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Staging investigations revealed no nodal or distant disease. She underwent bilateral mastectomy with right sentinel lymph node biopsy (SLNB), followed by adjuvant docetaxel\u2013cyclophosphamide chemotherapy. Radiotherapy was avoided given the elevated risk of radiation-induced sarcoma (RIS) in NF1. Postoperative reconstruction was staged and ultimately successful. At more than 3 years of follow-up, she remains disease-free with satisfactory cosmetic outcomes. This case highlights the importance of vigilant breast surveillance in NF1, challenges in balancing oncologic control with treatment-related risks, and the need for individualised multidisciplinary care.<\/jats:p>","DOI":"10.1136\/bcr-2025-270134","type":"journal-article","created":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T14:20:26Z","timestamp":1776694826000},"page":"e270134","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Triple-negative breast cancer with neurofibromatosis type 1: management challenges"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-1508-9526","authenticated-orcid":false,"given":"Iraj","family":"Fatima","sequence":"first","affiliation":[{"name":"College of Medicine, Dubai Medical College for Girls, Dubai, 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