Fig. 1: Breast cancer neoadjuvant therapy pathway.

a Pre-NAT phase. Breast cancer (BC) is diagnosed following a tumor screening/diagnosis (mammography and/or ultrasound) and biopsy, subsequent histopathology analysis, and a staging breast MRI. These measures help derive demographic, radiological, clinical and histopathological variables describing the patient’s state at diagnosis. cTNM refers to tumor node metastasis. b Mid-NAT phase. The mid-NAT MRI is performed to assess the response and see if therapy adjustments for unresponsive patients. c Post-NAT phase. Breast MRI is used to assess if patients have achieved pathological complete response (pCR). Subsequently, patients undergo surgery, and a histological examination is performed, assessing the post-NAT pathological tumor(ypT) and lymph node staging (ypN) scores (together ypTN)68, which is the international standard for post-neoadjuvant therapy pathology reporting.