So with the absolutely cracked drop rate increase in NMD (I left an ulders cave with 11 legendaries and the rest ancestrals) I managed to gear a blood Lance build to I'd say 75-80% optimal in a few hours last night.

Notes:

Hungering blood is now 100% to split and the modifier is for damage, peak is 98% on 2h.

Blood seekers, Untimely death, sacrificial, grasping veins all scale this.

Massive attack speed for hemorrhage orb tendrils to make a shit ton of orbs the splits spawns so many lances I almost had a seizure.

Health/barrier/fortify is topped off 99% of the time. I.e. more damage less squish.

Crowd killing is effortless. Single target was only slightly inconvenient. Huge attack speed helped get a bunch of orbs off to hit it with multiple lances very quickly.

I'm working on a build planner to share it but the key gear takeaways were:

*attack speed on anything that rolls it. Otherwise: -Willpower, max essence, damage after blood orb, max life helmet -Max lucky hit for essence, Lance ranks, max OP% gloves -blood skill damage, % damage, DR, total armor/another DR chest -right now temerity for pants cus I haven't got a decent set -tendrils ranks, fortify gen, ECR, orb healing boots -max overpower, core skill 2H but I'm looking potentially for a wand for the extra lucky hit essence, regardless the hits are huge -tides of blood ranks on Amulet plus whatever others -overpower and whatever preferences on rings

I just sailed through a t78 like I was in wt2. I'm still playing with what optimal completely looks like for the boards/affixes so once I get it completely mapped I'll post it in here.

TLDR - Lance slaps. Calling S tier now.