War or peace, crisis or prosperity, tranquility or troubled times, whatever circumstances we live in, as dedicated physicians and educators, especially specialized in oncology, we never stop! During the COVID-19 pandemic, oncologists all over the world, and all medical societies including @ASCO, @myESMO, @ASTRO_org, and @ASH_hematology, organized work and patient care for the circumstances, held institutional teaching and clinical meetings, held conferences virtually, issued guidelines to care for patients, conducted research, and made significant advances in the care of patients with cancer and the dissemination of knowledge and continuing medical education worldwide.

When we go into medicine, we pledge to alleviate suffering and improve health. Throughout our studies, training, and medical practice, we face challenges on a daily basis. During times of trouble, we show perseverance and dedication to continue and make a difference. In Lebanon, year after year, crisis after crisis, the American University of Beirut Medical Center (@AUBMC_Official) and the American University of Beirut (@AUB_Lebanon) have continued their mission of delivering excellent care for patients, conducting basic and clinical research, educating students, training graduating physicians, and providing post-graduate education for practicing physicians in Lebanon and the region. The Division of Hematology Oncology of the Department of Internal Medicine and the Breast Center of Excellence of the Naef K. Basile Cancer Institute held the annual Beirut Breast Cancer Conference in its tenth edition (BBCC-10). It was a great challenge to hold the meeting in spite of a surging omicron variant and a major financial collapse in Lebanon.

Rather than organizing speeches, our Opening Ceremony was held as an open forum with Firass Abiad, MD, the Minister of Public Health of Lebanon, and moderated by Roula Mouawad, a medical journalist who writes for Annahar, a leading daily newspaper. Participants included myself as president of the BBCC-10, Roger Khater, MD, president of the Lebanese Society of Medical Oncology (LSMO), Charaf Abou Charaf, MD, president of the Lebanese Order of Physicians, Rima Sassine-Kazan, RN, president of the Lebanese Order of Nurses, and Mirna Sabbah, vice president of the Lebanese Breast Cancer Foundation. Together, we  reiterated burning issues that patients with breast cancer are facing in Lebanon because of financial collapse, devaluation of the Lebanese pound, and sharp rises in the costs of laboratory tests, imaging, surgical procedures, and medications. Dr. Abiad was very attentive and responsive and promised that he and his team are working on solutions to obtain funds to support patients with cancer.  

BBCC-10 sessions were opened by Dr. Khater and Sami El Khatib, MD, president of the Arab Medical Association Against Cancer (AMAAC). Presentations and discussions included the impact of COVID-19 on cancer screening and care, new biomarker studies and classifications of breast cancer, HER2 enriched and HER2 low (HER2 1+ and HER2 2+), evolution of anti-HER2 therapy from monoclonal antibodies, tyrosine kinase inhibitors and the new antibody drug conjugates, immunotherapy in triple-negative breast cancer and PARP inhibitors for patients with BRCA germ-line mutations, hormonal therapy in combination with CDK4/6 inhibitors, surgery for the breast and axilla, surgery after neoadjuvant therapy, reconstructive surgery, locoregional radiation therapy and SBRT for oligometastatic lesions, ABC6 Guidelines for Advanced Breast Cancer, precision medicine, and supportive management. Tumor boards were held every day of the meeting at which cases were presented and discussed by panelists and participants. Special poster and oral sessions were held for research conducted by local junior physicians, fellows, and residents-in-training.

BBCC-10 was held virtually because of COVID-19. This helped us gather a very large faculty composed of breast cancer experts from the United States, Europe, Arab countries, and Lebanon (see the full list of esteemed faculty). Martine Piccart, MD (Institut Jules Bordet, Belgium), Mahmoud El-Tamer, MD (Memorial Sloan Kettering Cancer Center, United States) and Matti Aapro, MD (Genolier Cancer Center, Switzerland) were our keynote speakers this year. We were also pleased to have Sana Al Sukhun, MD, MSc, chair of the ASCO International Affairs Committee, among our faculty. Continuing the tradition of cooperation among oncologists from various hospitals and universities in Lebanon, Arab countries, Europe, and the United States was essential for the success of our meeting, which was attended by over 400 participants. Simultaneous sessions with oncology nursing, oncology pharmacy, and patient advocacy organized by the Lebanese Breast Cancer Foundation have become an essential part of our meeting, and are highly valued by nurses, pharmacists, patients, survivors, patient advocates, and volunteers; we recommend that all oncology conference organizers include them in their meetings everywhere.