PErsonalized TREatment of High-risk MAmmary Cancer - the PETREMAC Trial

Neoadjuvant tamoxifen + goserelin (premenopausal women)

Neoadjuvant letrozole (postmenopausal women)

Neoadjuvant endocrine therapy + palbociclib (if lack of response to endocrine therapy alone)

Neoadjuvant docetaxel + cyclophosphamide

Neoadjuvant docetaxel

Neoadjuvant docetaxel + trastuzumab + pertuzumab

Neoadjuvant docetaxel + cyclophosphamide + trastuzumab + pertuzumab

Neoadjuvant olaparib

Neoadjuvant cyclophosphamide (after 10 weeks of olaparib alone)

Breast conserving surgery or mastectomy + SNB/axillary dissection

Postoperative radiotherapy breast/chest wall + regional lymph nodes

Adjuvant trastuzumab

Adjuvant letrozole (postmenopausal women)

Adjuvant tamoxifen + goserelin (premenopausal women)

Adjuvant palbociclib (if palbociclib given neoadjuvant)

Adjuvant Epirubicin+ Cyclophosphamide