Inclusion Criteria:

          1. Written informed consent prior to beginning specific protocol procedures.

          2. Female or male patients ≥ 18 years of age.

          3. Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.

          4. Histologically proven invasive breast cancer.

          5. Operable breast cancer (cT1-3 and/or cN0-2 tumors) (breast cancer TNM classification)

          6. Tumor size larger than or equal to 1.5 centimeter (cm) in diameter by magnetic
             resonance imaging (MRI) or ultrasound with a significant 18F-FDG uptake defined as
             maximum standarized uptake value (SUVmax: maximum standarized uptake value) ≥1.5 x
             SUVmean (mean standarized uptake value) liver + 2 SD (standard deviation.

        Multicentric/multifocal tumors will be allowed only if:

          1. Histological confirmation of at least two lesions.

          2. All tumors must be HER2-positive.

          3. Largest lesion must be larger than or equal to 1.5 cm in diameter by MRI or
             ultrasound.

        7)Centrally confirmed HER2-positive disease according to the 2018 American Society of
        Clinical Oncology/College of American Pathologists (ASCO/CAP) criteria.

        8)Patient must have known estrogen receptor (ER) and progesterone receptor (PR) status
        locally determined prior to study entry.

        Patient has adequate bone marrow, liver, and renal function:

        9)Hematological: White blood cell (WBC) count > 3.0 x 109/L, absolute neutrophil count
        (ANC) ≥ 1.5 x 109/L, platelet count ≥ 100.0 x109/L, and hemoglobin ≥ 10.0 g/dL (≥ 6.2
        mmol/L).

        10)Hepatic: total bilirubin ≤ institutional upper limit of normal (ULN) (except for
        Gilbert's syndrome); alkaline phosphatase (ALP) ≤ 2.5 times ULN; aspartate transaminase
        (AST) and alanine transaminase (ALT) ≤ 1.5 times ULN.

        11)Renal: serum creatinine ≤ 1.5 x ULN or creatinine clearance ≥ 50 mL/min/1.73 m2 for
        patients with creatinine levels above institutional normal.

        12)Patient must be accessible for treatment and follow-up.

        Exclusion Criteria:

          1. Previous treatment with chemotherapy, anti-HER2 therapy, radiation therapy, or
             endocrine therapy for invasive breast cancer.

          2. cT4 and/or cN3 tumors (TNM breast cancer classification)

          3. Bilateral breast cancer.

          4. Evidence of metastatic disease by routine clinical assessment chest x-ray, liver
             ultrasound, and bone scan; or computed tomography (CT) scan of thorax and abdomen and
             bone scan, except patients with subclinic M1 (metastases) at baseline only according
             to 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography
             (PET/CT) that will be allowed to be included into cohort C.

          5. Known hypersensitivity reaction to any investigational or therapeutic compound or
             their incorporated substances.

          6. History of other malignancy within the last five years prior to first dose of study
             drug administration, except for curatively treated basal and squamous cell carcinoma
             of the skin and/or in situ cervical carcinoma.

          7. Left ventricular ejection fraction (LVEF) below 55% as determined by multiple-gated
             acquisition (MUGA) scan or echocardiography (ECHO).

          8. Uncontrolled hypertension (systolic > 150 mm Hg and/or diastolic > 100 mm Hg) despite
             adequate antihypertensive treatment.

          9. Clinically significant cardiovascular disease [stroke, unstable angina pectoris, or
             documented myocardial infarction within six months prior to study entry; history of
             documented congestive heart failure (CHF) (New York Heart Association II-III-IV);
             symptomatic pericarditis; documented cardiomyopathy; ventricular arrythmias with the
             exception of benign premature ventricular contractions; conduction abnormality
             requiring a pacemaker; other arrhythmias not controlled with medication].

         10. Active uncontrolled infection at the time of enrollment.

         11. Current known infection with HIV, hepatitis B virus, or hepatitis C virus.

         12. Patients with pulmonary disease requiring continuous oxygen therapy.

         13. Previous history of bleeding diathesis.

         14. Patient is currently receiving anti-coagulant therapy, chronic treatment with
             corticosteroids, or another immunosuppressive agent (standard premedication for
             chemotherapy and local applications are allowed).

         15. Major surgical procedure or significant traumatic injury within 14 days prior to
             randomization or anticipation of need for major surgery within the course of the study
             treatment.

         16. Patient has other concurrent severe and/or uncontrolled medical conditions that would,
             in the investigator´s judgment, contraindicate her participation in the clinical
             study.

         17. Concurrent participation in other clinical trial, except other translational studies.

         18. History of receiving any investigational treatment within 28 days prior to
             randomization.

         19. Pregnant or breast-feeding women or patients not willing to apply highly effective
             contraception as defined in the protocol.

        LINGain sub-study: The LINGAIN project intends to include a total of 126 blood samples from
        PHERGain trial, as follows:

        105 from patients treated with trastuzumab and pertuzumab ± endocrine therapy (according to
        HR status); 21 from patients treated with trastuzumab and pertuzumab + carboplatin and
        docetaxel.