The standard of care for patients with small, node-negative, HER2+ BC is upfront surgery followed by adjuvant PT, a regimen shown to be effective with a 7-year OS of 95 %.In contrast, for tumors larger than 2 cm or in case of nodal involvement, neoadjuvant systemic therapy is preferred over adjuvant therapy [5,24,25]. This evidence concerns the gene ERBB2 and breast cancer.