Dr. Laurie Pierce reviewed radiotherapy de-escalation, highlighting evidence supporting radiation omission in selected low-risk patients while emphasizing biomarker-guided selection and multidisciplinary decision-making.

Dr. Jose Bazan Jr. reviewed FLASH radiotherapy, highlighting ultra-high dose delivery that reduces normal tissue toxicity while maintaining tumor control. Early studies support future use in breast cancer and re-irradiation.

Dr. Henry Kuerer presented evidence that selected patients achieving exceptional responses to neoadjuvant therapy may safely omit breast surgery, supporting response-adapted, quality-of-life–focused care.

Panelists discussed FLASH radiotherapy for radio-resistant tumors, stressing the need for stronger clinical evidence, rigorous biopsy methods, and exploring treatment de-escalation in carefully selected patients.