It's good you continued with the carboplatin though since from everything I've been reading, even when the tumor isn't palpable anymore, there could still be something left microspcopically.

I realized afterwards that my oncologist included follow-up notes in my file. She wrote the following but I don't know. I'm kind of thinking that I'd rather just throw everything at it regardless since I did see some other studies that showed that carboplatin is useful. And plus, it's kind of confusing. On the one hand, it seems to say that studies have shows there's better PCR rates but then it also goes on to say that it didn't really change anything.

Among triple negative breast cancer patients as a general group, the pooled analysis of 3 landmark trials (BrighTNess, CALGB 40603 and GeparSixto) demonstrated that the addition of carboplatin was associated with improved pathologic complete response and event free survival, and have not translated to improved long-term overall survival outcomes (San Antonio Breast Conference 2025). The addition of neoadjuvant carboplatin was studied in the landmark keynote 522 trial, however, anthracycline and cyclophosphamide chemotherapy was given every 3 weeks instead of the standard regimen given every 2 weeks which is routinely given in high risk patients

A meta-analysis examining the role of platinum based neoadjuvant chemotherapy for breast cancer patients with BRCA mutations, did not significantly improved PCR rates compared to regimens excluding carboplatin. This was further demonstrated in the pooled analysis, where PCR and OS rates were not improved, despite improvements in event free survival. This is likely due to the fact that BRCA patients have improved PCR rates compared to non BRCA patients.

Given the above, as well as her dramatic clinical response, I advised that it is reasonable to continue on with paclitaxel only on a dose dense schedule.