[Key points in the Chinese experts' consensus on the diagnosis and treatment of HER2-targeted breast cancer 2025...

Based on the latest clinical research evidence and domestic practical experience, the Breast Cancer Committee of the Chinese Society of Clinical Oncology has systematically sorted out the core points regarding human epidermal receptor 2 (HER2) testing standardization, neoadjuvant therapy, adjuvant therapy, treatment of relapsed and metastatic breast cancer, and diagnosis and treatment of populations with HER2 low expression/ultra-low expression. The Chinese experts' consensus on the diagnosis and treatment of HER2-targeted breast cancer 2025 edition was updated. Combining with key clinical issues, this article further interprets the key points of the Expert Consensus and proposes that precise HER2 testing should focus on spatiotemporal heterogeneity, and clarify the definitions and testing standards for low expression and ultra-low expression; it also summarizes clinical key points according to different stages, and puts forward that for neoadjuvant therapy, the trastuzumab combined with pertuzumab regimen is preferred, and specific regimens should be selected according to patient characteristics, and adjuvant strategies should be formulated based on pathological complete response status; in adjuvant therapy, dual-targeted therapy is the standard regimen for high-risk patients, while low-risk and special populations require individualized selection; the treatment of relapsed and metastatic breast cancer should be formulated according to the degree of trastuzumab sensitivity, trastuzumab treatment failure, and characteristics of special populations; populations with HER2 low expression/ultra-low expression can benefit from new antibody-drug conjugates, and standardized testing and treatment selection are required. In conclusion, the diagnosis and treatment of HER2-related breast cancer should be based on precise testing, combined with patients' clinical characteristics and follow the consensus recommendations, so as to achieve individualized treatment and improve prognosis.