Background: Current guidelines suggest that asymptomatic Stage I and II node negative patients do not require staging investigations to rule out metastatic disease. Our provincial cancer centre’s guidelines released last year recommends blood work (CBC, kidney and liver function), CT scan of chest and abdomen, and bone scan for node positive breast cancer patients. Methods: We conducted a retrospective chart review of all triple-negative breast cancer patients diagnosed from January 2008 to December 2010. Triple negative is defined as <1% staining on immunohistochemistry (IHC) for both estrogen receptor (ER) and progestin receptor (PR) as well as the absence of HER2 overexpression on IHC or negative for gene amplification by FISH. The collected data included patients age, date of diagnosis, tumor size, grade, number of lymph nodes, presence/absence of lymphovascular invasion, and whether or not staging investigations were performed and their results. Results: One hundred and twelve patients were diagnosed with triple negative breast cancer in our centre between January 2008 and December 2010. Ninety five (86%) underwent staging investigations, 43 (45%) ordered by the medical oncologist and the remainder arranged by the referring physician. Twenty out of thirty stage I patients had some form of imaging (either bone scan, liver ultrasound, or CT). This did not yield any positive studies for metastatic disease. Similarly 25 out of 29 stage IIA patients were staged. Of those 25 patients, 12% had evidence of metastatic spread diagnosed on imaging. All 19 stage IIB patients were staged; of which 10.5% were also found to have metastatic disease. Conclusions: Stage I asymptomatic TNBC patients do not require routine staging investigations as the yield is quite low. However this study suggests that newly diagnosed triple negative patients that are stage II (either node negative or node positive) should undergo routine imaging to rule out any metastatic spread as this changes the intent of therapy. Further data collection is warranted.