2024
Patient-reported outcomes, and perceptions and knowledge about recurrence in women with hormone receptor-positive breast cancer
Rosenberg S, Zheng Y, Santos K, Riley E, Meadows H, Snow C, Hughes M, Frank E, Lin N, Partridge A, Winer E, Parsons H. Patient-reported outcomes, and perceptions and knowledge about recurrence in women with hormone receptor-positive breast cancer. Breast Cancer Research And Treatment 2024, 1-8. PMID: 39432162, DOI: 10.1007/s10549-024-07510-8.Peer-Reviewed Original ResearchBreast cancer survivorsEmotional healthBreast cancer risk perceptionBreast cancerCancer risk perceptionCollege degreeInaccurate risk perceptionsHR+ breast cancerLower educational attainmentPatient-reported outcomesRecurrence riskBreast cancer recurrenceRisk perceptionAssociated with overestimationCancer survivorsImprove risk communicationPROMIS AnxietyPopulation normsHormone receptor-positive breast cancerSurveyed patientsReceptor-positive breast cancerGeneral populationRisk overestimationYears post-treatmentLogistic regressionAssociation between mammographic screening history and stage at diagnosis among women with screen-detected breast cancer.
Huang S, Westvold S, Soulos P, Winer E, Robinson T, Dinan M. Association between mammographic screening history and stage at diagnosis among women with screen-detected breast cancer. Journal Of Clinical Oncology 2024, 20: 145-145. DOI: 10.1200/op.2024.20.10_suppl.145.Peer-Reviewed Original ResearchScreen-detected breast cancerBreast cancer mortalityScreening historyScreening mammographyScreening mammogramsCancer mortalityFee-for-service Medicare Parts ABreast cancerBreast cancer-specific mortalityScreening prior to diagnosisNon-Hispanic black raceNegative screening mammogramCohort study of womenFactors associated with increased oddsAssociated with lower riskRetrospective cohort study of womenRoutine screening mammographyMedicare Part AHigh school educationStudy of womenCancer-specific mortalityMultivariate logistic regressionSEER-Medicare databaseClaims-based algorithmSporadic screeningAdjuvant Pertuzumab and Trastuzumab in Early Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer in the APHINITY Trial: Third Interim Overall Survival Analysis With Efficacy Update.
Loibl S, Jassem J, Sonnenblick A, Parlier D, Winer E, Bergh J, Gelber R, Restuccia E, Im Y, Huang C, Dalenc F, Calvo I, Procter M, Caballero C, Clark E, Raimbault A, McConnell R, Monturus E, de Azambuja E, Gomez H, Bliss J, Viale G, Bines J, Piccart M, Aebi S, Andersson M, Bergh J, Bines J, Bliss J, Bonnefoi H, Caballero C, Cameron D, Cardoso F, Clark E, de Azambuja E, de Haas S, Dent S, Fein L, Frank E, Gelber R, Gnant M, Gomez Moreno H, Im S, Jackisch C, Janni W, Jassem J, Krop I, Kümmel S, Liu T, Loi S, Loibl S, Masuda N, Nili Gam-Yal E, Nyawira B, Pascual T, Piccart M, Pienkowski T, Procter M, Restuccia E, Rodríguez-Lescure Á, Suter T, Thomssen C, Tjan-Heijnen V, Tomasello G, Torres Ulloa M, Twelves C, Viale G, Walshe J, Wilcken N, Winer E. Adjuvant Pertuzumab and Trastuzumab in Early Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer in the APHINITY Trial: Third Interim Overall Survival Analysis With Efficacy Update. Journal Of Clinical Oncology 2024, jco2302505. PMID: 39259927, DOI: 10.1200/jco.23.02505.Peer-Reviewed Original ResearchInvasive disease-free survivalNode-negative cohortNode-positive cohortOverall survivalBreast cancerAPHINITY trialHuman epidermal growth factor receptor 2-positiveEpidermal growth factor receptor 2-positiveInvasive disease-free survival benefitHER2+) breast cancerHuman epidermal growth factor receptor 2-positive breast cancerInterim overall survival analysisYears of median follow-upIntent-to-treat populationInterim analysisHormone receptor-negativeDisease-free survivalMedian follow-upPrimary end pointOverall survival analysisAdjuvant pertuzumabAdjuvant trastuzumabReceptor-negativePlacebo groupClinical trial update1817MO Effect of a weight loss intervention (WLI) on exercise behaviors in women with breast cancer: Results from the breast cancer weight loss (BWEL) trial
