A multivariate Cox regression model confirmed that ctDNA positivity after NAT (HR, 5.505; 95% CI, 1.950–15.540; P = 0.001) was an independent prognostic factor for predicting recurrence after incorporating residual tumor size, lymph node status at surgery, pCR status, adjuvant anti-HER2 regimen, and ctDNA positivity after NAT. Here, ERBB2 is linked to neoplasm.