[Expert consensus on diagnosis and treatment of hormone receptor-positive/human epidermal growth factor receptor 2-negative advanced breast cancer visceral metastasis and visceral crisis (2025 edition)].

Abstract

Hormone receptor-positive (HR⁺), human epidermal growth factor receptor 2-negative (HER2^-) breast cancer is the most prevalent subtype. When the disease advances to a late stage with visceral metastases or a visceral crisis, patients face a poor prognosis with curative treatment rarely achievable. Moreover, the presence of visceral metastases or visceral crisis plays a critical role in determining appropriate treatment strategies. However, clinical diagnostic criteria and standardized treatment protocols for visceral metastases and visceral crisis in HR⁺/HER2^- advanced breast cancer remain undefined, which presents an urgent clinical challenge. In response, the Health China Research Center's Expert Committee of Cancer Prevention and Control has reviewed the latest domestic and international research evidence, guidelines, and expert consensus, while incorporating input from experts in various fields. This consensus establishes diagnostic criteria for visceral metastasis and visceral crisis and introduces the concept of an impending visceral crisis. Furthermore, it refines treatment strategies based on patients' treatment history (treatment-naïve versus pretreated) and recommends standardized treatment protocols for different patient groups, including the use of cyclin-dependent kinase 4/6 (CDK4/6) inhibitors in combination with endocrine therapy, chemotherapy, and antibody-drug conjugates. This consensus aims to provide clinical guidance for the diagnosis and treatment of HR⁺/HER2^- advanced breast cancer with visceral involvement, ultimately improving treatment outcomes and patient prognosis.