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Review
. 2025 Mar 8:1-19.
doi: 10.1159/000545019. Online ahead of print.

AGO Recommendations for the Diagnosis and Treatment of Patients with Early Breast Cancer: Update 2025

Tjoung-Won Park-Simon  1 , Volkmar Müller  2 , Ute-Susann Albert  3 , Maggie Banys-Paluchowski  4 , Rupert Bartsch  5 , Ingo Bauerfeind  6 , Vesna Bjelic-Radisic  7 , Jens-Uwe Blohmer  8 , Wilfried Budach  9 , Peter Dall  10 , Nina Ditsch  11 , Eva M Fallenberg  12 , Peter A Fasching  13 , Tanja Fehm  14 , Michael Friedrich  15 , Bernd Gerber  16 , Oleg Gluz  17 , Nadia Harbeck  18 , Andreas Daniel Hartkopf  19 , Jörg Heil  20 , Juliane Hörner-Rieber  9 , Jens Huober  21 , Hans-Heinrich Kreipe  22 , David Krug  23 , Thorsten Kühn  24 , Sherko Kümmel  25 , Sibylle Loibl  26 , Diana Lüftner  27 , Michael Patrick Lux  28 , Nicolai Maass  29 , Christoph Mundhenke  30 , Toralf Reimer  16 , Mattea Reinisch  31 , Kerstin Rhiem  32 , Achim Rody  4 , Marcus Schmidt  33 , Andreas Schneeweiss  34 , Florian Schütz  35 , Hans-Peter Sinn  36 , Christine Solbach  37 , Erich-Franz Solomayer  38 , Elmar Stickeler  39 , Christoph Thomssen  40 , Michael Untch  41 , Marion Tina van Mackelenbergh  29 , Isabell Witzel  42 , Achim Wöckel  3 , Rachel Wuerstlein  18 , Wolfgang Janni  43 , Marc Thill  44
Affiliations
Review

AGO Recommendations for the Diagnosis and Treatment of Patients with Early Breast Cancer: Update 2025

Tjoung-Won Park-Simon et al. Breast Care (Basel). .

Abstract

The Breast Committee of the Arbeitsgemeinschaft Gynäkologische Onkologie (German Gynecological Oncology Group, AGO) presents the 2025 update of the evidence-based recommendations for the diagnosis and treatment of patients with early breast cancer.

Keywords: (Post)(neo)adjuvant; Breast surgery; Communication; Early breast cancer; Radiotherapy; Reconstruction.

