Inclusion Criteria:  Enrolled were ≥ 18 years of age and < 80 years of age Female or male breast cancer Patients with early or locally advanced breast cancer who are HER2-positive, have a tumor larger than 2 cm and/or have lymph node metastasis: HER2-positive is defined as 3 + by immunohistochemistry, or 2 + by immunohistochemistry, with a positive FISH test. Left ventricular score ≥ 55% ECOGPS score 0 or 1 Able to understand the test requirements, willing and able to comply with the test and follow-up procedures Adequate organ function  Exclusion Criteria:  cardiac, hepatic, renal, or psychiatric disease history History of other malignancy within the last 5 years, with the exception of adequately treated basal or squamous cell carcinoma of the skin or carcinoma in situ of the cervix.