An international panel of specialists has produced the first consensus for the oncologic management of early-stage hormone receptor-positive, HER2-negative breast cancer adapted to the Spanish-speaking countries of Latin America. The document highlights marked disparities in access to genomic testing, systemic therapies and fertility preservation, and proposes recommendations tailored to the resources of each setting.
What was known
Significant inequalities persist in the management of early-stage HR+/HER2- breast cancer in Spanish-speaking Latin America, with limited access to genomic testing, systemic treatments and fertility preservation techniques. International guidelines (ESMO, ASCO, NCCN, SEOM) do not always capture differences in resources between countries and sectors.
What this work adds
The Latin American Breast Cancer Association (LABCA) convened a panel of experts to produce the first consensus adapted to Spanish-speaking countries. It began with a literature review (Embase, PubMed, Scopus, ClinicalKey and LILACS; 2014-2025), informed by international guidelines and registered in PROSPERO. A steering committee of three experts of Spanish nationality supervised the process. Twenty-one specialists from 11 countries took part through a modified Delphi method; 31 items were voted in the first round and 25 statements were retained within scope. Consensus was defined as agreement of 80% or more (or a median of 7-9).
Main results
Applying the 80% rule, 22 of the 25 statements (88%) reached full consensus; three (1.3, 2.4 and 3.3; 75-76%) were near-consensus and retained with caveats. The recommendations integrated clinicopathologic and molecular factors to guide risk stratification; genomic assays were reserved for selected scenarios and discouraged in very low-risk tumours or those with four or more positive lymph nodes. The consensus also covered ovarian suppression with endocrine therapy, fertility preservation, sexual health and genetic evaluation, as well as adjuvant CDK4/6 and PARP inhibitors when available. Marked heterogeneity in access by country and sector was documented.
What it means
This consensus offers the first region-specific, evidence-based, resource-adapted recommendations for early-stage HR+/HER2- breast cancer in Spanish-speaking Latin America, aiming to reduce disparities and strengthen more equitable oncology care. For breast units, it stresses that decisions on genomic testing and adjuvant therapies must be adapted to the real availability of each health system.
Reading from a breast unit
The work illustrates a principle useful in any breast unit, Spain included: risk stratification and the use of genomic testing should be weighed against clear criteria, avoiding both overtreatment of low-risk tumours and inequity driven by differences in access.
Reference: Landaverde DU, Petracci F, Grano de Oro A, Bravo Garzón MA, Estévez M, Arce-Salinas C, et al. Latin American consensus on the medical oncologic management of early-stage HR+/HER2- breast cancer: Addressing regional disparities in Spanish-speaking countries. Breast, 2026. DOI
