Concurrent WOKVAC Vaccination, Chemotherapy, and HER2-Targeted Monoclonal Antibody Therapy Before Surgery for the Treatment of Patients With Breast Cancer

Eligibility Criteria

• * Patients must be at least \>= 18 years of age
• * Clinical stage I-III breast cancer, HER2+ (per American Society of Clinical Oncology \[ASCO\]/College of American Pathologists \[CAP\] guideline update, 2018), regardless of estrogen receptor (ER)/ progesterone receptor (PR) status and planning to undergo neoadjuvant therapy with either paclitaxel, trastuzumab, and pertuzumab (THP) or docetaxel, carboplatin, trastuzumab, and pertuzumab (TCHP)
• * Patients who have received prior neoadjuvant chemotherapy are allowed but may only receive paclitaxel, trastuzumab, and pertuzumab for the duration the study
• * Subjects with Eastern Cooperative Oncology Group (ECOG) performance status score of 0 or 1
• * White blood cell (WBC) \>= 3000/mm\^3 (within 4 weeks of initiating study treatment)
• * Lymphocyte count \>= 500/mm\^3 (within 4 weeks of initiating study treatment)
• * Absolute neutrophil count (ANC) \>= 1,500/ uL (within 4 weeks of initiating study treatment)
• * Platelets \>= 75,000/ uL (within 4 weeks of initiating study treatment)
• * Total bilirubin =\< 1.5 x institutional upper limit of normal (ULN), except patients with Gilbert's syndrome in whom total bilirubin must be \< 3.0 mg/dL (within 4 weeks of initiating study treatment)
• * Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) =\< 3 x institutional upper limit of normal (ULN) (within 4 weeks of initiating study treatment)
• * Creatinine =\< 2.0 mg/dL or creatinine clearance \> 30 ml/min (within 4 weeks of initiating study treatment)
• * Left ventricular ejection fraction (LVEF) \>= lower limit of normal for institution performing the multi-gated acquisition (MUGA) or echocardiogram (ECHO) done within 3 months of initiating study treatment
• * Female patients of child-bearing potential must agree to use dual methods of contraception and have a negative urine pregnancy test at screening, and male patients must use an effective barrier method of contraception if sexually active with a female of child-bearing potential. Acceptable methods of contraception are condoms with contraceptive foam, oral, implantable or injectable contraceptives, contraceptive patch, intrauterine device, diaphragm with spermicidal gel, or a sexual partner who is surgically sterilized or post-menopausal. For both male and female patients, effective methods of contraception must be used throughout the study and for three months following the last vaccine
• * Ability to understand and willingness to sign a written informed consent document
• * Patients with any of the following cardiac conditions:
• * Symptomatic restrictive cardiomyopathy
• * Dilated cardiomyopathy
• * Unstable angina within 4 months prior to enrollment
• * New York Heart Association functional class III-IV heart failure on active treatment
• * Symptomatic pericardial effusion
• * Uncontrolled autoimmune disease requiring active systemic treatment
• * Known hypersensitivity reaction to the granulocyte-macrophage colony stimulating factor (GM-CSF) adjuvant; any known contra-indication to GM-CSF
• * Pregnant or breast feeding
• * Known human immunodeficiency virus (HIV)-positive
• * History of uncontrolled diabetes
• * Known current or a history of hepatitis B or C virus, including chronic and dormant states, unless disease has been treated and confirmed cleared
• * Major surgery within the 4 weeks prior to initiation of study vaccine
• * Current use of immunosuppressive agents or systemic corticosteroids. Topical, ocular, intra-articular, intranasal, inhalational corticosteroids (with minimal systemic absorption) are allowed. Patients who have received systemic corticosteroids =\< 30 days prior to starting study drug will be excluded
• * Patient is currently enrolled in any other clinical protocol or investigational trial that involves administration of experimental therapy and/or therapeutic devices, or investigational drug
• * Patients may not be receiving any other investigational agents