Breast cancer occurs when cells in the breast become abnormal and grow out of control. Triple-negative breast cancer (TNBC) is an aggressive form of breast cancer that grows and spreads quickly. It’s more likely than other types of breast cancer to return, and treatment options are more limited.
Triple-negative breast cancers account for about 10 to 15 percent of all breast cancers. Triple-negative breast cancer means the cancer cells have tested negative for three indicators that define other types of breast cancer:
- Receptors for the hormone estrogen
- Receptors for the hormone progesterone
- The protein called human epidermal growth factor (HER2)
Triple-negative breast cancer is classified as progesterone receptor-negative, estrogen receptor-negative, and HER2-negative.
Life expectancy for triple-negative breast cancer is often expressed in five-year survival rates, that is, how many people will be alive five years after diagnosis. Triple-negative breast cancer five-year survival rates are as follows in the table below.
| Type of Breast Cancer | Survival Rate |
|---|---|
| Localized (cancer has not spread outside the breast) | 91% |
| Regional (cancer has either spread to nearby structures or lymph nodes) | 65% |
| Distant (cancer has spread to distant parts of the body such as the bones, lungs, or liver) | 11% |
What Are Symptoms of Triple-Negative Breast Cancer?
Symptoms of triple-negative breast cancer are the same as all types of breast cancers and may include:
- A lump, which is commonly hard, painless and irregular, though it may be soft, round and painful
- Breast swelling
- Swelling or a lump under the arm or on the collarbone
- Skin dimpling, which may resemble of an orange peel
- Nipple discharge
- A nipple that turns inward
- Skin changes on the breast or nipple, including redness, dryness, thickening, or flaking
What Causes Triple-Negative Breast Cancer?
The cause of breast cancer is unknown, but certain risk factors are linked to the disease.
People who are more likely to be diagnosed with triple-negative breast cancer include:
- Black women
- Women younger than 40
- Women with a BRCA1 gene mutation
- Hispanic women
Risk factors for breast cancer include:
- Being a woman
- Age over 55
- Inherited genes, including BRCA1 and BRCA2 and others
- Overweight/obesity
- Physical inactivity
- Alcohol use
- Having a first child after age 30 or having no children
- Use of hormonal birth control
- Hormone replacement therapy (HRT) for menopause, particularly estrogen and progesterone (combined hormone therapy)
- Family history or personal history of breast cancer
- Dense breast tissue
- Ethnicity: White women are slightly more likely to develop breast cancer during their lifetime, but African-American women are more likely to develop breast cancer under age 45
- Certain benign breast conditions
- Early onset menstruation (before age 12)
- Menopause after age 55
- Radiation to the chest
How Is Triple-Negative Breast Cancer Diagnosed?
Sometimes, a woman may discover a lump or may notice breast changes that will cause her to seek medical care. A doctor will perform a physical exam to look for breast changes such as:
- A lump in the breast
- Changes in the size or shape of the breasts
- Dimpling skin on the breast
- Pulling in of a nipple
- Discoloration of breast skin
Tests used to confirm a diagnosis of breast cancer include:
- Imaging tests
- Mammogram (a special type of X-ray)
- 3D tomosynthesis is a special new type of digital mammogram
- Mammogram (a special type of X-ray)
- Breast ultrasound
- Breast magnetic resonance imaging (MRI)
- Only used in certain circumstances
- Biopsy, in which samples of tissue from the breast are removed and examined
- Fine-needle aspiration biopsy
- Core needle biopsy
- Surgical biopsy
What Is the Treatment for Triple-Negative Breast Cancer?
Treatment for triple-negative breast cancer usually involves a combination of surgery, radiation, chemotherapy, immunotherapy, and newer breast cancer treatment options through clinical trials.
Treatment options for triple-negative breast cancer include:
- Surgery
- Complete removal of the breast (mastectomy)
- Removal of nearby lymph nodes
- Chemotherapy before surgery to shrink a tumor or after surgery to help prevent the cancer from returning
- Capecitabine (Xeloda), taken for 18 to 24 weeks, to help kill cancer cells
- Radiation therapy
Additional treatments for advanced stages of triple-negative breast cancer include:
- PARP inhibitors, which are advanced forms of chemotherapy, such as olaparib (Lynparza) and talazoparib (Talzenna)
- Platinum-based chemotherapy drugs, such as carboplatin and cisplatin
- Immunotherapy
- Checkpoint inhibitors such as the monoclonal antibody drugs atezolizumab (Tecentriq) and pembrolizumab (Keytruda)
- Antibody drug conjugate: sacituzumab govitecan-hziy (Trodelvy)
- Enrolling in a clinical trial to possibly receive new treatments
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https://www.cancercenter.com/cancer-types/breast-cancer/types/rare-breast-cancer-types/triple-negative-breast-cancer#:~:text=Survival%20rates%20for%20triple%2Dnegative,the%20five%2Dyear%20period
http://www.cancer.org/cancer/breastcancer