Observational studyBreast cancer research and treatment2026
Contemporary therapy for small node-negative triple-negative breast cancer: a retrospective cohort study.
Observational study in Breast cancer research and treatment, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionMulti-agent neoadjuvant therapy (NAT) with immune checkpoint blockade is standard treatment for Stage II-III triple-negative breast cancer (TNBC), though its role in smaller node-negative tumors remains unclear.
methodsWe performed a retrospective multi-institutional cohort study evaluating demographics, treatment patterns, and outcomes in a contemporary "small TNBC" population (n = 215) comprising Stage I (n = 154) and Stage II, T < 3 cm TNBC (n = 61).
resultsWithin the small TNBC cohort, Stage II, < 3 cm tumors demonstrated higher rates of grade 3 histology (93.4% vs 74.7%, p = 0.0013), NAT (85.2% vs 61.0%, p = 0.0006), adjuvant pembrolizumab (56.8% vs 24.7%, adjusted p = 0.0024), and neoadjuvant KEYNOTE-522 (75.0% vs 45.7%, adjusted p = 0.0052) compared with Stage I disease. Despite these treatment differences, recurrence and mortality rates were similar between groups. Among NAT-treated patients with small TNBC (n = 146), the pathologic complete response (pCR) rate was 51.3% (75/146), without significant difference between Stage I and Stage II, < 3 cm tumors (51.1% vs 51.9%, p = 0.92). There were no significant differences in regimen-specific pCR rates or event-free survival (EFS) when comparing NAT between Stage I and Stage II, < 3 cm tumors, or comparing NAT vs. no NAT for the small TNBC cohort.
conclusionsStage I and Stage II, < 3 cm TNBC demonstrated overlapping clinicopathologic features, pCR rates, and short-term survival outcomes despite substantially different treatment approaches. These findings suggest that current stage-based treatment distinctions may not fully capture the clinical behavior of small TNBC and support further prospective evaluation of risk-adapted and size-based treatment frameworks to better individualize NAT selection in this understudied population.
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