triple-negative breast cancer

January 18, 2024January 18, 2024checkorphan

Synonyms

TNBC ,

Overview

Triple-negative breast cancer (TNBC) accounts for about 10-15% of all breast cancers. The term triple-negative breast cancer refers to the fact that the cancer cells don’t have estrogen or progesterone receptors (ER or PR) and also don’t make any or too much of the protein called HER2. (The cells test “negative” on all 3 tests.) These cancers tend to be more common in women younger than age 40, who are Black, or who have a BRCA1 mutation. TNBC differs from other types of invasive breast cancer in that it tends to grow and spread faster, has fewer treatment options, and tends to have a worse prognosis (outlook).

Symptoms

There are no unusual breast cancer symptoms associated with a triple negative breast cancer diagnosis. It is typically detected during routine breast cancer screening (on a mammogram) prior to presenting any symptoms. However, some individuals may have symptoms including:

– Changes in breast shape

– Mass or suspicious finding on a mammogram

– Breast or nipple pain

– Discharge from the nipple

– Nipple inversion

– Swelling of the breast

– A lump

– Thickening of the nipple skin

– New crease in the breast

Causes

Research shows that some people have a greater chance of developing TNBC if you are subject to certain risk factors. These risks include:

Age: Premenopausal women and those under the age of 50 have an increased risk of TNBC.
BRCA1 gene mutation: About 70 percent of the breast cancers diagnosed in women with an inherited BRCA1 mutation are TNBC.
Ethnicity: African American and Hispanic women have a higher rate of TNBC. Approximately 20 to 40 percent of breast cancers diagnosed in African American women are triple negative.

Penn’s MacDonald Cancer Risk Evaluation Center can evaluate your breast cancer risk and offers genetic counseling for anyone with an increased risk of a triple negative breast cancer diagnosis.

Diagnosis

Triple negative breast cancer is most commonly seen on a mammogram, or through other tests ordered when symptoms are present. Triple-negative breast cancer and IDC may also be found on breast examination.

If cancer is suspected on a mammogram, a biopsy may be ordered to test the cells in a pathology laboratory to further your breast cancer diagnosis journey.

Prognosis

Because triple negative breast cancer lacks the receptors that other types of breast cancer have, some treatment options may be less effective. Size and spread of TNBC will determine a prognosis. And like other types of breast cancer, catching TNBC early through routine cancer screening can help improve prognosis.

As technology and treatments continue to develop, we hope to see the prognosis for all breast cancer, including TNBC, improve. Your health care provider can discuss your specific prognosis with you based on your diagnosis and treatment options.

Treatment

Triple-negative breast cancer has fewer treatment options than other types of invasive breast cancer. This is because the cancer cells do not have the estrogen or progesterone receptors or enough of the HER2 protein to make hormone therapy or targeted HER2 drugs work. Because hormone therapy and anti-HER2 drugs are not choices for women with triple-negative breast cancer, chemotherapy is often used.

If the cancer has not spread to distant sites, surgery is an option. Chemotherapy might be given first to shrink a large tumor, followed by surgery. Chemotherapy is often recommended after surgery to reduce the chances of the cancer coming back. Radiation might also be an option depending on certain features of the tumor and the type of surgery you had.

In cases where the cancer has spread to other parts of the body (stage IV), platinum chemotherapy, targeted drugs like a PARP inhibitor or antibody-drug conjugate, or immunotherapy with chemotherapy might be considered.