AUTHOR=Prasath Vishnu , To Briana , Quiroga Dionisia M. , Oppong Bridget A. , Johnson Kai , Facer Benjin , Wesolowski Robert 

TITLE=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

JOURNAL=Frontiers in Oncology

VOLUME=Volume 15 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2025.1465147

DOI=10.3389/fonc.2025.1465147

ISSN=2234-943X

ABSTRACT=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.