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Do you have a certain tumor size threshold in which you change chemotherapy recommendations for a small, triple negative breast cancer?

(For instance, TCx4 instead of ddAC->T for smaller tumors?) Does this affect your decision about treating with neoadjuvant versus adjuvant chemotherapy?
5 Answers
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Medical Oncology · Yale School of Medicine
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Breast cancer death from small tumors is often underestimated. In 2000, 0.92%, 4.0%, and 10.7% breast cancer-specific deaths were due to T1a, T1b, and T1c node-negative cancers, respectively, which increased significantly to 1.9%, 5.8%, and 14.7% by 2017. This is an interesting read on death from sm...

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Medical Oncology · Penn Medicine, University of Pennsylvania Health System
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This is often a subject of heated debate at our breast cancer conference. I tend to favor sequential use of weekly paclitaxel after AC for patients with node-negative TNBC, even if the tumor size is small. Higher proportional benefit has been demonstrated for the addition of a taxane after AC for pa...

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Medical Oncology · University of Hawai'i Cancer Center
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For small, triple-negative breast cancer TNBC, chemotherapy recommendations often depend on the size of the tumor, nodal involvement, and other risk factors, as TNBC is an aggressive subtype with a higher risk of recurrence.

Tumor size 5–10 mm (pT1b): Due to TNBC's aggressive nature, c...

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Medical Oncology · Mary Lanning Healthcare Morrison Cancer Center/University of Nebraska Medical Center Adjunct Faculty
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For tumors equal to or smaller than 0.5 cm if pN0 no adjuvant therapy, if pN1mi consider adjuvant chemotherapy. (NCCN Category 2A) In select patients with tumors equal to or smaller than 0.5 cm with high-risk features (e.g., young patients with high-grade histology), adjuvant chemotherapy may be con...

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Medical Oncology · Maricopa Integrated Health Svcs
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There is no such thing as "small" TNBC to the extent that you can take a chance that a curable patient in adjuvant setting may have been a "missed opportunity" when either A or T is not used. This may not apply to neoadjuvant where one can offer TC before surgery and if residual disease is seen in s...

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