PubMed Disclaimer

Conflict of interest statement

Prof. Dr. Tjoung-Won Park-Simon has received honoraria for lectures and/or consulting from Roche, AstraZeneca, GSK, Pfizer, Lilly, MSD, Exact Sciences, Daiichi Sankyo, Seagen, Novartis, Gilead Science, NCO, Onkowissen, Exact Sciences, Seagen, Stemiline-Menarini and received travel compensation from Roche, AstraZeneca, Pfizer, Lilly, Daiichi Sankyo, Gilead, Pierre Fabre, Novartis. Prof. Dr. med. Volkmar Müller has received speaker honoraria from AstraZeneca, Daiichi Sankyo, Eisai, Pfizer, MSD, Medac, Novartis, Roche, Seagen, Onkowissen, high5 Oncology, Medscape, Gilead, Pierre Fabre, iMED Institut; consultancy honoraria from Roche, Pierre Fabre, PINK, ClinSol, Novartis, MSD, Daiichi Sankyo, Eisai, Lilly, Seagen, Gilead, Stemline; and received institutional research support from Novartis, Roche, Seagen, Genentech, AstraZeneca; travel grants from AstraZeneca, Roche, Pfizer, Daiichi Sankyo, Gilead. Prof. Dr. med. Ute-Susann Albert has received honoraria for lectures from AstraZeneca GmbH, Lilly Deutschland GmbH, Menarini Stemline Deutschland GmbH, Novartis GmbH, Pfizer GmbH, PrimaVera Life GmbH. Prof. Dr. Maggie Banys-Paluchowski M.B. has received honoraria for lectures and advisory from Roche, Novartis, Pfizer, pfm, Eli Lilly, Onkowissen, Seagen, AstraZeneca, Eisai, Amgen, Stemline, Samsung, Canon, MSD, GSK, Daiichi Sankyo, Gilead, Sirius Medical, Syantra, Pierre Fabre, Exact Sciences; received study support from EndoMag, Mammotome, MeritMedical, Gilead, Hologic, Exact Sciences; and received travel/congress support from Eli Lilly, Exact Sciences, Pierre Fabre, Pfizer, AstraZeneca, Daiichi Sankyo, and Roche. Prof. Dr. med Rupert Bartsch received advisory role from AstraZeneca, Daiichi, Eisai, Eli Lilly, Gilead, Gruenenthal, MSD, Novartis, Pfizer, Pierre Fabre, Roche, Seagen, Stemline; received lecture honoraria from Amgen, AstraZeneca, BMS, Daichi, Eisai, Eli Lilly, Gilead, Gruenenthal, MSD, MedMedia, Novartis, Pfizer, Pierre Fabre, Roche, Seagen, Stemline; received travel support from Astra-Zenca, Daiichi, MSD, Novartis; and received research support from Daiichi. Dr. med. Ingo Bauerfeind has received honorary for lectures from Lilly, Aurikamed, LMU München, Pfizer, Menarimi Stemline. Prof. Dr. med. Vesna Bjelic-Radisic received honoraria for advisory boards from Pfizer, Roche, Lilly, Stemline, Pfm; received lecture honoraria from Pfizer, Lilly, Stemline, Pfm, mammotome; and received travel support from Pfizer. Prof. Dr. med. Jens-Uwe Blohmer has received honoraria for advisory boards and lectures from AstraZeneca, Daiichi Sankyo, Eisai, Gilead, Lilly, MSD, Novartis, Pfizer, Roche, Seagen. Prof. Dr. med. Wilfried Budach has received honoraria for lectures and advisory boards from Merck, BMS, Jörg Eickeler Veranstaltungen, med publico GmbH, BVDST. Prof. Dr. med. Peter Dall has received honoraria for lectures and advisory boards from Novartis, Pierre Fabré, MSD, Lilly, AstraZeneca, Gilead Sciences, Daiichi Sankyo, Eisai and Polytech. Prof. Dr. Nina Ditsch received honoraria for advisory boards from Gilead, Lilly, MSD, Novartis, Pfizer, Roche, Seagen, Exact Sciences; received honoraria for lectures and speakers bureaus from AstraZeneca, Daiichi Sankyo, Exact Sciences, Pierre Fabre, I-Med-Institute, Meritmedical, pfm medical, Medi-Seminar GmbH, Roche, Lilly, Pfizer, Gilead, Novartis, Onkowissen, Jörg Eickeler Kongress, if-Kongress; received manuscript support from pfm medical ag; received trial funding from Gilead, BZKF. Prof. Dr. med. Eva Maria Fallenberg received research grant from DFG and received speaker honorarium from GE Healthcare, Bayer Healthcare, Guerbet, Siemens, BD, Roche, EUSOBI, ESOR, ESMO, B-Rayz. Prof. Dr. med. Peter A. Fasching participation on a Data Safety Monitoring Board or Advisory Board: Novartis, Pfizer, Roche, Daiichi Sankyo, AstraZeneca, Lilly, Eisai, Merck Sharp and Dohme, Pierre Fabre, SeaGen, Agendia, Sanofi Aventis, Gilead, Mylan; received honoraria for lecture, speakers bureaus, manuscript writing, or