Abstract PS4-11-26: First latin american consensus on the medical oncology management of early-stage hr+/her2− breast cancer: addressing regional disparities in spanish-speaking countries of central and south america

Abstract Background: Despite the global progress in early-stage hormone receptor-positive, HER2-negative (HR+/HER2−) breast cancer management, Latin America faces persistent and significant disparities in access to genomic testing, systemic therapies, fertility preservation, and multidisciplinary care. This work represents the first Latin American consensus developed exclusively by experts from Spanish-speaking countries in Central and South America, aiming to adapt international recommendations to the realities of the region and reduce inequities in care delivery. Methods: A systematic review of the literature was performed focusing on international guidelines (ESMO, ASCO, NCCN, SEOM). A multidisciplinary panel of 24 oncology experts from 11 Latin American countries participated in a Delphi-based consensus process. Statements were rated on a 9-point Likert scale; consensus was defined as a mean score ≥7.0 with ≤1 outlier. Data were collected using REDCap, and descriptive statistics were used for analysis. Results: Consensus was reached on 90% of 32 proposed statements. Key recommendations included the use of clinical-pathological and molecular factors (nodal status, tumor grade, ER, Ki-67, gene signatures) for risk stratification and adjuvant therapy decision-making. Genomic assays were endorsed for selected cases, though their availability remains limited or restricted to the private sector in most countries. The panel agreed that testing should be omitted in very low clinical-risk tumors and in patients with ≥4 positive nodes. The consensus supports ovarian suppression plus endocrine therapy for premenopausal women at high risk, and highlights the unmet need for routine fertility preservation counseling, sexual health management, and access to imaging and genetic counseling. The experts underscored the regional heterogeneity in resource availability, infrastructure, and bureaucratic barriers as major obstacles to equity in breast cancer care. Conclusions: This is the first regional consensus developed by Spanish-speaking oncology experts from both Central and South America to address the challenges of HR+/HER2− early breast cancer in Latin America. The recommendations reflect the urgent need to bridge the gaps in access, infrastructure, and implementationacross diverse healthcare systems. This consensus represents a critical step toward promoting contextualized, equitable, and evidence-based oncology care throughout the region. Citation Format: D. U. Landaverde, F. Petracci, A. Grano de Oro, M. A. Bravo-Garzon, M. I. Estevez, I. González, C. Arce-Salinas, I. Veliz, J. L. Amador, O. Castillo, V. Enciso, L. Codas, F. Valencia, M. Galvez, J. Valentin-Bejarano, S. Sánchez, I. V. Lemes-Pistón, D. Hannois, J. P. Miranda-Olivares, G. Guillen. : First latin american consensus on the medical oncology management of early-stage hr+/her2− breast cancer: addressing regional disparities in spanish-speaking countries of central and south america [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2025; 2025 Dec 9-12; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2026;32(4 Suppl):Abstract nr PS4-11-26.