Ligibel J, Ballman K, mccall L, Goodwin P, Weiss A, Crane T, Irwin M, Thomson C, Hahn O, Spears P, Hershman D, Paskett E, Hopkins J, Bernstein V, Stearns V, White J, Wadden T, Winer E, Carey L, Partridge A. 1817MO Effect of a weight loss intervention (WLI) on exercise behaviors in women with breast cancer: Results from the breast cancer weight loss (BWEL) trial. Annals Of Oncology 2024, 35: s1078. DOI: 10.1016/j.annonc.2024.08.1913.Peer-Reviewed Original ResearchAnalysis of HER2 expression changes from breast primary to brain metastases and the impact of HER2-low expression on overall survival
Pereslete A, Hughes M, Martin A, Files J, Nguyen K, Buckley L, Patel A, Moore A, Winer E, Dillon D, Li T, Tolaney S, Lin N, Sammons S. Analysis of HER2 expression changes from breast primary to brain metastases and the impact of HER2-low expression on overall survival. Neuro-Oncology 2024, noae163. PMID: 39211994, DOI: 10.1093/neuonc/noae163.Peer-Reviewed Original ResearchHER2-low expressionHER2-lowMetastatic breast cancerHER2-positiveHER2 expressionHER2-0Primary tumorBrain metastasesEstrogen receptorBreast cancerHER2-positive primary tumorsASCO-CAP guidelinesNCI-designated centersMultivariate survival analysisCox proportional hazards modelsAntibody-drug conjugatesProportional hazards modelActive antibody-drug conjugateASCO-CAPHER2 gainHER2 statusInferior survivalOverall survivalIntracranial activityRetrospective analysisBarriers to and facilitators of improving physical activity and nutrition behaviors during chemotherapy for breast cancer: a sequential mixed methods study
Puklin L, Irwin M, Sanft T, Ferrucci L, Harrigan M, McGowan C, Cartmel B, Zupa M, Winer E, Deyling M, Ligibel J, Basen-Engquist K, Spiegelman D, Sharifi M. Barriers to and facilitators of improving physical activity and nutrition behaviors during chemotherapy for breast cancer: a sequential mixed methods study. Supportive Care In Cancer 2024, 32: 590. PMID: 39141176, DOI: 10.1007/s00520-024-08789-5.Peer-Reviewed Original ResearchConceptsPhysical activityLifestyle interventionSelf-reported PA questionnaireSelf-reported diet qualityBreast cancerHealthy Eating Index-2015Stage I-III breast cancerBenefits of PASequential mixed methods studyI-III breast cancerChemotherapy-related symptomsMixed methods studyThematic content analysisBehavioral goalsSense of controlBody mass indexPA questionnaireSemi-structured interviewsMean body mass indexTranscribed verbatimIntervention armTailored educationDiet qualityNutritional behaviorMental benefitsSecond primary non-breast cancers in young breast cancer survivors
Zhang B, Brantley K, Rosenberg S, Kirkner G, Collins L, Ruddy K, Tamimi R, Schapira L, Borges V, Warner E, Come S, Winer E, Bellon J, Partridge A. Second primary non-breast cancers in young breast cancer survivors. Breast Cancer Research And Treatment 2024, 207: 587-597. PMID: 38858235, DOI: 10.1007/s10549-024-07400-z.Peer-Reviewed Original ResearchPrimary non-breast cancerNon-breast cancerSubdistribution hazard ratiosYoung breast cancer survivorsStage 0-III BCBreast cancer survivorsConfidence intervalsGray subdistribution hazard modelRisk factorsMedical record reviewPrimary BCBreast cancerCumulative incidenceBC survivorsCancer survivorsYoung breast cancerSubdistribution hazard modelPrimary tumor characteristicsMedian follow-upRecord reviewType of malignancyGermline geneticsHazard ratioLong-term surveillancePatient factorsHelping ourselves, helping others: the Young Women’s Breast Cancer Study (YWS) – a multisite prospective cohort study to advance the understanding of breast cancer diagnosed in women aged 40 years and younger
