Over the last several decades breast cancer management has made great strides in the improvement of oncologic treatment outcomes, particularly so in patients with early stage disease. While wide-spread access to screening resulting in early detection is undoubtedly to be credited for this trend, at the same time, the management of breast cancer has evolved to be an intricate multidisciplinary collaboration between breast imagers, surgeons, medical oncologists and radiation oncologist. As a result, with better mutual understanding of multidisplinary goals and challenges, the treatment strategies have become more individualized, with a great emphasis being placed on the intrinsic disease biology. Furthermore, the indications for neoadjuvant systemic therapy have significantly broadened, with a substantial number of patients with early stage breast cancer being able to take advantage of this strategy to decrease the extent of breast surgery they would undergo at its completion.