Breast cancer experts from UCSF Health will present trial results and clinical guidance at the annual San Antonio Breast Cancer Symposium, the world’s largest and most prestigious breast cancer conference. This year’s meeting will be held Dec. 9–12, 2025.
Combining clinical, translational and basic research, the meeting brings together leading breast cancer researchers and clinicians, helping to shape clinical practices and research directions, and share the latest information about the biology, etiology, prevention, diagnosis and therapy of breast cancer and premalignant breast disease. The symposium is presented by UT Health San Antonio Mays Cancer Center and the American Association for Cancer Research (AACR).
This year’s scientific program features numerous presentations and updates on trial data, including WISDOM 1.0 study results, by breast experts at the UCSF Helen Diller Family Comprehensive Cancer Center (HDFCCC).
Here are some highlights (all times are CST):
Results from WISDOM Trial
Dec 12: 9:00 am to 11:30 am
General Session 3:
Laura J. Esserman, MD, MBA, the Alfred A. de Lorimier Endowed Chair in General Surgery, director of the UCSF Breast Care Center; and co-leader of the Breast Oncology Program at the UCSF Helen Diller Family Comprehensive Cancer Center, presents “Risk-Based Breast Cancer Screening is Safe, Preferred by Women and Identifies Highest Risk Individuals: Results from WISDOM 1.0” (GS3-07).
The WISDOM 1.0 Study (Women Informed to Screen Depending on Measures of Risk) is the first large-scale investigation testing a novel, personalized approach to breast cancer screening compared to annual mammography. More than 86,000 women between the ages 30 to 74 have enrolled nationally so far, with plans to expand to 100,000. The study, a randomized, preference sensitive pragmatic trial, was designed to test the non-inferiority of risk-based vs. annual screening for the primary outcome of Stage ≥2B BC, and to determine if risk-based screening is less morbid, preferred by women, and more conducive to prevention interventions. Esserman reports on results that show a risk-based approach to BC screening and prevention is safe and acceptable to women and is an opportunity to improve breast cancer early detection and prevention by identifying the highest risk women who should be screened more frequently.
Other WISDOM-related presentations and posters:
12:30 p.m. to 1:30 p.m.
Kirkpatrick Fergus, MD, MAS, a senior general surgery resident and surgical oncology fellow at UCSF, presents “Germline Pathogenic Variants in the Personalized Screening Arm of the WISDOM Study: Findings from 23,098 Women with No Personal History of Breast Cancer” (RF5-04) during Rapid Fire 5 oral session. *Fergus has also been named one of SABCS Clinical Science Scholars for 2025 for this abstract.
The population prevalence of pathogenic variants (PVs) in breast cancer susceptibility genes (BCSG’s) remains largely unknown, in part due to restrictions in genetic testing guidelines. Fergus and his collaborators report early BCSG prevalence estimates from the WISDOM trial, where women in the personalized screening arm were offered unrestricted genetic testing, and evaluate the relationship of test positivity to family history and other patient characteristics. Participants in the personalized arm were offered germline testing for nine breast cancer susceptibility genes (BRCA1, BRCA2, ATM, CHEK2, PALB2, CDH1, PTEN, STK11, TP53). Unrestricted access to genetic testing in a real-world setting identified a substantial number of women with clinically actionable results, many of whom would not have qualified for genetic testing under guideline-concordant criteria. These findings support expanding genetic testing to all women as part of personalized breast cancer risk assessment.
Poster Session 3 on Thursday, Dec. 11, 12:30 p.m. to 2:00 p.m.
Allison Fiscalini, MPH, Director of the Athena Breast Health Network and The WISDOM Study at UCSF, presents the poster “Recruitment Strategy Success and Challenges in WISDOM 1.0: A Nationwide Risk-Based Breast Cancer Screening Trial” (PS3-02-09) during Poster Session 3 on Thursday, Dec. 11, 12:30 p.m. to 2:00 p.m. As a large-scale screening trial, WISDOM aimed to enrolled individuals with no personal history of breast cancer using a preference tolerant randomized trial design that aimed to reflect the heterogeneity of the U.S. population. The goal of this analysis was to evaluate the recruitment strategies employed during WISDOM 1.0 and assess their effectiveness in building a geographically and racially diverse cohort of U.S. women for breast cancer screening research. Fiscalini and her collaborators analyzed enrollment and recruitment data sources and found that WISDOM 1.0 demonstrated the feasibility of recruiting a large, nationwide cohort for a personalized breast cancer screening trial using multi-modal, decentralized outreach with physician emails and MyChart emerging as the highest-yield strategy.
