Roche, Daiichi Sankyo, AstraZeneca, Pfizer, Celgen, Eisai, Novartis, MSD, Hexal, Amgen, Exact Sciences, Pierre Fabre, RG. Advisory Boards: Roche, AstraZeneca, Pfizer, Celgen, Eisai, Novartis, MSD, Hexal, Amgen, ExactSciences, Pierre Fabre. J.E. received Speakers Bureau, Travel Grants or Advisory Boards: Eli Lilly, Novartis, Pfizer, Gilead, Daiichi Sankyo, GSK, Onkowissen, AstraZeneca, Menarini. T.F. received as consulting fees or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events personal payments from Onkowissen, Medconcept, Payments to institution from AstraZeneca, Daichii Sankyo, Roche, Novartis, Pfizer, AbbVie. MSD, Support for attending meetings and/or travel from Roche, Daichii Sankyo, Pfizer; S.S. received consulting fees or Payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca, Daiichi-Sankyo, GE HealthCare, Gilead, GSK, Lilly, MSD, Novartis, Pfizer, Roche, Stemline Menarini and support for attending meetings from AstraZeneca, GE HealthCare, Gilead, Lilly, Pfizer, Stemline Menarini. L.L.M. received fees for speaking engagements and accommodation expenses in connection with congress participations from Roche, Pfizer, Lilly Pharma, Daiichi Sankyo, AstraZeneca, Onkowissen, Gilead, Novartis. W.W.J. received research Grants and/or honoraria from AstraZeneca, Cellgene, Chugai, Daiichi Sankyo, Eisai, ExactScience, Gilead, GSK, Guardant Health, Janssen, Lilly, Menarini Stemline, MSD, NeoGenomics, Novartis, Pfizer, Roche, Sanofi-Aventis, Seagen. M.W. received Grants or contracts from Novartis, Consulting fees from AstraZeneca, Daichi-Sankyo, Pfizer, Novartis, Roche, Ethicon, Onkowissen, Menari, Storz, PlantTec, honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from AstraZeneca, Daichi-Sankyo, Pfizer, Novartis, Roche, Ethicon, Onkowissen, Menari, Storz, PlantTec, Payment for expert testimony from Astra-Zeneca, Daichi-Sankyo, Pfizer, Novartis, Roche, Menari, fees for participation on a Data Safety Monitoring Board or Advisory Board from Astra-Zeneca, Daichi-Sankyo, Pfizer, Novartis, Roche, Ethicon, Onkowissen, Menari, Storz, PlantTec and is an ESGE AdBoard member, AGE Steering Board, Member of AGO “uterus committee”, Coordinator S2-LL Uterine sarcomas, P.A.F. has received institutional funding from BioNTech, Cepheid and Pfizer and peronal honoraria from Novartis, Pfizer, Roche, Daiichi Sankyo, AstraZeneca, Lilly, Eisai, Merck Sharp & Dohme, Pierre Fabre, SeaGen, Agendia, Sanofi Aventis, Gilead and Mylan for consulting, participation in advisory boards and steering committees and/or lectures. His institution conducts research for Novartis. C.M. received consulting fees from AbbVie, Celgene/BMS, Pfizer, Nordic Pharma, honoraria for lectures or presentations from Daiichi Sankyo, Novartis, Lilly and support for attending meetings and/or travel from Brustkrebs Deutschland eV, Novartis, Roche, Mundipharma, Amgen, Servier Deutschland GmbH, AbbVie. The other authors do not have a competing interest.