Do you consider the presence of multifocality to decide whether to offer adjuvant therapy for patients with node-negative, multiple pT1a triple negative breast cancers?  

I take into account the number of invasive foci and the span of involvement (assuming the patient's nodes are negative—if node-positive I would treat as a stage II TNBC). This sometimes occurs in the setting of an area of high grade DCIS with multiple small foci of invasion, which can range fr...