In this first segment of a roundtable discussion with Paolo Tarantino, MD, PhD, Maryam Lustberg, MD, MPH, Margaret Gatti-Mays, MD, MPH, and Matthew Kurian, MD, we explore how the early-stage HER2-positive breast cancer landscape is rapidly evolving after new data from ASCO 2026 and ESMO Breast Cancer 2026. The panel discusses key data from DESTINY-Breast11 and emerging bispecific therapies like anbenitamab, questioning whether TCHP should remain the standard of care. The conversation highlights growing interest in de-escalation, alternative regimens like THP, and the need to better tailor treatment intensity based on patient risk, reflecting ongoing uncertainty and active debate in clinical practice.