Pyrotinib Combined With Trastuzumab, Dalpiciclib, Letrozole Versus TCbHP (Trastuzumab Plus Pertuzumab With Docetaxel and Carboplatin) as Neoadjuvant Treatment in HR +/HER2 + Breast Cancer

This study compares two pre-surgery (neoadjuvant) treatment regimens in women with hormone receptor–positive AND HER2-positive breast cancer. One regimen uses targeted oral drugs (pyrotinib, trastuzumab, dalpiciclib, letrozole); the other uses standard IV chemotherapy plus dual HER2 blockade. **You may be eligible if...** - You are a woman between 18 and 75 years old - You have stage II or III breast cancer that is both estrogen receptor–positive (ER+) and HER2-positive - You have not yet received any cancer treatment - You are in good general health (ECOG 0–1) **You may NOT be eligible if...** - You have received any prior cancer treatment - Your cancer is stage I or IV - You are premenopausal and unwilling to receive hormone suppression therapy Talk to your doctor to see if this trial is right for you.