educational events from Novartis, Pfizer, Roche, Daiichi Sankyo, AstraZeneca, Lilly, Eisai, Merck Sharp and Dohme, Pierre Fabre, SeaGen, Agendia, Sanofi Aventis, Gilead, Mylan; received honoraria for consulting from Novartis, Pfizer, Roche, Daiichi Sankyo, AstraZeneca, Lilly, Eisai, Merck Sharp and Dohme, Pierre Fabre, SeaGen, Agendia, Sanofi Aventis, Gilead, Mylan; medical writing from Merck; honoraria paid to the institution Biontech, Cepheid, Pfizer. Prof. Dr. med. Tanja N. Fehm received honoraria from Onkowissen, MedCOncept, FOMF; honoraria paid to the institution Roche, Novartis, Pfizer, MSD, AstraZeneca, Eisai, Lilly, Daichii Sankyio, Prof. Dr. med. Michael Friedrich received honoraria for advisory board from Gilead Sciences and other honoraria from Roche, MSD. Prof. Dr. med. Bernd Gerber received travel support from Pfizer. PD Dr. med. Oleg Gluz received honoraria for lectures and/or consulting from Amgen, AstraZeneca, Daiichi Sanyko, Eisai, Gilead Science, Lilly, MSD, Novartis, Pfizer, Roche, Seagen, Exact Sciences, Agendia, MedConcept, GynUpdate; received minority shareholder from Westdeutsche Studiengruppe (WSG). Prof. Nadia Harbeck, MD has received honoraria for consulting and/or lectures from AstraZeneca, Daiichi Sankyo, Gilead, Lilly, MSD, Novartis, Pierre Fabre, Pfizer, Roche, Seagen, Viatris, Zuelligpharma. Co-Director Westdeutsche Studiengruppe (WSG). Prof. Dr. med. Andreas Daniel Hartkopf has received honoraria for consulting and speaking engagements from AstraZeneca, Agendia, Amgen, Clovis, DaichiiSankyo, Eisai, ExactScience, Gilead, GSK, Hexal, Lilly, MSD, Novartis, Onkowissen, Pfizer, Roche, Pierre Fabre, Seagen, Stemline and Verazyte. Prof. Dr. med. Jörg Heil: None. Hörner-Rieber Juliane has received honoraria for lecture from Accuray International Sàrl, Pfizer Inc., AstraZeneca, Sanofi, and ViewRay Inc.; travel reimbursement from Varian Medical Systems; received research grants from IntraOP Medical and Varian Medical Systems, in each case “outside the submitted work”. Prof. Dr. med. Jens Huober has received honoraria for lectures from Lilly, Novartis, Roche, Pfizer, AstraZeneca, MSD, Seagen, Gilead, Daiichi; honoraria for consulting/advisory board from Lilly, Novartis, Roche, Pfizer, AstraZeneca, MSD, Daiichi, Gilead; and travel grants from Roche, Pfizer, Daiichi, Gilead. Prof. Dr. med. Hans-Heinrich Kreipe received honoraria for advisory board from Lilly; received lecture fees from AstraZeneca, Roche, Daiichi Sankyo, Pfizer. PD Dr. David Krug. D.K. received honoraria from AstraZeneca, best practice onkologie, ESO, ESMO, Gilead, med update, Merck Sharp and Dohme, Novartis, onkowissen, and Pfizer and received research funding from Stiftung Deutsche Krebshilfe and Merck KGaA. Prof. Dr. med. Thorsten Kühn has received from advisory board/lecture from Sysmex, Neodynamics, Pfizer, MSD, Merit Medical, Sirius Medical, Hologic, Endomag, Lilly and received trial funding from Merit Medical, Endomag, Mammotome. Prof. Dr. med. Sherko Kümmel has received lecture fees from Roche, Lilly, Exact Sciences, Novartis, Amgen, Daiichi Sankyo, AstraZeneca, MSD, Pfizer, Seagen, Gilead, Agendia; Hologic, PINK!; Stemline; received other honoraria from Roche, Daiichi Sankyo, Sonoscape; and received advisory board from Lilly, MSD, Roche, AstraZeneca, Stemline, Novartis, Daiichi Sankyo, MSD, Seagen, Gilead, Exact Science, Prof. Dr. med. Sibylle Loibl has received honoraria for advisory board, institutional from: Abbvie, Amgen, AstraZeneca, BMS, Celgene, DSI, Eirgenix, GSK, Gilead Science, Lilly, Novartis, Olema, Pfizer, Pierre Fabre, Relay Therapeuticas, Puma, Roche, Seagen, Stemline-Menarini; received honoraria for invited speaker, personal from Medscape; and received trial funding/others from: AstraZeneca, Abbvie, Celgene, Daiichi Sankyo, Greenwich Life Sciences, GSK, Immunomedics/Gilead, Molecular Health, Novartis, Pfizer, Roche, Stemline-Menarini, VM Scope GmbH. Prof. Dr. med. Diana Lüftner D.L. has received honoraria for advisory board activities and/or oral presentations