Triple-negative breast cancer
Treatment options in Shanghai

The size and distribution of breast disease, lymph node findings and overall stage help determine whether surgery or systemic treatment comes first. A small tumor that can be removed appropriately may be treated with surgery first. Larger tumors or higher-risk situations may prompt neoadjuvant treatment, meaning treatment before the operation. The decision also considers fitness and the proposed breast and axillary surgery. Ask the team to state the clinical stage, explain any remaining uncertainty about nodes or distant disease, and identify the feature that makes preoperative treatment preferable in your case. TNBC alone is not that complete explanation.

Chemotherapy can reduce the tumor before surgery and treat cancer cells beyond the visible breast mass. Shrinkage may change the extent of breast surgery that is feasible, although breast conservation is not guaranteed. Treating before surgery also lets clinicians assess the tumor's response and use the surgical pathology to inform later decisions. Ask what improvement the team expects to measure, how they will monitor it and what happens if the cancer fails to respond. The plan should name both the planned medicine phase and the subsequent operation; “try treatment first” is not enough to explain the whole pathway.

Some patients receive an immune checkpoint inhibitor with chemotherapy as part of a perioperative plan. This is not an automatic addition for every person with TNBC. Stage, the chosen regimen, other illnesses and the relevant local indication all matter. Describe autoimmune disease, previous immune-related problems, organ transplantation and regular medicines to the oncologist rather than deciding eligibility yourself. Ask what added benefit is expected, what risks apply and whether continuation after surgery is planned. A drug mentioned by a US source does not establish approval, supply or insurance coverage in China; these must be checked for the exact regimen.