How would you approach a patient with a T3 spindle cell metaplastic breast cancer?

This is a tough and controversial situation, and hard to reach a consensus due to the paucity of prospective data specifically focused on this subtype. The data available suggest that these tumors are less responsive to chemotherapy. Given these concerns for chemorefractoriness, I generally favor participation in clinical trials if available.

However, while these tumors may benefit less from chemotherapy, we cannot conclude that there is no benefit at all from the data available. As such, I would...