Kimberly Badal, PhD, assistant professor of surgery in the UCSF Department of Surgical Oncology, presents the poster “National Cost of the WISDOM Risk-Based Breast Cancer Screening Algorithm with Comparison to Advocated Guidelines” (PS3-01-23) during Poster Session 3 on Thursday, Dec. 11, 12:30 p.m. to 2:00 p.m. Badal and her collaborators aimed to estimate the total, national, yearly cost of screening in the USA if WISDOM’s screening algorithm were used, with comparison to current screening guidelines. Badal reports WISDOM’s risk-based screening algorithm can reduce national cost substantially, even with the added cost of genetic testing, while maintaining intensive screening for the highest-risk women. The resources saved can be used to improve screening for women at high risk of fast-growing cancers, which are often identified between screens, and to encourage improved adherence.
Jackelyn Moya, a resident physician in the UCSF Department of Surgery, presents the poster “Completion Rates of Risk Counseling Consultations for Women at High-Risk for Breast Cancer within the WISDOM 1.0 Pragmatic Screening Trial” (PS3-02-24) during Poster Session 3 on Thursday, Dec. 11, 12:30 p.m. to 2:00 p.m. Women in the WISDOM Study identified as high-risk were invited to complete a Breast Health Specialist consultation, which included use of an automated educational tool to identify their specific breast cancer risk factors. Badal sought to understand whether completion rates of consultations with trained breast health specialist varied among race/ethnicity, geography, and age. There were notable differences in completion of clinician consultations rates seen across categories of age, geography, and race/ethnicity. Based on these results and participant feedback, the WISDOM 2.0 study has changed consultation workflows, improved clinician availability and scheduling methods with the goal of providing a more equitable method of providing specialty consultations to high-risk participants.
Rapid Fire and Poster Spotlight Sessions
Tuesday, Dec. 9, 4:30 p.m. to 5:30 p.m.
Amrita Basu, PhD, associate professor of Surgery in the UCSF Division of Surgical Oncology, presents “Early Adverse Symptoms Predict Response to Treatment Among Patients in the I-SPY Trial” (RF1-04) during Rapid Fire 1 oral session. Adoption of immunotherapies and antibody-drug conjugates are transforming the nature and frequency of adverse events (AEs). These AEs come with both short and long-term symptoms that significantly impact patient quality of life. Basu and her collaborators sought to identify symptoms associated with pathologic complete response (PCR) using patient-reported outcomes (PROs) in early-stage high-risk breast cancer patients enrolled on the I-SPY2 trial, who received IO and ADC neoadjuvant therapies ± standard paclitaxel. The study utilized a computational framework that defined sentinel symptoms such as muscle and joint pain, mouth/throat sores, headache, and swelling, as early as weeks 1-3 that were associated with a favorable tumor response. This work can help provide earlier proactive monitoring to mitigate toxicities, to enhance treatment response, and a potential symptom-based early understanding to personalize treatment efficacy.
Basu also presents “A Roadmap to Ethical Implementation of AI Tools” (ED15-02) during Educational Session 15: “Real Impact with Artificial Intelligence” on Thursday, Dec. 11, 2:30 p.m. to 4:15 p.m. The session highlights the use of digital biomarkers and risk prediction, big data to address complex challenges, and strategies for implementing AI tools in breast cancer care.
Dec. 10, 2025, 7:00 a.m. to 8:30 a.m.
Melissa Taylor, a medical oncologist at UCSF Health, presents “Early Outcomes from the IMPACCT Project (Improving Participation in Cancer Clinical Trials): An Intervention to Improve Clinical Trial Participation Among Underrepresented Cancer Patients” (PD1-04) during Poster Spotlight 1 session. Persistent barriers to equitable cancer care and clinical trial access remain for underrepresented populations. While artificial intelligence (AI) tools have improved clinical trial patient matching, multiple barriers continue to limit trial participation. Taylor and her collaborators developed a three-phase prospective pilot project at a large academic cancer center titled IMPACCT (Improving Participation in Cancer Clinical Trials) to improve clinical trial representation among breast and GI cancer patients. The early findings suggest the intervention may be scalable across cancer types and clinical settings, with potential to inform broader equity-focused recruitment strategies in oncology trials.
Thursday, Dec. 11, 7:00 a.m. to 8:30 a.m.
