Abstract: Berlin became the focal point for innovation in breast cancer treatment at the European Society for Medical Oncology Breast Cancer (ESMO BC) Annual Meeting held in May 2024. The conference showcased the latest advancements in breast cancer treatment, including innovative therapies and strategies. Notably, research on cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors combined with endocrine therapy (ET) in the neoadjuvant treatment of early breast cancer, though not yet reaching its primary endpoint, suggests further research is needed in this area. The combination of CDK4/6 inhibitors with ET continues to be the standard adjuvant therapy for high-risk patients, with abemaciclib showing consistent preliminary benefits in a subgroup of patients with germline BRCA1/2 mutations. Although ribociclib’s adverse reactions can be managed, its use requires close monitoring. New selective CDK4 inhibitors, AKT inhibitors, antibody-drug conjugates, and immunotherapies offer additional treatment alternatives for patients with advanced breast cancer. This year's meeting showcased advancements in breast cancer treatment and provides new perspectives for future research directions and patient treatment strategies. This article overviews the critical research developments presented at the meeting.