American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended treatment approach for early-stage triple-negative breast cancer?

1. Radiation therapy

2. Surgery followed by adjuvant chemotherapy

3. Hormonal therapy

4. Observation and follow-up

The correct answer is: Surgery followed by adjuvant chemotherapy

The recommended treatment approach for early-stage triple-negative breast cancer is surgery followed by adjuvant chemotherapy. This choice is based on the aggressive nature of triple-negative breast cancer, which lacks expression of estrogen receptors, progesterone receptors, and HER2. As such, it does not respond to hormonal therapies or targeted therapies that are effective for other breast cancer subtypes. The surgery typically involves either a lumpectomy or mastectomy, depending on the size and location of the tumor, with the objective of removing the cancerous tissue. Following surgery, adjuvant chemotherapy is administered to target any residual cancer cells and reduce the risk of recurrence. This approach is crucial because triple-negative breast cancer tends to have a higher rate of recurrence compared to other types when not aggressively treated. While radiation therapy can be a part of the treatment plan, especially for patients who have undergone breast-conserving surgery, it typically follows the chemotherapy phase and is not the primary initial treatment approach. Hormonal therapy is not applicable due to the lack of hormone receptors in this cancer subtype, and observation and follow-up alone are not sufficient given the aggressive characteristics of triple-negative breast cancer. Hence, the combination of surgery followed by chemotherapy stands as the most effective treatment strategy for early-stage cases