ERBB2 and breast carcinoma: Current guidelines recommend treatment with neoadjuvant therapy (NAT) primarily for node-positive or high-risk node-negative patients, while stage I disease is generally managed with upfront surgery.3 This approach is echoed in the article, “trends in the management of small HER2 positive breast cancers,” which highlights treatment patterns among patients with cT1N0 breast cancer.4 The use of NAT rose from 7.1% in 2018 to a peak of 30.2% in 2021, before declining to 9.1% in 2022.