Rosenberg S, Zheng Y, Ruddy K, Poorvu P, Snow C, Kirkner G, Meyer M, Tamimi R, Schapira L, Peppercorn J, Come S, Borges V, Warner E, Gelber S, Collins L, Winer E, Partridge A. Helping ourselves, helping others: the Young Women’s Breast Cancer Study (YWS) – a multisite prospective cohort study to advance the understanding of breast cancer diagnosed in women aged 40 years and younger. BMJ Open 2024, 14: e081157. PMID: 38951008, PMCID: PMC11218027, DOI: 10.1136/bmjopen-2023-081157.Peer-Reviewed Original ResearchConceptsYoung Women's Breast Cancer StudyMultisite prospective cohort studyBreast Cancer StudyProspective cohort studyStage 0-IV breast cancerBreast cancerCohort studyOlder womenDied of breast cancerFear of recurrencePatient-reported outcome dataYoung womenCancer studiesClinical data abstractionPost-traumatic stressQuality of lifeImprove careFollow-upPsychosocial outcomesYoung survivorsCommunity sitesBiospecimen collectionUnderstudied populationData abstractionOutcome dataSecond Primary Breast Cancer in Young Breast Cancer Survivors
Brantley K, Rosenberg S, Collins L, Ruddy K, Tamimi R, Schapira L, Borges V, Warner E, Come S, Zheng Y, Kirkner G, Snow C, Winer E, Partridge A. Second Primary Breast Cancer in Young Breast Cancer Survivors. JAMA Oncology 2024, 10: 718-725. PMID: 38602683, PMCID: PMC11009864, DOI: 10.1001/jamaoncol.2024.0286.Peer-Reviewed Original ResearchGenetic testingYoung Women's Breast Cancer StudyYoung breast cancer survivorsBreast cancerBreast cancer survivorsYoung BC survivorsPrimary breast cancerGermline genetic testingIII BCMedical record reviewBreast Cancer StudyGermline pathogenic variantsPathogenic variantsBC survivorsTreatment decision-makingCancer survivorsFine-Gray subdistribution hazard modelCumulative incidencePV carriersSubdistribution hazard modelStage 0Patient surveyCharacterize risk factorsUnilateral mastectomyPrimary BCOutcomes with trastuzumab deruxtecan (T-DXd) by HER2 status and line of treatment in a large real-world database of patients with metastatic breast cancer.
Tarantino P, Lee D, Foldi J, Soulos P, Gross C, Grinda T, Winer E, Lin N, Krop I, Tolaney S, Lustberg M, Sammons S. Outcomes with trastuzumab deruxtecan (T-DXd) by HER2 status and line of treatment in a large real-world database of patients with metastatic breast cancer. Journal Of Clinical Oncology 2024, 42: 1077-1077. DOI: 10.1200/jco.2024.42.16_suppl.1077.Peer-Reviewed Original ResearchReal-world progression-free survivalLines of therapyMetastatic breast cancerMedian real-world progression-free survivalT-DXdHER2+Overall survivalHER2-lowHER2- patientsBreast cancerHER2- metastatic breast cancerTreat metastatic breast cancerProgression-free survivalKaplan-Meier methodLines of treatmentDatabase of patientsRetrospective observational studyClinical trial settingHER2 casesIHC 0Trastuzumab deruxtecanHR statusHER2 statusTriple-negativeMedian ageTBCRC 048 (olaparib expanded) expansion cohorts: Phase 2 study of olaparib monotherapy in patients (pts) with metastatic breast cancer (MBC) with germline (g) mutations in PALB2 or somatic (s) mutations in BRCA1 or BRCA2.
Tung N, Robson M, Nanda R, Li T, Vinayak S, Shah P, Khoury K, Kimmick G, Santa-Maria C, Brufsky A, DeMeo M, Vieira J, Carey L, Wulf G, Domchek S, Krop I, Wolff A, Winer E, Garber J. TBCRC 048 (olaparib expanded) expansion cohorts: Phase 2 study of olaparib monotherapy in patients (pts) with metastatic breast cancer (MBC) with germline (g) mutations in PALB2 or somatic (s) mutations in BRCA1 or BRCA2. Journal Of Clinical Oncology 2024, 42: 1021-1021. DOI: 10.1200/jco.2024.42.16_suppl.1021.Peer-Reviewed Original ResearchProgression-free survivalDuration of responseMetastatic breast cancerClinical benefit rateTriple-negative breast cancerMedian duration of responseMedian progression-free survivalMutant allele frequencyExpansion cohortHER2-negativeHER2-positiveCohort 2aNon-respondersBreast cancerEarly due to slow enrollmentMetastatic chemotherapy regimensResponse to olaparibPhase 2 studyPhase II trialKaplan-Meier methodPredictors of responseCohort of womenWilcoxon rank sum testRank sum testBRCA1mCorrelation of stress, depression, sleep, and pain with race and body mass index (BMI): Secondary analysis from Alliance A011502.
