Cardoso F, Kyriakides S, Ohno S, Penault-Llorca F, Poortmans P, Rubio IT, Zackrisson S, Senkus E, Guidelines Committee ESMO (2019) Early breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 30(8):1194–1220. https://doi.org/10.1093/annonc/mdz173

Article  CAS  PubMed  Google Scholar 

Cardoso F, Spence D, Mertz S, Corneliussen-James D, Sabelko K, Gralow J, Cardoso MJ, Peccatori F, Paonessa D, Benares A, Sakurai N, Beishon M, Barker SJ, Mayer M (2018) Global analysis of advanced/metastatic breast cancer: decade report (2005–2015). Breast 39:131–138. https://doi.org/10.1016/j.breast.2018.03.002

Article  PubMed  Google Scholar 

Korde LA, Somerfield MR, Carey LA, Crews JR, Denduluri N, Hwang ES, Khan SA, Loibl S, Morris EA, Perez A, Regan MM, Spears PA, Sudheendra PK, Symmans WF, Yung RL, Harvey BE, Hershman DL (2021) Neoadjuvant chemotherapy, endocrine therapy, and targeted therapy for breast cancer: ASCO guideline. J Clin Oncol 39(13):1485–1505. https://doi.org/10.1200/JCO.20.03399

Article  CAS  PubMed  PubMed Central  Google Scholar 

Loi S (2019) The ESMO clinical practise guidelines for early breast cancer: diagnosis, treatment and follow-up: on the winding road to personalized medicine. Ann Oncol 30(8):1183–1184. https://doi.org/10.1093/annonc/mdz201

Article  CAS  PubMed  Google Scholar 

Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) (2018) Long-term outcomes for neoadjuvant versus adjuvant chemotherapy in early breast cancer: meta-analysis of individual patient data from ten randomised trials. Lancet Oncol 19(1):27–39. https://doi.org/10.1016/S1470-2045(17)30777-5

Article  Google Scholar 

von Minckwitz G, Untch M, Blohmer JU, Costa SD, Eidtmann H, Fasching PA, Gerber B, Eiermann W, Hilfrich J, Huober J, Jackisch C, Kaufmann M, Konecny GE, Denkert C, Nekljudova V, Mehta K, Loibl S (2012) Definition and impact of pathologic complete response on prognosis after neoadjuvant chemotherapy in various intrinsic breast cancer subtypes. J Clin Oncol 30:1796–1804. https://doi.org/10.1200/JCO.2011.38.8595

Article  Google Scholar 

Pasha N, Turner NC (2021) Understanding and overcoming tumor heterogeneity in metastatic breast cancer treatment. Nat Cancer 2(7):680–692. https://doi.org/10.1038/s43018-021-00229-1

Article  CAS  PubMed  Google Scholar 

Fayanju OM, Ren Y, Thomas SM, Greenup RA, Plichta JK, Rosenberger LH, Tamirisa N, Force J, Boughey JC, Hyslop T, Hwang ES (2018) The clinical significance of breast-only and node-only pathologic complete response (pCR) after neoadjuvant chemotherapy (NACT): a review of 20,000 breast cancer patients in the National Cancer Data Base (NCDB). Ann Surg 268(4):591–601. https://doi.org/10.1097/SLA.0000000000002953

Article  PubMed  Google Scholar 

Cortazar P, Zhang L, Untch M, Mehta K, Costantino JP, Wolmark N, Bonnefoi H, Cameron D, Gianni L, Valagussa P, Swain SM, Prowell T, Loibl S, Wickerham DL, Bogaerts J, Baselga J, Perou C, Blumenthal G, Blohmer J, Mamounas EP, Bergh J, Semiglazov V, Justice R, Eidtmann H, Paik S, Piccart M, Sridhara R, Fasching PA, Slaets L, Tang S, Gerber B, Geyer CE Jr, Pazdur R, Ditsch N, Rastogi P, Eiermann W, von Minckwitz G (2014) Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis. Lancet 384(9938):164–172. https://doi.org/10.1016/S0140-6736(13)62422-8

Article  PubMed  Google Scholar 

Hassett MJ, Li H, Burstein HJ, Punglia RS (2020) Neoadjuvant treatment strategies for HER2-positive breast cancer: cost-effectiveness and quality of life outcomes. Breast Cancer Res Treat 181(1):43–51. https://doi.org/10.1007/s10549-020-05587-5

Article  CAS  PubMed  Google Scholar 

Valachis A, Mamounas EP, Mittendorf EA, Hayashi N, Ishitobi M, Natoli C, Fitzal F, Rubio IT, Tiezzi DG, Shin HC, Anderson SJ, Hunt KK, Matsuda N, Ohsumi S, Totomi A, Nilsson C (2018) Risk factors for locoregional disease recurrence after breast-conserving therapy in patients with breast cancer treated with neoadjuvant chemotherapy: an international collaboration and individual patient meta-analysis. Cancer 124:2923–2930. https://doi.org/10.1002/cncr.31518

Article  CAS  PubMed  Google Scholar 

Cardoso F, Paluch-Shimon S, Senkus E, Curigliano G, Aapro MS, André F, Barrios CH, Bergh J, Bhattacharyya GS, Biganzoli L, Boyle F, Cardoso MJ, Carey LA, Cortés J, El Saghir NS, Elzayat M, Eniu A, Fallowfield L, Francis PA, Gelmon K, Gligorov J, Haidinger R, Harbeck N, Hu X, Kaufman B, Kaur R, Kiely BE, Kim SB, Lin NU, Mertz SA, Neciosup S, Offersen BV, Ohno S, Pagani O, Prat A, Penault-Llorca F, Rugo HS, Sledge GW, Thomssen C, Vorobiof DA, Wiseman T, Xu B, Norton L, Costa A, Winer EP (2020) 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5). Ann Oncol 31:1623–1649. https://doi.org/10.1016/j.annonc.2020.09.010

