In total, 1506 (18.0%) DFS events were observed, with 3- and 7-year DFS rate estimates in the entire population equal to 88.3% (95% CI 87.6–89.0%) and 80.1% (95% CI 79.1–81.0%), respectively….In summary, our study concludes that ESA administration to patients receiving adjuvant anti-HER2 treatment for HER2-positive EBC in the ALTTO trial was safe and had no detrimental impact on survival outcomes.