Wen Li, PhD, associate professional researcher in the UCSF Department of Radiology and Biomedical Imaging, presents “Validation of MRI Predictive Models for Treatment Optimization in the I-SPY 2 TRIAL” (PD6-03) during session Poster Spotlight 6. Functional tumor volume (FTV) measured from MRI serves as an imaging biomarker for redirecting treatment in the I-SPY 2 trial. This study aimed to validate FTV-based MRI models used to predict favorable response early in treatment. Receptor subtype-specific FTV-based models were developed to predict the binary outcome RCB-0/I vs RCB-II/III, with RCB-0/I being the positive outcome. Wen reports on results showing comparable performance in the training and test sets, with the highest AUC in the TNBC subtype and the highest positive predictive in the HR-/HER2+ subtype. The FTV-based models are currently being used in combination with core biopsy as part of the pre-RCB clinical algorithm for shortening therapy in I-SPY 2.
Friday, Dec. 12, 7:00 a.m. to 8:30 a.m.
Jo Chien, MD, UCSF professor and medical director of UCSF Breast Medical Oncology, presents, “I-SPY2 Endocrine Optimization Pilot (EOP): Neoadjuvant Vepdegestrant Monotherapy or in Combination with Letrozole or Abemaciclib in Molecularly Selected Patients with Stage 2/3 HR+ HER2-Negative Breast Cancer” (PD10-02) during Poster Spotlight 10. I-SPY2 Endocrine Optimization Pilot (EOP) is an I-SPY2 sub-study designed to test novel endocrine-based strategies in patients predicted to have modest benefit from chemotherapy. Vepdegestrant is a selective oral PROTAC estrogen receptor (ER) degrader that has demonstrated efficacy in mutant ER+ HER2-negative MBC. The study tested vepdegestrant in the neoadjuvant setting in patients with early breast cancer and demonstrated excellent responses in ki67 which is a marker of proliferation, decreases in MRI functional tumor volume, clearance of ctDNA, and evidence of axillary nodal clearance. The study demonstrates the tolerability and activity of vepdegestrant and the value of testing agents in the neoadjuvant setting.
Chien also presents the poster “US Real-World Clinical Outcomes of Tucatinib, Trastuzumab, And Capecitabine Following Trastuzumab Deruxtecan for the Treatment of Her2+ Metastatic Breast Cancer” (PS5-01-28) during Poster Session 5, on Friday, Dec. 12, 12:30 p.m. to 2:00 p.m. US and EU treatment guidelines currently recommend tucatinib in combination with trastuzumab and capecitabine (TTC) in third-line (3L) for patients with human epidermal growth factor receptor 2-positive (HER2+) metastatic breast cancer, and in second-line (2L) for those patients with brain metastases (BM). This study aimed to describe real-world outcomes in patients with HER2+ MBC in the US who were treated with TTC in 2L, 3L and fourth line (4L) immediately following T-DXd. Chien reports on results that reinforce the effectiveness of tucatinib in a population more applicable to current clinical practice, and thus more relevant to clinical decision making in this rapidly evolving landscape.
Friday, Dec. 12, 7:00 a.m. to 8:30 a.m.
Anthony Sun, MS, a biomarker data analyst in the Breast Care Center division of the UCSF Department of Surgery, presents “Predicting Treatment Outcomes in Breast Cancer from H&E Slides Using Pathology Foundation Models with Multiple Instance Learning” (PD11-03) during Poster Spotlight 11 session. (UCSF’s Amrita Basu, MD, serves as moderator of the session). Sun and his collaborators developed a deep-learning model, BRAVE, that predicts patient response to neoadjuvant therapy directly from pre-treatment tumor biopsy slides. By leveraging pathology foundation models and attention-based multiple instance learning, BRAVE captures subtle morphologic features that are not reflected in standard clinical or pathology assessments.
Friday, Dec. 12, 7:00 a.m. to 8:30 a.m.
Laura Huppert, MD, an oncologist and assistant professor in the UCSF Division of Hematology/Oncology, presents “Site(s) of Distant Recurrence after Neoadjuvant Therapy for Patients with High-Risk Early-Stage Breast Cancer (BC): Analysis of Data from the I-SPY2 Trial” (PD13-01) during “Poster Spotlight 13: Focus on CNS.” The incidence of central nervus system (CNS) metastases varies with BC subtype, but there is limited data about clinical and molecular predictors of CNS vs non-CNS recurrence risk after neoadjuvant chemotherapy (NACT). In this study, Huppert and her team present patterns of distant recurrence among patients in the I-SPY2 trial. These results support future research to identify biomarkers that predict CNS recurrence risk and to incorporate CNS-penetrant therapies into early-stage treatment for CNS high-risk patients.
