This practice pattern is consistent with data suggesting increased response rates to NAC in tumors with higher Ki67.29 Additionally, we previously found that younger age and larger tumor size were significantly associated with receipt of preoperative systemic therapy in patients with ILC in the National Cancer Database.30 However, the absence of a relationship between grade, pleomorphic status, and nodal status with receiving NAC in this HR positive HER-2 negative population may reflect the lack of clear indicators of benefit from NAC in this patient population. The gene discussed is MKI67; the disease is neoplasm.