What is Triple-Negative Breast Cancer?

This is a type of breast cancer in which cancer cells test negative for 3 main things usually found in breast cancer. For instance, Estrogen and Progesterone hormone and protein (known as HER2). Mostly, these receptors fuel breast cancer growth and physicians prescribe treatment such as hormone therapy or other medicines. People with triple-negative breast cancer (TNBC) do not have these receptors and that’s why there are challenging to treat this breast cancer type.

This cancer type is more aggressive compared to other breast cancer forms and it is more prone to spread throughout the body. The life expectancy in people with triple-negative breast cancer is up to 5 years.

Usually, the treatments used for other breast cancer types do not work for triple-negative breast cancer. However, it does not mean it is not treatable. If you are diagnosed with this cancer type, doctors will find the best treatment plan for you.

Symptoms

The symptoms are similar to other breast cancer types. For example:

  • Mass or lump in the breast
  • Nipple pain or redness
  • Discharge
  • Breast swelling
  • Dimpled skin
  • Dry, flaking, or thickened skin on the breast or nipple
  • Swollen lymph nodes
  • Irritation, itchiness, or warmth of the breast
  • Breast size, shape, or symmetry changes

If you experience any of the previous symptoms, do not hesitate to visit a healthcare professional.

Risk Factors for TNBC

Experts do not know the exact cause of TNBC. It usually affects roughly 20% of all breast cancer cases. Healthcare providers consider the following factors that may increase your risk of this cancer type. Examples include:

Discuss with your healthcare professional for more details.

Diagnosis

Physicians usually diagnose this cancer type through mammograms. In some cases, they can determine whether you have TNBC or not using ultrasound. This test can show things that cannot be noticed in the mammograms. For example lumps, fluid-filled masses, abnormal regions in the breast, and others. Moreover, doctors can perform a biopsy. A test that involves a cut of a small sample of tissue to test the cells under a microscope. It helps to verify whether the cells are cancerous or noncancerous. In case they determine you have cancer, additional tests are done to check if cancerous cells have Estrogen, Progesterone, and HER2 receptors. In case there are no receptors, TNBC is diagnosed.

TNBC Stages

The doctors divide this cancer type into 4 stages. They determine what stage a person experiences using the following tests. Examples include:

  • MRI (magnetic resonance imaging) – This helps to determine the exact size and location of the cancer.
  • Ultrasound – This test uses soundwave imagery to diagnose different cancer types including those that occur in the breast, underarms, liver, and other body parts.
  • CT (computed tomography) scan – This test helps to check if the cancer has not spread to other tissues or organs in the body.
  • PET (positron emission tomography) scan – During this test, doctors inject to patients a radioactive substance that attaches to cancer cells.

However, there are different staging systems, and most physicians use that set by the American Joint Committee on Cancer (AJCC) known as the TNM system. For example:

  • T (size or extent of the tumor) – The first stage is ranked on a scale from 0 to 4, which means how big the tumor is.
  • N (spreading to near lymph nodes) – It is ranked on a scale from 0 to 3 that shows how many lymph nodes the cancer spread to.
  • M (spread to farther organs) – This stage is ranked on a scale from 0 to 1 and tells if the cancer spread to organs such as bones, liver, or lungs.

Another staging system that is used less commonly includes terms and phrases. For example:

  • In situ – Abnormal cells that have not spread to other tissues.
  • Localized – Cancer stays in the place where it begins.
  • Regional – The tumors spread to near lymph nodes, tissues, or organs.
  • Distant – In such cases, the cancer goes to the farthest organs and tissues.

Physicians have to stage cancer types because it helps to understand how severe the cancer type a person experiences, the survival rate, and proper treatment options.

Treatment

The treatment for this cancer type usually involves a combination of surgery, radiation, and chemotherapy. Check the treatment options below in detail:

Chemotherapy

These are medications used to kill cancer tumors and this group of drugs is usually the first doctors try in cancer treatment. They are usually given to patients via injection or in tablets. Physicians can also prescribe chemotherapy in 3 ways. For example:

  • Neoadjuvant Therapy – This chemotherapy type is recommended by doctors before surgery. It is considered the best way to treat advanced TNBC when they are not sure if it is possible to operate or not.
  • Adjuvant Therapy – This type is usually used after surgery of a large tumor or a lymph node. However, other treatments (such as hormonal therapy) will not work for TNBC.
  • Platinum Chemotherapy – This chemotherapy type involves platinum-based medications including Carboplatin or Cisplatin. They can recommended for use either before or after surgery. As per studies, these medications improve the survival chance and reduce cancer recurrence in TNBC cases.

Additionally, doctors may prescribe immunotherapy along with chemotherapy in case the cancer spreads to other parts of the body and surgery is not an option. These medications help to improve your body’s defense (immune system), so it can fight against cancer cells and prevent their spreading. A combination of these therapies works quite well for TNBC because there are more genetic mutations that the immune system can target. Furthermore, for people with stage II and III cancers, immunotherapy is an effective option either before or after surgery.

Lymph Nodes Procedures

If the cancerous tumor spreads to certain lymph nodes, your doctor may perform a sentinel lymph node biopsy. It is a procedure in which doctors localize and remove the lymph node to verify if the cancer stats spreading to other tissues around it.

Axillary Lymph Node Dissection

During this procedure, surgeons remove 10 to 40 lymph nodes to verify for cancer spread. Commonly, it is used along with mastectomy or breast-conserving surgery. Axillary lymph node dissection is often used in the following cases. For example:

  • The sentinel lymph node biopsy showed 3 or more lymph nodes containing cancer cells.
  • You have swollen underarm or collarbone lymph nodes.
  • The cancer begins growing beyond the lymph nodes.

Surgery

Many healthcare professionals think that mastectomy is the best way to treat TNBC because it is more aggressive than other breast cancer types. However, it occurs in the following cases. Examples include:

  • Several tumors occur
  • Skin cancer
  • Nipple tumors
  • Breast cancer
  • Large tumors
  • A person experiences calcium deposits or other cells in the breast

In any case, physicians may decide to perform a lumpectomy which involves the removal of the tumor and nearby tissues only.

Radiation

In case there remain some cancer cells after surgery, this procedure is done to kill any cancer in that region. Radiation therapy is used to prevent cancer recurrence.

Targeted Drug Therapy

These are specific medicines used to stop the growth of cancer cells and destroy them. Healthcare providers prescribe these medications in case the cancer spreads throughout the body and surgery cannot be performed.

What Are Possible Treatment Adverse Reactions?

There are many cases where the treatment helps to get rid of TNBC. However, it depends on the tumor size and if the cancer spreads to other tissues and organs or not. Check below the most common treatment negative effects:

  • Hair loss
  • Nausea
  • Tiredness
  • Brain fog
  • Vomiting

Frequently Asked Questions

Can triple-negative breast cancer be cured?

This cancer type can be treated in the early stages only. However, in more advanced stages, treatment can help to lessen the symptoms and improve the quality of life.

Why TNBC is considered aggressive?

Experts consider this cancer type more aggressive than others because it grows and spreads to other body parts more quickly. Discuss with your healthcare professional for more details.

What are the harder cancers to cure?

  • Pancreatic cancer
  • Liver and intrahepatic bile duct cancer
  • Esophageal cancer
  • Lung and bronchus cancer
  • Acute myeloid leukemia
  • Brain and other nervous system cancer
  • Stomach cancer
  • Ovarian cancer

If you have any other questions, ask your healthcare professional.

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