The european society for medical oncology (esmo) has updated its guideline for metastatic breast cancer, shifting towards a more molecular and subtype-driven approach to care. Reports from various outlets suggest that this update may involve new considerations for treatments such as trastuzumab deruxtecan and tucatinib, as well as the potential role of liquid biopsy and molecular tumor boards. However, the specifics of the updated guideline and its implications for patient care are not entirely clear from the available information.