How would you approach the treatment of low grade, stage IA, triple negative apocrine adenocarcinoma of the breast in a female patient in her 70s?

I would not treat this the way I would a typical triple-negative breast cancer, since the risk of distant recurrence from occult metastatic disease is low. Assuming she had breast-conserving surgery, radiation, favoring partial breast, is reasonable. In terms of systemic therapy, if the cancer in the breast was < 1 cm, I would just observe. Even with a tumor 1.1-2 cm, I would favor observation; if you choose to administer adjuvant chemo I would give her 4 cycles of weekly paclitaxel/carboplatin ...