Do you recommend mastectomy for triple-negative?

The decision to perform a mastectomy or lumpectomy is not based upon the tumor being triple-negative or being estrogen-receptor positive or progesterone-receptor positive or HER2/neu positive. Lumpectomy followed by radiation therapy and mastectomy are equal treatment options for the local treatment of breast cancer. The determination for whether or not radiation therapy would be required after mastectomy would be determined by whether or not more than three lymph nodes were involved with tumor, or whether the tumor had spread beyond the capsule of the lymph node. Removing a woman's breast does not guarantee that a tumor will not recur elsewhere in the body. I always begin my breast cancer consults with my patients by stating to them that no woman ever died of breast cancer in her breast; women die of breast cancer as a result of cancer cells spreading outside the breast and lodging in other organs. Because of this fact, mastectomy would be the option for the treatment of breast cancer for several reasons. If a breast cancer is what we call locally advanced or inflammatory, where the actual skin of the breast shows signs of edema or actually has cancer cells within the dermis of the breast, then chemotherapy would be given in what we call neoadjuvant or prior to surgery, and regardless of the clinical response of that breast, the mastectomy and radiation therapy would be indicated. If a tumor is identified in the breast that is so large that the cosmetic defect of the breast would be great, mastectomy would also be an option, but neoadjuvant chemotherapy to shrink the tumor would also be an option to preserve the breast. Just because a tumor is triple-negative does not mean a mastectomy is mandatory.