Guidance for Canadian Breast Cancer Practice: National Consensus Recommendations for the Systemic Treatment of Patients with Triple Negative Breast Cancer in Both the Early and Metastatic Setting 2025.

Triple-negative breast cancer (TNBC) has been associated with a poorer prognosis than other subtypes, due to its more aggressive behaviour. Since 2020, significant advances in locoregional and systemic therapy have improved outcomes for patients with TNBC, but the implementation of these treatments remains inconsistent across Canada. There is, therefore, a critical need for evidence-informed, consensus-driven guidance to support the integration of new therapies into practice. Research Excellence, Active Leadership Canadian Breast Cancer Alliance (REAL Alliance), a pan-Canadian group of breast cancer specialists and Breast Cancer Canada, a patient advocacy organization, convened to develop national clinical consensus recommendations for the management of breast cancer. Through a selective literature review and modified Delphi process of national experts in the fields of medical oncology, radiation oncology, surgical oncology and pharmacy, REAL Alliance developed national consensus recommendations for the management of TNBC. The result is a set of 23 recommendations: four overall general recommendations, 11 in early-stage TNBC, and eight in metastatic TNBC. These recommendations are intended for oncology healthcare professionals, and are intended to guide evidence-informed, consistent care across Canada.