In conclusion, pretreatment and changes in contralateral parenchymal enhancement during neoadjuvant endocrine treatment were associated with PEPI-group in unilateral ER+/HER2− breast cancer patients: a high pretreatment CPE and a decrease in CPE during NET were associated with a poor prognosis after NET on the basis of PEPI. Here, ESR1 is linked to breast carcinoma.