The 43rd Annual Miami Breast Cancer Conference exemplified the importance of bringing together medical oncologists, nurses, physician assistants, surgeons, radiation oncologists, and more to dive deep into collaborative conversations and learning experiences with the goal of improving patient care.
In the spirit of the meeting’s multidisciplinary nature, we asked oncology professionals to share the questions that came up for them during the meeting, many of which their colleagues then answered! Read on for a glimpse at the conversations that took Miami by storm.
Multidisciplinary Discussions at Miami Breast: Highlights
- Oncology professionals are investigating the use of GLP-1 receptor agonists to manage patient weight gain associated with anti-estrogen therapies and to leverage the potential anti-inflammatory effects of these agents across different breast cancer subtypes.
- Medical oncologists are encouraged to maintain open communication regarding integrative medicine modalities, such as acupuncture and naturopathy, to improve patient safety and strengthen patient-oncologist relationships.
- Modern cancer management is shifting toward treatment de-escalation, including the use of shorter ultra-hypofractionated radiation schedules and more conservative axillary lymph node surgery to reduce the risk of long-term complications like lymphedema.
How do GLP-1 receptor agonists augment breast cancer care?
Patricia Jakel, MSN, an oncology nurse consultant, was curious about the performance of GLP-1 receptor agonists in patients with breast cancer.
Jakel: “We have not respected that patients who receive anti-estrogen agents—be it tamoxifen [Nolvadex] or an aromatase inhibitor—gain weight. People say maybe they ate too much, or maybe they didn't exercise enough. [However], convincing data show that it's hard not to gain weight during anti-estrogen therapy.
As a medical oncology advanced practice nurse, I need to respect that more with my patients. Telling a patient with joint pain and stiffness to go out and exercise [requires] finesse. You have to have a conversation. You have to have realistic goals for [the patient]. [We heard] fascinating data on GLP-1 receptor agonists. There's more to come with that. That was a sit-up-and-take-notice presentation.
I would like to see how [the GLP-1 receptor agonists] worked in different [breast cancer] subtypes. The science about what happens with adipose tissues, the regulation of cancer, and the drivers for cancer was fascinating. I'm looking forward to seeing the article about that.
[However], what [patient] subgroups benefited from [GLP-1 receptor agonists]? Which groups did not benefit? [These agents generate] an anti-inflammatory response, and they decrease adipose tissue; that's supposed to help with breast cancer. But there are a lot more questions that need to be answered.”
Want more oncology nursing insights from Jakel? Check out this clip from our interview, where she highlighted a multidisciplinary case discussion presented at the meeting about a patient with breast cancer.1
Neil M. Iyengar, MD, of the Winship Cancer Institute of Emory University in Atlanta, Georgia, responded with insights about future plans for GLP-1 receptor research.
Iyengar: “There are several population or observational datasets that have evaluated the effects of GLP-1 receptor agonists by subtype of breast cancer, mainly stratified by the big 3 [subtypes]—HER2-positive, triple-negative, and hormone receptor [HR]–positive—to [identify] differential effects of weight loss. Data have emerged showing that use of hormone therapy may reduce some of the weight loss that is induced by GLP-1 receptor agonists, although that needs to be proven in larger datasets. Planned studies will investigate GLP-1 receptor agonists in small prospective trials in specific subtypes, like HR-positive [breast cancer]. A major future direction will be to investigate the specific effects of the GLP-1 receptor agonists across breast cancer subtypes, as well as across all cancer types.”
Is there a role for hormone therapy in menopausal breast cancer survivors?
Iyengar also queried his fellow medical oncologists about the use of hormone therapy in menopausal patients.
Iyengar: “There's been a lot of attention to menopausal hormone therapy in recent days, just in the general [breast cancer] population. The question is: When are we going to start seeing either more studies investigating where it is safe or maybe not safe for the use of menopausal hormone therapy in breast cancer survivors? Right now, we assume it's not safe for [patients with] HR-positive breast cancer. But is there a point in survivorship where it is safe, or are there different types of hormone formulations that might be safe—for example, testosterone?”
How can health care providers counsel patients with cancer about integrative medicine modalities?
Lillian Rodich, MSPAS, MPH, of Memorial Sloan Kettering Cancer Center in New York, New York, asked medical oncologists to consider learning more about integrative medicine and incorporating these modalities into their patient conversations.
Rodich: “I would ask [medical oncologists] to think about how they can be more open to these conversations. On my end, what I'm seeing every day from patients is that they did bring up [integrative medicine] to their medical oncologists, and they got shut down. Maybe they were told not to worry about any of those [modalities], they don't matter, they don't make a difference, they are all hocus pocus. The patient, in turn, isn't going to want to disclose [the integrative medicine practices] they’re doing. This leads to a whole other potential cause of patient safety [issues] and negative adverse effects [AEs].