from Amgen, AstraZeneca, Daiichi Sankyo, Eli Lilly, Gilead, GSK, high5md, Loreal, MSD, Mundipharma, Novartis, onkowissen.de, Pfizer, Pierre Fabre, Roche and TEVA. Prof. Dr. med. Michael Patrick Lux. M.P.L. has participated on advisory boards for AstraZeneca, Lilly, MSD, Novartis, Hexal, Pfizer, Eisai, Gilead, Exact Sciences, Daiichi Sankyo, Agendia and Roche and has received honoraria for lectures from MSD, Lilly, Roche, Novartis, Hexal, Pfizer, Exact Sciences, Daiichi Sankyo, Grünenthal, Gilead, AstraZeneca, and Eisai. He received travel expenses from AstraZeneca, Gilead, Pfizer and Daiichi Sankyo. Prof. Dr. med. Nicolai Maass has participated on advisory board from Amgen, AstraZeneca, Clovis, Daiichi Sankyo, GSK, Lilly, MSD, Novartis, Pierre Fabre, Pfizer, Roche, Seagen and has received honoraria for lectures from AstraZeneca, Daiichi Sankyo, GSK, Lilly, Novartis, Pfizer, Roche. Prof. Dr. med. Christoph Mundhenke has participated on advisory board from AstraZeneca, Pfizer, Daiichi Sankyo, Seagen, Novartis and has received honoraria for lectures from Pfizer, Novartis, Prof. Dr. med. Toralf Reimer received honoraria for consulting and/or lectures from AstraZeneca, Daiichi Sankyo, Menarini, MSD, Novartis, Pfizer, Roche. PD Dr. med. Mattea Reinisch received honoraria and/or consultancy fee from AstraZeneca, Daiichi Sankyo, Gilead, Lilly, MSD, Novartis, Pfizer, Roche, Seagen, Streamed Up, and Somatex and received travel support from AstraZeneca, Daiichi Sankyo, Gilead, Lilly, Novartis, Pfizer, Roch. Prof. Dr. med. Kerstin Rhiem received honoraria for lectures from AstraZeneca, Pfizer, Novartis, streamed up GmbH. Prof. Dr. med. Achim Rody has participated on advisory board: AstraZeneca, Novartis, Roche, Exact Sciences, Pierre Fabre, Lilly, Seagen, Amgen, MSD, Gilead; has received honoraria for lectures from Pfizer, Celgene, Eisai; and received trial funding from Eisai. Prof. Dr. med. Marcus Schmidt M.S. reports personal fees from AstraZeneca, BioNTech, Daiichi Sankyo, Eisai, GILEAD, Lilly, Menarini Stemline, Molecular Health, MSD, Novartis, Pantarhei Bioscience, Pfizer, Pierre Fabre, Roche, and SeaGen; his institution has received research funding from AstraZeneca, BioNTech, Eisai, Genentech, German Breast Group, Novartis, Palleos, Pantarhei Bioscience, Pierre Fabre, and SeaGen. In addition, he has a patent for EP 2390370 B1 and a patent for EP 2951317 B1 issued. Prof. Dr. med. Andreas Schneeweiss received research grants from Celgene, Roche; 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, Metaplan, MSD, Mylan, NanoString Technologies, Novartis, onkowissen.de, Pfizer, Pierre Fabre, promedicis, Roche, Seagen, Streamed up, Tesaro and has received travel support from AstraZeneca, Celgene, Daiichi Sankyo, Gilead, Pfizer, Roche. Prof. Dr. med. Florian Schütz received honoraria for lectures from Amgen, AstraZeneca, Daiichi Sankyo, Eisai, Exact Sciences, Gilead, Lilly, MSD, Novartis, ClinSol, Pfizer, Roche Pharma; has participated on advisory board from Lilly, MSD, Gilead, Atheneum Partners, ClinSol. He received travel expenses from Lilly, Gilead. Prof. Dr. med. Hans-Peter Sinn has participated on advisory board from AstraZeneca, Exact Sciences, Daiichi Sankyo, Lecture: AstraZeneca, Diacentus and received trial funding from AstraZeneca. Prof. Dr. med. Christine Solbach received honoraria for lectures from DiaLog Service GmbH, Jörg Eickeler, Pfizer, Roche, AstraZeneca, MedConcept, I-Med, GBG, BVF Akademie, LÄK Hessen Akademie, Meet the Expert Academy and has participated on advisory board from MSD, Roche, Menarini Stemline Deutschland GmbH. Prof. Dr. med. Erich-Franz Solomayer received honoraria for lectures and/or consulting from Roche, Amgen, Celgen, Tesaro, AstraZeneca, Pfizer, Storz, Erbe, Gedeon Richter, Eisai, Medac, MSD, Vifor, Teva, Ethikon, Johnson Johnson, Daiichi Sankyo, Gilead, Exact Sciences, GSK, Pierre Fabre. Prof. Dr. med. Elmar Stickeler has participated on advisory board from Amgen, AstraZeneca, Gilead, Iomedico, Lilly, MSD, Novartis, Seagen, Roche and