Our current population-based real-world findings are particularly timely in light of the recently published KEYNOTE-756 (KN756) [33] and CheckMate 7FL [34] trials, both of which demonstrated the benefit of adding pembrolizumab to neoadjuvant chemotherapy in high-risk, ER-positive /HER2-negative breast cancer. This evidence concerns the gene ESR1 and breast carcinoma.