Beat Thürlimann, MD, Cantonal Hospital St. Gallen, St. Gallen, Switzerland, and Michael Knauer, MD, PhD, Breast Center Eastern Switzerland, St. Gallen, Switzerland, share the major topics in systemic therapy that were reviewed as part of the St. Gallen International Breast Cancer Consensus Session 2021. Controversial topics including genetic testing, avoiding anthracycline-based chemotherapy and the use of Ki67 are discussed. This interview took place during the 17th St. Gallen International Breast Cancer Conference.