Our finding of an inverse correlation between mast cell abundance and pCR aligns with Reddy et al.‘s observations in inflammatory breast cancer41, where spatial profiling suggested mast cells may promote treatment resistance through multiple mechanisms: suppression of CD8 + T cell activity, amplification of immunosuppressive CD163+ macrophages, and direct stimulation of tumor cell proliferation via both contact-dependent and paracrine signaling. This evidence concerns the gene CD8A and neoplasm.