Risk category is defined as follows:~Low risk:~Baseline Ki67 ≤ 10% (OR)~Luminal A molecular intrinsic subtype by PAM50~High risk:~Non-Luminal A molecular intrinsic subtype by PAM50 (OR)~In cases of non-diagnostic PAM50 molecular intrinsic subtype, patients will enroll in the high-risk group and undergo Week 4 tumor biopsy.
This study aims to utilize a novel biomarker-driven approach to guide neoadjuvant treatment selection. It is the hypothesis that this will improve clinical response for postmenopausal women with clinical stage II/III ER-positive, HER2-negative breast cancer and identify those who may not require neoadjuvant chemotherapy, with a primary focus on outcomes in Black patients.