The management of locally advanced breast cancer and, in some cases, operable node-positive disease, includes neoadjuvant chemotherapy (with or without HER2-targeted therapies), surgery, and locoregional radiotherapy. Pathological complete response to neoadjuvant therapy is considered an important prognostic factor in locally advanced breast cancer, but such prognostic information is primarily relevant in triple-negative breast cancer and HER2-positive subtypes. ^,  In luminal breast cancer, systemic chemotherapy can result in clinical downstaging or clinical response, but pathological complete response is not reached in most cases making the use of this endpoint of questionable value in this subtype. Data from various studies have suggested the value of neoadjuvant endocrine therapy in the ability to achieve a measurable clinical response that is even more pronounced when endocrine agents are combined with a biological agent. ^{,  ,  ,  ,}  Several biomarkers have been investigated in such studies, primarily proliferation markers such as Ki67, suggesting an early effect of neoadjuvant endocrine therapy. ^,  Few studies have compared chemotherapy to combination endocrine therapy with regards to the effects of clinical efficacy and biomarkers in patients with luminal breast cancer. ^, 

中文翻译：

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腔内乳腺癌分子下降分期发生改变的时间到了。

局部晚期乳腺癌的治疗，在某些情况下还包括可手术治疗的淋巴结阳性疾病，包括新辅助化疗（有或没有HER2靶向治疗），手术和局部放疗。对新辅助疗法的病理完全反应被认为是局部晚期乳腺癌的重要预后因素，但此类预后信息主要与三阴性乳腺癌和HER2阳性亚型有关。^， 在管腔型乳腺癌中，全身化疗可导致临床分期降低或临床反应，但在大多数情况下，使用该亚型的可疑数值终点无法达到病理完全反应。来自各种研究的数据表明，新辅助内分泌治疗在实现可测量的临床反应的能力中具有价值，当内分泌药物与生物药物联合使用时，这种作用更加明显。^{，  ，  ，  ，} 的几个生物标记物已被在这样的研究调查，主要是增殖标志物如Ki67的，这表明新辅助内分泌治疗的早期效果。^， 关于腔内乳腺癌患者的临床疗效和生物标志物的影响，很少有研究将化学疗法与联合内分泌疗法进行比较。^，