Fig. 1

CONSORT diagram. Patients with HER2-positive breast cancer who received neoadjuvant therapy across five hospitals were assessed for eligibility. Breast magnetic resonance imaging (MRI) was performed at baseline, after every two cycles of neoadjuvant therapy, and prior to surgery. Early response was evaluated after the first two cycles of docetaxel plus carboplatin and trastuzumab (TCbH) treatment according to the Response Evaluation Criteria in Solid Tumours (RECIST) version 1.1. Responders continued with an additional four cycles of TCbH treatment (cohort A). Non-responders were further divided into cohorts B and C based on their preferences. Cohort B received four more cycles of neoadjuvant TCbH treatment, and cohort C received TCbH combined with oral pyrotinib for four cycles