Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://gs.amegroups.com/article/view/10.21037/gs-2025-72/coif). C.S. reports involvement in a research collaboration with Proteotype. R.C. reports the following conflicts of interest: 1. Grants or Contracts: Astra-Zeneca, awarded an educational grant to the University of Southampton in November 2021 for the long-term follow-up of the POSH study. 2. Leadership or Fiduciary Roles: NICE, acts as a Breast Cancer Topic Advisor, contributing to guideline development. Association of Breast Surgery, Member of the clinical practice and standards committee. 3. Receipt of Equipment, Materials, etc.: SECA provided equipment for measuring body composition to University Hospital Southampton under a model industry collaborative agreement. E.C. reports grants from Astra-Zeneca and Daaichi-Sankyo; consultancy fees from Pfizer; honoraria for speaking engagements from Astra-Zeneca, Lilly, Menarini Stemline, Novartis, Pfizer and Roche; support for attending meetings from Novartis and Roche; advisory board payments from Astra-Zeneca, Lilly, Menarini Stemline, Novartis, Pfizer and Roche. E.C. is chair of expert committee for WCRF, has received use of research equipment from SECA and is involved in a research collaboration with Proteotype. The authors have no other conflicts of interest to declare.