Dave Cescon, MD, PhD, Princess Margaret Cancer Centre, Toronto, Canada, discusses the late recurrence of estrogen receptor (ER)-positive breast cancer. Current strategies to overcome late recurrence in this patient population focus on extending endocrine treatment, where a benefit of over 5 years can be observed. Dr Cescon additionally comments on the detection of minimal residual disease (MRD) with circulating tumor DNA (ctDNA) or circulating tumor cells (CTCs) to aid in identifying patients who can benefit from extended therapy, as well as targeted strategies. This interview took place at the European Society for Medical Oncology (ESMO) Breast Cancer 2022 congress in Berlin, Germany.