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REVIEW article

Front. Oncol.

Sec. Breast Cancer

Volume 15 - 2025 | doi: 10.3389/fonc.2025.1465147

This article is part of the Research TopicMultidisciplinary and Personalized Approach in the Treatment of Advanced Breast CancerView all 21 articles

Size Matters: A Review of the Challenges in and Importance of Multimodal Approaches to the Management of Patients with Small, Node-Negative, Triple-Negative Breast Cancer

Provisionally accepted
Vishnu PrasathVishnu Prasath1Briana ToBriana To1Dionisia QuirogaDionisia Quiroga2Bridget OppongBridget Oppong3Kai JohnsonKai Johnson2Benjin FacerBenjin Facer4Robert WesolowskiRobert Wesolowski2*
  • 1Department of Internal Medicine, Wexner Medical Center, The Ohio State University, Columbus, Ohio, United States
  • 2Division of Medical Oncology, Comprehensive Cancer Center, The Ohio State University, Columbus, United States
  • 3Division of Surgical Oncology, Comprehensive Cancer Center, The Ohio State University, Columbus, United States
  • 4Division of Radiation Oncology, Comprehensive Cancer Center, The Ohio State University, Columbus, United States

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Patients diagnosed with small (T1a-c) node-negative triple-negative breast cancer (TNBC) comprise an understudied population. These patients have been commonly excluded from participation in large, practice-changing clinical trials that establish improvements in disease-free and overall survival due to neoadjuvant or adjuvant systemic therapies as well as innovative local therapies. Despite this, patients with small, node-negative TNBC are at higher risk for early relapse compared to patients with hormone receptor-positive breast cancer matched for the same T and N stage. We highlight retrospective and prospective studies that analyze the benefit of chemotherapy in small node-negative TNBC patients. Furthermore, we discuss current guidelines for radiation therapy, surgical management, and relevant studies examining local therapy for patients with early-stage node-negative TNBC.

Keywords: Triple-negative breast cancer, chemotherapy, radiation therapy, Surgery, Multimodal management

Received: 15 Jul 2024; Accepted: 10 Jul 2025.

Copyright: © 2025 Prasath, To, Quiroga, Oppong, Johnson, Facer and Wesolowski. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Robert Wesolowski, Division of Medical Oncology, Comprehensive Cancer Center, The Ohio State University, Columbus, United States

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Supplementary Material