Gandhi S, Ballman K, Holmes M, Visvanathan K, Symington B, Carvan M, Matyka C, Weiss A, Winer E, Razaq W, Carey L, Partridge A, Chen W. Correlation of stress, depression, sleep, and pain with race and body mass index (BMI): Secondary analysis from Alliance A011502. Journal Of Clinical Oncology 2024, 42: e23171-e23171. DOI: 10.1200/jco.2024.42.16_suppl.e23171.Peer-Reviewed Original ResearchPittsburgh Sleep Quality IndexPerceived Stress ScaleBrief Pain InventoryBody mass indexCESD-REpidemiologic Studies Depression Scale-RevisedCenter for Epidemiologic Studies Depression Scale-RevisedModerate/severe painBlack womenPoor sleepSleep qualityCESD-R scoresPerceived Stress Scale scoresAssociated with higher stressPittsburgh Sleep Quality Index scoreNonmetastatic breast cancerAssociation of stressSleep Quality IndexBreast cancerAssociated with worse clinical outcomesStatistically significant associationNo depressionBrief Pain Inventory scoresOutcome disparitiesChi-square testPrevalence and dynamics of circulating tumor DNA (ctDNA) among patients (pts) with HER2+ breast cancer (BC) receiving neoadjuvant paclitaxel/trastuzumab/pertuzumab (THP) in the DAPHNe trial.
Waks A, Tarantino P, Li T, Ogayo E, Rahman T, DiLullo M, El-Refai S, Abbott C, Boyle S, Chen R, Desai N, Spring L, Tung N, King T, Krop I, Tayob N, Mittendorf E, Tolaney S, Winer E, Parsons H. Prevalence and dynamics of circulating tumor DNA (ctDNA) among patients (pts) with HER2+ breast cancer (BC) receiving neoadjuvant paclitaxel/trastuzumab/pertuzumab (THP) in the DAPHNe trial. Journal Of Clinical Oncology 2024, 42: 588-588. DOI: 10.1200/jco.2024.42.16_suppl.588.Peer-Reviewed Original ResearchMinimal residual diseaseResidual cancer burdenBreast cancerResidual diseaseDynamics of circulating tumor DNAMinimal residual disease dataRCB 0RCB IIResidual cancer burden-IDetect minimal residual diseaseQuantify minimal residual diseaseResidual cancer burden scoreHER2+ breast cancerAdjuvant systemic therapyClinical stage IINode-negative tumorsHER2 + BCMedian follow-upPlasma samplesBreast cancer recurrenceImmediately post-operativelyLong-term outcomesAssociated with elevated riskCtDNA-positiveT3/T4 tumorsAssociation of higher baseline stress and pain with clinical outcomes: Secondary analysis from Alliance A011502.
