Highlights of the San Antonio Breast Cancer Symposium 2025 (Part 1)

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 48^th 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 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 is the first of a two-part report highlighting important presentations and focuses on lifestyle and risk factors for breast cancer, de-escalation of axillary surgery for both initial staging and management of node-positive disease together with active surveillance for low-risk ductal carcinoma-in-situ.