45 yr peri menopausal lady rt ca breast 2x2cm retro areolar er pr neg her2 ng STAGING normal axilla clinically negative staging your suggestions please

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Triple negative is aggresive disease. Neoadjuvant dose dense chemotherapy 4 AC/EC 》 4 Peclitaxel. Surgery; Breast preservation / mastectomy. Sentinel lymph node / complete axillary dissection as per desire of patient & facility at health care provider. Radiation if indicated.

Triple negative breast cancer is a chemosensitive disease. Neoadjuvant chemotherapy can be given even in small tumours. If nodes are negative at this point, cab do BCT + sentinel node biopsy later. If nodes positive now, better to do BCT with axillary clearance. Obv to rule out any other contraindications of BCT and patients choice to be considered..

Simple mastectomy followed by chemotherapy, radiotherapy

In Indian scenario, and as per the pic, I feel pt seems to be low socioeconomic status.....I prefer to suggest.... Modified Radical mastectomy rather than breast conserving surgery... Re-evaluate with pathologist about other features like skin involvement, posterior margin,nodal evaluation LV invasion etc...Followed by chemotherapy with 4cycles of ADR+Cyclo and 4 cycles of Paclitaxel...+/-....Adj RT depending on PO specimen histopathology findings

ER,PR and HER 2 protein negative. Generally more aggressive disease. A BCS with axillary clearance. Radiotherapy and chemotherapy is required

Triple negative worst prognosis,do your best by simple mastectomy post op chemo and radiotherapy

In indian scenario considering economic status and compliance of patient MRM followed by CT\RT would be more effective rather BCS...

I agree with Dr.T.Patel

If metastatoc workup normal better to go for MRM as tumor is retroareolar and for clinically negative axilla SLNB is recommended follwed by axillary dissection if SLNB is positive

BCS followed by chemotherapy and radiotherapy

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