Gandhi S, Ballman K, Holmes M, Visvanathan K, Symington B, Carvan M, Matyka C, Weiss A, Winer E, Razaq W, Carey L, Partridge A, Chen W. Association of higher baseline stress and pain with clinical outcomes: Secondary analysis from Alliance A011502. Journal Of Clinical Oncology 2024, 42: 11016-11016. DOI: 10.1200/jco.2024.42.16_suppl.11016.Peer-Reviewed Original ResearchInvasive disease-free survivalBrief Pain InventoryPerceived Stress ScaleOverall survivalPittsburgh Sleep Quality IndexMultivariate Cox modelClinical outcomesBreast cancerCESD-RClinical trialsAssociated with worse clinical outcomesDouble-blind clinical trialCox modelBrief Pain Inventory scoresHormone receptor statusDisease-free survivalEpidemiologic Studies Depression Scale-RevisedCenter for Epidemiologic Studies Depression Scale-RevisedHigher Perceived Stress ScaleBody mass indexNonmetastatic breast cancerSleep qualityCESD-R scoresPerceived Stress Scale scoresPittsburgh Sleep Quality Index scoreAspirin vs Placebo as Adjuvant Therapy for Breast Cancer
Chen W, Ballman K, Partridge A, Hahn O, Briccetti F, Irvin W, Symington B, Visvanathan K, Pohlmann P, Openshaw T, Weiss A, Winer E, Carey L, Holmes M. Aspirin vs Placebo as Adjuvant Therapy for Breast Cancer. JAMA 2024, 331: 1714-1721. PMID: 38683596, PMCID: PMC11059055, DOI: 10.1001/jama.2024.4840.Peer-Reviewed Original ResearchSurvivors of breast cancerInvasive disease-free survival eventsDisease-free survival eventsNonmetastatic breast cancerBreast cancer recurrenceBreast cancerFollow-upRisk of breast cancer recurrenceHazard ratioInvasive cancer eventOverall survivalPrevent breast cancer recurrenceCancer recurrenceBreast cancer survivalInvasive disease-free survivalRates of grade 3Adjuvant breast cancer treatmentTrial of aspirinSurvival eventsDisease-free survivalMedian follow-upDouble-blind trialDaily aspirin therapyStudies of aspirinBreast cancer treatment6th and 7th International consensus guidelines for the management of advanced breast cancer (ABC guidelines 6 and 7)
Cardoso F, Paluch-Shimon S, Schumacher-Wulf E, Matos L, Gelmon K, Aapro M, Bajpai J, Barrios C, Bergh J, Bergsten-Nordström E, Biganzoli L, Cardoso M, Carey L, Mac Gregor M, Chidebe R, Cortés J, Curigliano G, Dent R, Saghir N, Eniu A, Fallowfield L, Francis P, Millan S, Gilchrist J, Gligorov J, Gradishar W, Haidinger R, Harbeck N, Hu X, Kaur R, Kiely B, Kim S, Koppikar S, Kuper-Hommel M, Lecouvet F, Mason G, Mertz S, Mueller V, Myerson C, Neciosup S, Offersen B, Ohno S, Pagani O, Partridge A, Penault-Llorca F, Prat A, Rugo H, Senkus E, Sledge G, Swain S, Thomssen C, Vorobiof D, Vuylsteke P, Wiseman T, Xu B, Costa A, Norton L, Winer E. 6th and 7th International consensus guidelines for the management of advanced breast cancer (ABC guidelines 6 and 7). The Breast 2024, 76: 103756. PMID: 38896983, PMCID: PMC11231614, DOI: 10.1016/j.breast.2024.103756.Peer-Reviewed Original ResearchAdvanced breast cancerLevel of evidenceInternational consensus guidelinesBreast cancerConsensus guidelinesGrading of RecommendationsConsensus conferenceHighest level of evidenceManagement of advanced breast cancerBreast cancer subtypesInternational Consensus ConferencePercentage of consensusTreatment algorithmCancer subtypesSupportive careGuidelinesExpert opinionGlobal AllianceCancerPatientsManagement optionsRecommendationsCareHigher levelsConsensusContribution of tumour and immune cells to PD‐L1 expression as a predictive biomarker in metastatic triple‐negative breast cancer: exploratory analysis from KEYNOTE‐119