If we can learn how to have a bit more of an open conversation about this with patients, that will improve the patient-oncologist relationship, as well as increase patient safety. [Medical oncologists] don't have to necessarily be experts in [integrative medicine], but they should be aware that it exists and that it's something that most patients want to speak about. [Medical oncologists should then] send [patients] to the right places, rather than shutting down the conversation, being dismissive of integrative modalities, and then having the patient never want to disclose what they're using.”
Kevin Kalinsky, MD, MS, FASCO, of the Winship Cancer Institute of Emory University, responded with ways for medical oncologists to become more familiar with integrative medicine.
Kalinsky: “At my institution, we have an integrative oncology program where we have naturopaths. They meet with patients 3 times virtually to talk about supplements, herbs, nutrition, and diet. We are also further establishing a survivorship clinic. We also have acupuncture that can be complementary for our patients; this can be beneficial for patients who have joint aches, for instance, from the aromatase inhibitors we prescribe for HR-positive disease.
There's more we can be doing. Ideally, we should also be evaluating those [integrative] modalities in a structured way. We've seen that there was a benefit with acupuncture because there were randomized trials comparing [real acupuncture] vs sham acupuncture. When we think about [integrative medicine] from a western medicine perspective, [we need to consider] how well-studied a particular approach is, to help inform how we should best care for our patients.”
To hear more about integrative medicine, watch Rodich outline ways to discuss these approaches with patients in clinic.2 Additionally, be sure to watch Kalinsky speak to highlights from a molecular tumor board discussion presented at the meeting on the topic of HR-positive breast cancer management.3
How do radiation oncologists choose between different treatment modalities for patients with breast cancer?
Meghan R. Flanagan, MD, MPH, of the Fred Hutchinson Cancer Center in Seattle, Washington, posed a question as a surgical oncologist to radiation oncologists regarding treatment decision-making.
Flanagan: “One of the advancements that I have noticed over the past approximately 2 years is significant changes in radiation after lumpectomies and even mastectomies. We've gone from longer treatment courses to hypofractionated [radiation] to ultra-hypofractionated, accelerated partial breast [irradiation (APBI)]. It's still a little confusing to me how the radiation oncologists choose one [form of radiation] vs another. If you pick 5 radiation oncologists, 3 of them might [consider one from], and 2 of them [might consider another]. I'd love to hear more discussion from the radiation oncology group about how they consider ultra-hypofractionated APBI or hypofractionated regimens and when they use which different types of radiation.”
For insights on how Flanagan, a breast surgical oncologist, works with multidisciplinary teams, see our video about tumor boards for breast cancer treatment de-escalation.4
How is the role of axillary lymph node dissection evolving in breast cancer management?
La-Urshalar Brock, FNP, BSN, MSN, of the Winship Cancer Institute of Emory University, inquired surgical oncologists about axillary lymph node dissection from a nurse’s perspective.
Brock: “The surgeons were talking about [when to pursue] axillary dissection vs not. That's a hot topic for them as they talk about how to treat the patient surgically but also removing as little of the lymph nodes as possible, or whether to do that at all, depending on who the patient is. That was an interesting thought process in terms of where they're going now. They were debating that at Miami Breast, and it was a fantastic session to look at.
For me, in medical oncology, I'm there to treat [patients], and I've seen a lot of patients who had a lot of lymph nodes dissected and developed lymphedema. [However], now, we're not removing that many lymph nodes. It will be interesting to see, moving forward: When do we get to that point where there are some patients who don't need [axillary] dissection, or don't need a biopsy at all? In the coming years, we will probably know that answer.”
To learn more about how Brock prioritizes patient safety, check out this compilation from oncology professionals about AE awareness, education, and mitigation strategies.5
References
- Jakel P. Jakel on a multidisciplinary discussion about individualized breast cancer management. March 7, 2026. Accessed March 26, 2026. https://www.onclive.com/view/jakel-on-a-multidisciplinary-discussion-about-individualized-breast-cancer-management
- Rodich L. Rodich on how oncologists can discuss integrative medicine for breast cancer. March 7, 2026. Accessed March 26, 2026. https://www.onclive.com/view/rodich-on-how-oncologists-can-discuss-integrative-medicine-for-breast-cancer
- Kalinsky K. Dr Kalinsky on multidisciplinary considerations for ESR1+ breast cancer care. March 8, 2026. Accessed March 26, 2026. https://www.onclive.com/view/dr-kalinsky-on-multidisciplinary-considerations-for-esr1-breast-cancer-care
- Flanagan MR. Dr Flanagan on the importance of multidisciplinary breast cancer tumor boards. March 7, 2026. Accessed March 26, 2026. https://www.onclive.com/view/dr-flanagan-on-the-importance-of-multidisciplinary-breast-cancer-tumor-boards
- Wahner A. oncology experts highlight ways to educate and empower patients about AE management. March 13, 2026. Accessed March 26, 2026. https://www.onclive.com/view/oncology-experts-highlight-ways-to-educate-and-empower-patients-about-ae-management
