It has been argued that the pluripotent ES cell state represents a metastable ground state in which a fluid transcriptome allows for its multilineage potential. It may also be pertinent to understanding pathological states of disordered cell differentiation as in cancer. Neoadjuvant treatment is a well-established treatment approach for locally advanced breast cancer. While, in early operable breast cancer, NAT shows equivocal efficacy compared with adjuvant therapy. A putative advantage of effective NAT could significantly increase the breast conserving surgery rate and also provide prognostic information. This would guide subsequent individual treatment, because patients achieving pathological complete remission after NAT have more favorable outcomes than those without pCR. Several different subtypes of breast cancer, including luminal A, luminal B, HER2+, basal like, and normal breast like subtype, have been identified by microarray data. Immunohistochemical status of SW033291 estrogen CX-6258 hydrochloride hydrate receptor, progesterone receptor, HER2, and Ki67, has been adapted to construct molecular breast cancer subtype which can be used to make therapeutic choices. Regarding NAT and patients with triple negative breast cancer, defined as ER-/PgR-/HER2-, such patients have a higher pCR rate than non-TNBC patients, while those TNBC patients who fail to achieve pCR after NAT have a poor prognosis. The Collaborative Trials in Neoadjuvant Breast Cancer working group has embarked upon a large meta-analysis, including more than 12,000 patients enrolled in published trials, to evaluate the relationship between pCR and patient��s outcome. Importantly, this study demonstrated that pCR is most likely to predict clinical benefit in TNBC and HER2 positive breast cancer patients. Furthermore, Food and Drug Administration has made an agreement to use pCR as an endpoint for accelerated new drug approval in high risk early breast cancer, leading to the approval of pertuzumab in NAT of HER2+ breast cancer. At present, the standard NAT regimen for TNBC usually includes 4�C8 cycles of taxanes and anthracyclines. Integrating anti-HER2 agents into NAT has nearly doubled the pCR rate compared with chemotherapy alone in HER2+ breast cancer patients.