What You Should Know About Triple-Negative Breast Cancer

Introduction

Triple-negative breast cancer (TNBC) is a less common but aggressive form of invasive breast cancer, accounting for about 15% of all breast cancer cases. In the United States, it affects approximately 13 out of every 100,000 women.

The term “triple-negative” refers to the fact that these cancer cells do not have the three common receptors found in many other types of breast cancer—estrogen, progesterone, and HER2. These receptors usually help cancer cells grow, and many standard treatments are designed to target them.

Since TNBC lacks these receptors, it does not respond to hormonal therapies or HER2-targeted treatments. This can make treatment more challenging. However, ongoing research is making progress. New approaches, including combining certain cancer drugs, have shown promise in improving outcomes for people living with TNBC.

Symptoms of Triple Negative Breast Cancer

• A lump in the breast or underarm – Often hard and irregular in shape, and usually painless.
• Swelling in part of the breast – Even without feeling a distinct lump.
• Changes in breast shape or size – One breast may appear different from the other.
• Skin changes on the breast – Dimpling, redness, or thickening that looks like an orange peel.
• Nipple changes – Inversion (pulling inward), discharge (not breast milk), or pain.
• Breast pain or tenderness – Less common but still possible.

These symptoms can also occur with other types of breast cancer or non-cancerous conditions. It’s important to speak with a healthcare provider if you notice any of these changes. Early detection can make a difference.

Causes of Triple Negative Breast Cancer

The exact causes of Triple-Negative Breast Cancer (TNBC) are not fully understood, but several factors may increase the risk of developing it:

1. Genetic Mutations

BRCA1 gene mutation is strongly linked to TNBC. Women with this mutation have a higher chance of developing this type of breast cancer.

2. Age

TNBC is more commonly diagnosed in women under the age of 50, compared to other types of breast cancer.

3. Race and Ethnicity

TNBC is more common in Black women and Hispanic women compared to white women.

4. Family History

Having a close relative with breast or ovarian cancer increases the risk of getting breast cancer.

5. Lifestyle Factors

Although research is ongoing, factors like obesity, lack of physical activity, and alcohol consumption may contribute to breast cancer risk in general, including TNBC.

While these factors may increase risk, having one or more of them does not mean a person will definitely develop TNBC. Similarly, people without these risk factors can still be diagnosed. Ongoing research is helping to better understand the causes and improve prevention and treatment options.

How Triple-Negative Breast Cancer Is Diagnosed

If you have symptoms that could be related to breast cancer, your doctor (GP) will refer you to a breast clinic for further tests. You might also be referred if something unusual shows up during a routine breast screening (mammogram).

At the breast clinic, you’ll usually have a few tests to help diagnose triple-negative breast cancer:

• Mammogram: This is a special X-ray that takes pictures of your breast to check for any unusual changes.
• Breast Ultrasound: This scan uses sound waves to look more closely at any lumps or changes seen on the mammogram.
• Biopsy: A small sample of tissue is taken from your breast and examined under a microscope to check for cancer cells.

If the tests show that you might have triple-negative breast cancer, your doctor may also recommend genetic testing. This is done to check for inherited changes in the BRCA1 or BRCA2 genes, which can increase the risk of developing this type of cancer.

These steps help doctors understand exactly what type of breast cancer you have so they can plan the most effective treatment for you.

Treatment for Triple-Negative Breast Cancer (TNBC)

Surgery is often the primary treatment for triple-negative breast cancer, especially in its early stages. However, your oncologist may recommend combining it with other therapies to improve outcomes and reduce the risk of recurrence. These may include:

• Chemotherapy: Often used for early-stage TNBC (Stage I or II), chemotherapy can help destroy cancer cells throughout the body. It’s commonly given before (neoadjuvant) or after (adjuvant) surgery to improve the effectiveness of treatment.
• Immunotherapy + Chemotherapy: For certain cases, especially when tumors are larger or more advanced, a combination of immunotherapy and chemotherapy may be given before surgery. Immunotherapy helps your immune system recognize and attack cancer cells more effectively.
• Radiation Therapy: After surgery, radiation may be used to target any remaining cancer cells in the breast or nearby lymph nodes. This helps reduce the chance of the cancer returning in the same area.
• Targeted Therapy: Some patients with TNBC who have inherited BRCA gene mutations may benefit from targeted therapies. These include:
  • PARP inhibitors: These drugs block an enzyme cancer cells use to repair themselves, making it harder for the cancer to survive.
  • Antibody-drug conjugates: These are special treatments that deliver cancer-killing drugs directly to cancer cells, limiting harm to healthy cells.

Furthermore, breast cancer clinical trials are exploring potential new drugs and innovative treatment approaches. Participating in a clinical trial may offer access to potential new treatment options that are not yet widely available. Speak with your care team to learn if a trial may be a good fit for you.

Other Types of Breast Cancer

Other than triple-negative breast cancer, several other breast cancer types exist—each with unique characteristics, treatment plans, and outcomes. These include:

• Metaplastic Breast Cancer
• HER2-Positive Breast Cancer
• Inflammatory Breast Cancer
• Secondary Breast Cancer
• Mucinous Carcinoma
• Invasive Ductal Carcinoma
• Metastatic Breast Cancer (Stage IV)
• Fungating Breast Cancer
• Invasive Lobular Carcinoma (ILC)

Conclusion:

Triple-negative breast cancer (TNBC) presents unique challenges due to its aggressive nature and limited treatment options. However, early diagnosis, advancements in therapies, and personalized treatment plans continue to improve survival outcomes. Ongoing research, especially in genetic testing, immunotherapy, and targeted therapy, is helping redefine care for TNBC patients. For those exploring new treatment avenues, participating in clinical research can be a valuable option. It offers access to potential therapies not yet widely available. If you or a loved one has been diagnosed with TNBC, consider talking to your healthcare provider about enrolling in paid clinical trials in Nebraska.