Article  CAS  PubMed  Google Scholar 

Schlam I, Dower J, Lynce F (2024) Addressing residual disease in HER2-positive and triple-negative breast cancer: what is next? Curr Oncol Rep 26(4):336–345. https://doi.org/10.1007/s11912-024-01501-0

Article  PubMed  Google Scholar 

Shaaban AM, Provenzano E (2022) Receptor status after neoadjuvant therapy of breast cancer: significance and implications. Pathobiology 89(5):297–308. https://doi.org/10.1159/000521880

Article  CAS  PubMed  Google Scholar 

Rey-Vargas L, Mejia-Henao JC, Sanabria-Salas MC, Serrano-Gomez SJ (2020) Effect of neoadjuvant therapy on breast cancer biomarker profile. BMC Cancer 20:675. https://doi.org/10.1186/s12885-020-07179-4

Article  CAS  PubMed  PubMed Central  Google Scholar 

Xian Z, Quinones AK, Tozbikian G, Zynger DL (2017) Breast cancer biomarkers before and after neoadjuvant chemotherapy: does repeat testing impact therapeutic management? Hum Pathol 62:215–221. https://doi.org/10.1016/j.humpath.2016.12.019

Article  CAS  PubMed  Google Scholar 

Coiro S, Gasparini E, Falco G, Santandrea G, Foroni M, Besutti G, Iotti V, Di Cicilia R, Foroni M, Mele S, Ferrari G, Bisagni G, Ragazzi M (2021) Biomarkers changes after neoadjuvant chemotherapy in breast cancer: a seven-year single institution experience. Diagnostics (Basel) 11(12):2249. https://doi.org/10.3390/diagnostics11122249

Article  CAS  PubMed  Google Scholar 

Ellis IO, Rakha E, Pinder S (2016) Pathology reporting of breast disease in surgical excision specimens incorporating the dataset for histological reporting of breast cancer. Royal College Pathologists, pp 89–95

Google Scholar 

WHO Classification of Tumours Editorial Board (2019) Breast tumours. WHO classification of tumors series, vol 2, 5th edn. International Agency for Research on Cancer, Lyon

Google Scholar 

Salgado R, Denkert C, Demaria S, Sirtaine N, Klauschen F, Pruneri G, Wienert S, Van den Eynden G, Baehner FL, Penault-Llorca F, Perez EA, Thompson EA, Symmans WF, Richardson AL, Brock J, Criscitiello C, Bailey H, Ignatiadis M, Floris G, Sparano J, Kos Z, Nielsen T, Rimm DL, Allison KH, Reis-Filho JS, Loibl S, Sotiriou C, Viale G, Badve S, Adams S, Willard-Gallo K, Loi S (2015) The evaluation of tumor-infiltrating lymphocytes (TILs) in breast cancer: recommendations by an International TILs Working Group 2014. Ann Oncol 26(2):259–271. https://doi.org/10.1093/annonc/mdu450

Article  CAS  PubMed  Google Scholar 

Bankhead P, Loughrey MB, Fernández JA, Dombrowski Y, McArt DG, Dunne PD, McQuaid S, Gray RT, Murray LJ, Coleman HG, James JA, Salto-Tellez M, Hamilton PW (2017) QuPath: open source software for digital pathology image analysis. Sci Rep 7(1):16878. https://doi.org/10.1038/s41598-017-17204-5

Article  CAS  PubMed  PubMed Central  Google Scholar 

Ai X, Liao X, Wang M, Hu Y, Li J, Zhang Y, Tang P, Jiang J (2020) Prognostic value of lymph node ratio in breast cancer patients with adequate pathologic evidence after neoadjuvant chemotherapy. Med Sci Monit 26:e922420. https://doi.org/10.12659/MSM.922420

Article  PubMed  PubMed Central  Google Scholar 

Mrkonjic M, Berman HK, Done SJ, Youngson B, Mulligan AM (2019) Breast specimen handling and reporting in the post-neoadjuvant setting: challenges and advances. J Clin Pathol 72(2):120–132. https://doi.org/10.1136/jclinpath-2018-205598

Article  CAS  PubMed  Google Scholar 

Therneau T, Atkinson B (2022) rpart: recursive partitioning and regression trees. R package version 4.1.19, https://CRAN.R-project.org/package=rpart

R Core Team (2021) R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna

Google Scholar 

Therneau T (2024) A package for survival analysis in R. R package version 3.6–4. https://CRAN.R-project.org/package=survival

Wickham H (2016) ggplot2: elegant graphics for data analysis. Springer-Verlag, New York

Book  Google Scholar 

Harbeck N, Penault-Llorca F, Cortes J, Gnant M, Houssami N, Poortmans P, Ruddy K, Tsang J, Cardoso F (2019) Breast cancer. Nat Rev Dis Primers 5(1):66. https://doi.org/10.1038/s41572-019-0111-2

Article  PubMed  Google Scholar 

Davey MG, Hynes SO, Kerin MJ, Miller N, Lowery AJ (2021) Ki-67 as a prognostic biomarker in invasive breast cancer. Cancers (Basel) 13(17):4455. https://doi.org/10.3390/cancers13174455

Article  CAS  PubMed  Google Scholar 

Moldoveanu D, Hoskin TL, Day CN, Schulze AK, Goetz MP, Boughey JC (2024) Nodal pCR and overall survival following neoadjuvant chemotherapy for node positive ER+/Her2− breast cancer. Breast Cancer Res Treat 203(3):419–428. https://doi.org/10.1007/s10549-023-07152-2