received honoraria for lectures from AstraZeneca, BSH Düsseldorf, Gilead, Iomedico, MSD, Novartis, Onkowissen, Pfizer, PharmaMar, Roche. Prof. Dr. med. Christoph Thomssen C.T. received honoraria as compensation for lectures and medical expertise from Rottalinn-Kliniken; Klinikum Basel; Onkowissen TV; ESMO, and BfArM (Federal Institute for Drugs and Medical Devices). Prof. Dr. med. Michael Untch M.U. has received honoraria to travel support, lectures and consulting or advisory role from AstraZeneca, Amgen, Daiichi Sankyo, Lilly, Roche, Pfizer, MSD Oncology, Pierre Fabre, Sanofi Aventis, Myriad, Seagen, Novartis, Gilead, Stemline, Genzyme, Agendia, Onkowissen, Eisai and has received all honoraria and fees to the employer/institution. Prof. Dr. med. Marion Tina van Mackelenbergh has received honoraria to advisory role from Daiichi Sankyo, Exact Sciences, Gilead, Novartis, Pfizer, Pierre Fabre, Roche; received honoraria from AstraZeneca, Daiichi Sankyo, Elsevier, GSK, Jenapharm, Lilly, Menarini, Novartis, Pfizer, Seagen; received travel support from Daiichi Sankyo, Gilead. Prof. Dr. med. Isabell Witzel I.W. has received honoraria from AstraZeneca, Daiichi Sankyo, Gilead, GSK, Pfizer, MSD, Novartis, Roche, Seagen, Prof. Dr. med. Achim Wöckel has received honoraria as compensation for advisory boards, lectures, trial funding and has participated on advisory board from Amgen, AstraZeneca, Aurikamed, Celgene, Eisai, Lilly, Novartis, Pfizer, Roche, Tesaro, Sirtex, MSD, Exact Sciences, Pierre Fabre, Clovis, Organon, Daiji Sankyo, Seagen, Stemline, Gilead. PD. Dr. Rachel Würstlein served as advisor, consultant, speaker and travel grant: Agendia, Amgen, Apogepha, Aristo, AstraZeneca, Celgene, Clovis Oncology, Daiichi Sankyo, Eisai, Esteve, Exact Sciences, Gilead, Glaxo Smith Kline, Hexal, Lilly, Medstrom Medical, MSD, Mundipharma, Mylan, Nanostring, Novartis, Odonate, Paxman, Palleos, Pfizer, Pierre Fabre, PINK, PumaBiotechnolgogy, Riemser, Roche, Sandoz/Hexal, Sanofi Genzyme, Seattle Genetics/Seagen, Sidekick, Stemline, Tesaro Bio, Teva, Veracyte, Viatris, Wiley, FOMF, Aurikamed, Clinsol, Pomme Med, medconcept, MCI, Medi-Seminar. Prof. Dr. med. Wolfgang Janni has received research grants and/or honoraria from AstraZeneca, Celgene, Chugai, Daiichi Sankyo, Eisai, ExactScience, GSK, Janssen, Lilly, Menarini, MSD, Novartis, Sanofi Aventis, Roche, Pfizer, Seagen, Gilead, Inivata, Guardant Health. Prof. Dr. med. Marc Thill has participated on advisory board from Agendia, Amgen, AstraZeneca, Aurikamed, Becton/Dickinson, Biom‘Up, ClearCut, Clovis, Daiichi Sankyo, Eisai, Exact Sciences, Gilead Science, Grünenthal, GSK, Lilly, MSD, Neodynamics, Novartis, Onkowissen, Organon, Pfizer, pfm Medical, Pierre Fabre, Roche, RTI Surgical, Seagen, Sirius Medical, Sysmex; received manuscript support from Amgen, ClearCut, Clovis, Organon, pfm medical, Roche, Servier; received travel expenses from Amgen, Art Tempi, AstraZeneca, Clearcut, Clovis, Connectmedica, Daiichi Sankyo, Eisai, Exact Sciences, Gilead, Hexal, I-Med-Institute, Lilly, MCI, MSD, Neodynamics, Novartis, Pfizer, pfm Medical, Roche, RTI Surgical, Seagen; received congress support from Amgen, AstraZeneca, Celgene, Daiichi Sanyko, Gilead, Hexal, Lilly, Neodynamics, Novartis, Pfizer, Pierre Fabre, Roche, Sirius Medical; received honoraria for lectures from Amgen, Art Tempi, AstraZeneca, Clovis, Connect Medica, Eisai, Exact Sciences, Gedeon Richter, Gilead Science, GSK, Hexal, I-Med-Institute, Jörg Eickeler, Laborarztpraxis Walther et al. Lilly, MCI, Medscape, MSD, Medtronic, Novartis, Onkowissen, Pfizer, pfm medical, Roche, Seagen, Streamed Up, Stemline, Sysmex, Vifor, Viatris, ZP Therapeutics; received trial funding from Endomag, Exact Sciences; and received trial honoraria from AstraZeneca, Biom’Up, Celgene, Clearcut, Neodynamics, Novartis, pfm medical, Roche, RTI Surgical.

Figures

Fig. 1.
Fig. 1.
Treatment algorithm for early HR+/HER2− BC.
See this image and copyright information in PMC

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