
Panelists discuss how treatment sequencing in early-stage breast cancer requires a stepwise approach, adding one therapy at a time (typically radiation, then hormonal therapy, then CDK4/6 inhibitors, with special considerations for BRCA-positive patients receiving olaparib first), while in metastatic settings the sequencing is more straightforward with first-line CDK4/6 inhibitors plus endocrine therapy, and how patient adherence can be optimized through shared decision-making, detailed toxicity education with graded explanations, frequent health care team touchpoints especially during the challenging first 90 days, and addressing the unique adherence challenges in early-stage patients who are asymptomatic compared to metastatic patients.