Surgery · Breast (Benign, Carcinoma Breast, Staging, Treatment)

A 38-year-old woman with triple-negative breast cancer (T3N2M0) achieves pathological complete response (pCR) after neoadjuvant chemotherapy. She then undergoes mastectomy. According to the CREATE-X trial, what additional adjuvant therapy is indicated if residual disease had been found?

A Olaparib for 1 year
B Pembrolizumab for 1 year
C Capecitabine for 6–8 cycles ✓
D Trastuzumab for 1 year

Correct answer: C. Capecitabine for 6–8 cycles

Explanation

The CREATE-X trial demonstrated that adjuvant capecitabine significantly improved disease-free and overall survival in HER2-negative breast cancer patients (including TNBC) with residual invasive disease after neoadjuvant chemotherapy. Since pCR was achieved here, this is academic but the question asks about the trial's protocol for residual disease. Olaparib is for BRCA-mutated HER2-negative high-risk patients (OlympiA trial). Pembrolizumab is used in early TNBC in combination with neoadjuvant chemotherapy (KEYNOTE-522). Trastuzumab is not indicated for HER2-negative tumors.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.

A 38-year-old woman with triple-negative breast cancer (T3N2M0) achieves pathological complete response (pCR) after neoadjuvant chemotherapy. She then undergoes mastectomy. According to the CREATE-X trial, what additional adjuvant therapy is indicated if residual disease had been found?

Explanation

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