Highlights of the San Antonio breast cancer symposium 2025 (Part 2).

The annual San Antonio Breast Cancer Symposium (SABCS) combines the principles of multidisciplinary management, with the basic science underlying pathobiological processes in breast cancer. The 48th meeting was held at the Henry B Gonzales Convention Center in downtown San Antonio, Texas, United States of America on 9-12 December 2025. The symposium delivers a range of presentations covering basic, translational, and clinical sciences with input from patient advocates and an increasingly patient-centric approach and focus on standards of clinical care and survivorship issues. Important trials that are potentially practice changing are often presented as late-breaking news and published concurrently or shortly thereafter. This second of a two-part report covers a range of topics related to indications for pre-operative breast magnetic resonance imaging (MRI), benefits of acupuncture on cognitive function, age as a prognostic factor in younger patients, primary irradiation, antibody-drug conjugates for advanced human epidermal growth factor receptor 2 (HER2) positive/negative disease, and selective estrogen receptor down-regulators for early-stage breast cancer.