Do you consider post-NAC isolated tumor cells in LNs to be residual disease in TNBC to justify capecitabine?

The brief answer is yes, I would. These patients were included in the CREATE-X trial (Masuda et al., PMID 28564564). Also, there is data out of Boston that following neoadjuvant chemotherapy, patients with even isolated tumor cells in lymph nodes have a poorer prognosis (Wong et al., PMID 31228134)....

I would consider ITCs and/or LVI to be residual disease. This exact scenario hasn't come up for me (yet) as a clinical scenario but I would likely follow the same strategy that I do all TN breast cancer patients with residual disease post NAC. I recommend adjuvant capecitabine for all patients with ...

Yes absolutely. The stakes are too high to ignore this. The survival of TNBC drops precipitously with residual disease and I’m not aware of any data suggesting ITCs are not significant.