Breast cancer care requires multimodal reasoning across a clinical workflow spanning screening, diagnosis, and treatment planning. However, existing medical MLLMs are typically limited to isolated modalities or narrow task settings, restricting their ability to support workflow-level clinical reasoning. To address this gap, we introduce BreastStage, a workflow-aligned breast imaging instruction corpus containing 1.86M instruction-following pairs from 17 sub-datasets, 5 imaging modalities, and 136 task templates, together with BreastStage-Bench, a benchmark for evaluating multimodal reasoning across the breast cancer care continuum. Built upon this corpus, we propose BreastGPT, a unified MLLM with a dual-branch visual encoder and concept-preserving token compression to bridge standard radiology and gigapixel pathology. On BreastStage-Bench, BreastGPT achieves 75.66% closed-ended accuracy and 89.92% open-ended score, outperforming both general-purpose and medical-specific MLLMs across clinical stages and task formats. Data, code, and model checkpoints are publicly released at https://anonymous.4open.science/w/BreastGPT_io/.

The advancement of LLM agents with tool-use capabilities requires diverse and complex training corpora. Existing data generation methods, which predominantly follow the paradigm of random sampling and shallow generation, often yield simple and homogeneous trajectories that fail to capture complex, implicit logical dependencies. To bridge this gap, we introduce **HardGen**, an automatic agentic pipeline designed to generate hard tool-use training samples. First, HardGen establishes a dynamic API Graph built upon agent failure cases, from which it samples hard tool-execution sequences. Second, these execution sequences are used to reversely build advanced tools that combine multi-step operations into one, which then help generate hard queries requiring unstated intermediate steps. Finally, advanced tools and hard queries drive the generation of Chain-of-Thought (CoT), which is iteratively refined through closed-loop verification feedback. Extensive evaluations demonstrate that a 4B parameter model trained with our curated dataset achieves superior performance compared to several leading open-source and closed-source competitors (e.g., GPT-5.2, Gemini-3-Pro and Claude-Opus-4.5). Our code, models and the curated dataset with 27,000 samples will be open-sourced to facilitate future research.

Volumetric medical VQA requires reasoning over long and redundant 3D visual token sequences, especially in multi-sequence MRI where complementary modalities provide diverse diagnostic cues but expose the decoder to many repeated anatomical regions. To investigate reasoning under multi-sequence visual redundancy, we first introduce BreMRIs-VQA, a clinically curated breast MRI benchmark with 1.19M QA pairs from 71.0K sequences and 12.9K patients, covering both free-text and multiple-choice questions. We further propose SeVeR, a selective visual exposure framework that compresses dense volumes into modality-wise prototypes and retrieves complementary multi-level evidence with change-aware gated attention during decoding, trained with a marginal-utility self-consistency objective that suppresses unhelpful retrieval. Experiments on BreMRIs-VQA and public benchmarks show that SeVeR improves both discriminative and generative performance while exposing substantially fewer visual tokens.