Cortes J, Winer E, Lipatov O, Im S, Gonçalves A, Muñoz‐Couselo E, Lee K, Schmid P, Tamura K, Testa L, Witzel I, Ohtani S, Hund S, Kulangara K, Karantza V, Mejia J, Ma J, Jelinic P, Huang L, Pruitt S, Emancipator K. Contribution of tumour and immune cells to PD‐L1 expression as a predictive biomarker in metastatic triple‐negative breast cancer: exploratory analysis from KEYNOTE‐119. The Journal Of Pathology Clinical Research 2024, 10: e12371. PMID: 38627977, PMCID: PMC11021797, DOI: 10.1002/2056-4538.12371.Peer-Reviewed Original ResearchConceptsMetastatic triple-negative breast cancerPD-L1 expressionTriple-negative breast cancerPD-L1 CPSPD-L1Breast cancerTreated metastatic triple-negative breast cancerIncreased programmed death ligand 1PD-L1 IHC 22C3 pharmDxEfficacy of pembrolizumab monotherapyPD-L1 expression assessmentProgrammed death-1 blockadeExpression of PD-L1Objective response rateProgression-free survivalTumor proportion scoreDeath-ligand 1Contribution of tumorImmune cell densityReceiver operating characteristic curveArea under the receiver operating characteristic curvePredictive of responsePembrolizumab monotherapyOverall survivalUniform scoring systemMortality Risks Over 20 Years in Men With Stage I to III Hormone Receptor–Positive Breast Cancer
Leone J, Hassett M, Freedman R, Tolaney S, Graham N, Tayob N, Vallejo C, Winer E, Lin N, Leone J. Mortality Risks Over 20 Years in Men With Stage I to III Hormone Receptor–Positive Breast Cancer. JAMA Oncology 2024, 10: 508-515. PMID: 38421673, PMCID: PMC10905378, DOI: 10.1001/jamaoncol.2023.7194.Peer-Reviewed Original ResearchBreast cancer-specific mortalityRisk of breast cancer-specific mortalityBreast cancer-specific mortality riskHR+ breast cancerBreast cancerStage I to III hormone receptor-positive breast cancerEnd Results ProgramPopulation-based dataHormone receptor-positive (HR+) breast cancerCancer-specific mortalityObservational cohort studyResults ProgramRisk of late mortalityHigher stages of diseaseHormone receptor-positive breast cancerReceptor-positive breast cancerMortality riskCohort studyRisk of distant recurrenceStage IIICumulative riskStage IIMultivariate regressionMedian follow-upGrade I tumorsEndocrine-Sensitive Disease Rate in Postmenopausal Patients With Estrogen Receptor–Rich/ERBB2-Negative Breast Cancer Receiving Neoadjuvant Anastrozole, Fulvestrant, or Their Combination
X. C, Suman V, Sanati S, Vij K, Anurag M, Leitch A, Unzeitig G, Hoog J, Fernandez-Martinez A, Fan C, Gibbs R, Watson M, Dockter T, Hahn O, Guenther J, Caudle A, Crouch E, Tiersten A, Mita M, Razaq W, Hieken T, Wang Y, Rimawi M, Weiss A, Winer E, Hunt K, Perou C, Ellis M, Partridge A, Carey L. Endocrine-Sensitive Disease Rate in Postmenopausal Patients With Estrogen Receptor–Rich/ERBB2-Negative Breast Cancer Receiving Neoadjuvant Anastrozole, Fulvestrant, or Their Combination. JAMA Oncology 2024, 10: 362-371. PMID: 38236590, PMCID: PMC10797521, DOI: 10.1001/jamaoncol.2023.6038.Peer-Reviewed Original ResearchConceptsNeoadjuvant endocrine therapyBreast cancerWeek 4Neoadjuvant chemotherapyPostmenopausal womenPAM50 subtypesNonluminal tumorsClinical stage II to IIIRate of pathological complete responseClinical trialsHER2)-negative breast cancerPhase 3 randomized clinical trialLuminal B tumorsPathological complete responseLuminal A tumorsEarly-stage diseaseRandomized clinical trialsStage II to IIIAnastrozole armNeoadjuvant anastrozoleTumor Ki67Postmenopausal patientsB tumorsComplete responseA tumorsHER2 heterogeneity and treatment response-associated profiles in HER2-positive breast cancer in the NCT02326974 clinical trial
Li Z, Filho O, Viale G, dell'Orto P, Russo L, Goyette M, Kamat A, Yardley D, Abramson V, Arteaga C, Spring L, Chiotti K, Halsey C, Waks A, King T, Lester S, Bellon J, Winer E, Spellman P, Krop I, Polyak K. HER2 heterogeneity and treatment response-associated profiles in HER2-positive breast cancer in the NCT02326974 clinical trial. Journal Of Clinical Investigation 2024, 134: e176454. PMID: 38300710, PMCID: PMC10977978, DOI: 10.1172/jci176454.Peer-Reviewed Original ResearchPathological complete responseHER2-positive breast cancerHER2 heterogeneityBreast cancerEarly-stage HER2-positive breast cancerHER2-targeted therapyPre-treatment tumorsErbB signalingHER2-targeted antibodiesBasal-like featuresHER2 protein levelsStratification of patientsNational Cancer InstituteNeoadjuvant trialsComplete responseResidual tumorT-DM1Copy number heterogeneityTrastuzumab emtansineERBB2 mRNAImmune infiltrationDownstream pathway componentsClinical challengeClinical trialsTumor