We would like to express our opinion regarding a Parise and Caggiano paper recently published in your journal. We certainly believe this is a great contribution, since it found that node-negative HER2 (+) breast cancer patients have better survival contrary to the common knowledge. This finding could reflect the consequences of targeted therapies that are changing the natural history of the disease. However, we think that such an interesting analysis could also have been done with stage III and IV patients, since this group of people could benefit greatly from these findings. In fact, new guidelines now recommend the use of HER2-specific therapy for stage IV patients with positive markers, even for life if they do not show signs of progression. Additionally, we would like to discuss the value of adding the Ki-67 marker to the classification proposed by the authors, because several papers consider it an important prognostic factor.