Somatic mutation analysis revealed alterations in <i>TP53</i> (p.Gly199Ter), NF1 (p.Phe1593SerfsTer31), and <i>PIK3CA</i> (p.Glu542Lys), all supported by OncoKB level-1 evidence.<h4>Discussion</h4>This case highlights the potential of integrating precision oncology for TNBC patients undergoing NAC by identifying inherited cancer risks, detecting actionable mutations, and developing personalized neoantigen-based immunotherapies. The gene discussed is PIK3CA; the disease is cancer.