Breast cancer management has undergone revolutionary changes in recent decades, yet numerous controversial topics continue to challenge established paradigms and spark intense debate within the medical community. This special issue aims to address the most pressing and contentious issues at the intersection of surgical and systemic therapeutic approaches to breast cancer care.

The evolving landscape of breast cancer treatment demands critical examination of controversial topics that shape current clinical practice. From the ongoing debate surrounding the optimal timing of neoadjuvant versus adjuvant therapy to the contentious discussions about de-escalation strategies in low-risk patients, clinicians face complex decisions that require evidence-based guidance. The integration of novel biomarkers, liquid biopsies, and artificial intelligence in treatment selection represents another frontier where controversy and innovation intersect.

Surgical controversies including the role of contralateral prophylactic mastectomy, oncoplastic surgery techniques, and the evolving criteria for breast-conserving therapy challenge traditional approaches. Simultaneously, systemic therapy debates encompass the optimal duration of targeted therapies, the role of immunotherapy in triple-negative breast cancer, and personalized treatment strategies based on tumor heterogeneity.

This special issue will feature cutting-edge research, expert opinions, and comprehensive reviews that address these controversial topics head-on. We seek contributions that challenge conventional wisdom, present novel therapeutic strategies, and provide evidence-based solutions to current dilemmas. By fostering open scientific discourse on these contentious issues, we aim to advance the field and ultimately improve patient outcomes.

Keywords: Breast cancer, surgical oncology, systemic therapy, neoadjuvant treatment, personalized medicine, oncoplastic surgery, immunotherapy, biomarkers