Huppert also presents the poster “Trial in Progress: Phase II Open-Label Study of ARX788 (anti-HER2 Antibody Drug Conjugate (ADC)) for Patients with HER2-Low Locally Advanced Unresectable or Metastatic Breast Cancer” (PS5-08-11) during Poster Session 5 on Friday, Dec. 12, 12:30 p.m. to 2:00 p.m. ARX788 is a next-generation, site-specific ADC composed of a monoclonal antibody targeting human epidermal growth factor receptor 2 (HER2) conjugated via a non-natural amino acid linker to a potent tubulin inhibitor payload AS269. The poster describes this single-arm, open-label, Phase II clinical trial of ARX788 monotherapy in patients with HER2-low locally advanced unresectable or metastatic breast cancer with enrollment beginning in the third quarter of 2025.
Educational Session
Javid Moslehi, MD, the William Grossman Distinguished Professor in Cardiology and UCSF Section Chief of Cardio-Oncology, Immunology and Metabolism, presents “Trial Strategies to Optimize Cardiac Outcomes” during Educational Session 13: “Optimizing Cardiac Outcomes in Breast Cancer—The Next Chapter” on Thursday, Dec. 11, 2:30 p.m. to 4:15 p.m. Moslehi will focus on innovative clinical trial approaches to improve cardiac outcomes.
Select Poster Abstracts
Denise M Wolf, PhD, a bioinformatics research scientist in the UCSF Department of Surgery, presents the poster “Pneumonitis But Not Other Immune Related Adverse Events (IrAEs) Associate with Pre-Treatment Immune Signatures in Early-Stage Breast Cancer Patients Receiving Neoadjuvant Immunotherapy (IO): Results From 5 IO Arms In I-SPY2” (PS1-01-05) during Poster Session 1 on Wednesday, Dec. 10, 12:30 p.m. to 2:00 p.m. The I-SPY2 and other trials have shown the efficacy of neoadjuvant immunotherapy in HR+HER2-, especially in immune+ subsets. However, IO agents carry risk of immune-related toxicities, some long-term. In this study, Wolf and her collaborators pool irAE data from 5 IO arms in I-SPY2 to assess whether irAE development may be predicted by gene expression signatures in pre-treatment tumor biopsies. Wolf reports that pneumonitis, but no other irAE, associated with pre-treatment immune signatures, suggesting mRNA signatures may help enable early identification and treatment of IO patients likely to develop pneumonitis.
Jennifer Rosenbluth, MD, PhD, the Sulochana Pradhan, MD, Endowed Professorship in Breast Cancer at UCSF, presents the poster “Global Expression of Small DNA Damage-associated RNAs (sdRNAs) in Breast Cancers” (PS2-12-09) during Poster Session 2 on Wednesday, Dec. 10, 5:00 p.m. to 6:30 p.m. Rosenbluth and her collaborators examined a newly recognized class of small RNAs involved in DNA-damage repair and found they are markedly elevated across breast cancers, especially triple-negative tumors. Using an organoid-based platform, they showed that select DNA-damage–associated RNAs can accelerate growth in normal breast tissue and can also be detected in blood, suggesting potential roles in early tumor development and as future biomarkers.
Tam Binh Bui, MSc, MD, UCSF PhD candidate and member of the Rosenbluth Lab at UCSF, presents the poster “Quiescent-like phenotype characterizes treatment-resistant early-stage HER2-negative breast cancers and suggests novel therapeutic targets; analysis of over 2000 patients from the I-SPY2 trial” (PS2-11-06) during Poster Session 2 on Wednesday, Dec. 10, 5:00 p.m. to 6:30 p.m. *(Bui was selected for a SABCS Clinical Science Scholars Award for this abstract). Response Predictive Subtypes (RPS), developed in the I-SPY2 breast cancer clinical trial can help doctors group patients based on how likely they are to respond—or not respond—to certain treatments. However, almost one-third of patients in the I-SPY2 study are not expected to benefit from any existing drugs, including those that target HER2, the immune system, or DNA repair pathways. This research leverages the rich I-SPY2 trial data to identify new biological targets in these difficult-to-treat tumors and their surrounding environment and suggests new treatment strategies for these patients, including epigenetic drugs.
Kelsey Natsuhara, MD, a breast oncologist and assistant professor of Medicine, presents the poster "Real-world Treatment Patterns of Capivasertib in Metastatic Breast Cancer in the US" (PS5-05-23) during Poster Session 5 on Friday, Dec. 12, 12:30 p.m. to 2:00 p.m. PIK3CA inhibitors, such as capivasertib, are approved for the treatment of hormone-positive HER2-negative metastatic breast cancer. Natsuhara and her collaborators aimed to evaluate treatment patterns and clinical outcomes using capivasertib + fulvestrant in a large real-world cohort to better understand how clinicians are using and sequencing these agents. The poster reports that the study demonstrated the efficacy of this regimen in the real-world and highlights the need for future studies to better understand optimal sequencing of therapy for HR+ MBC.
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