Triple Negative Breast Cancer

Definition

To understand triple-negative breast cancer, a person needs to know more about the three major types of breast cancer. These are:

Progesterone receptor positive and estrogen receptor positive are the most common types of breast cancers.

For people who develop one of these types of cancers, there are hormonal therapy options that can help attack the cancer cells. If one therapy does not work, often another therapy may.

Another common breast cancer type is HER2 receptor positive. In cases of HER2, the cancer cells have an abundance of HER2 receptors on their surfaces. Similarly to the breast cancers caused by hormone receptors, HER2 breast cancer can be treated with different therapies that target the HER2 receptor.

Triple-negative breast cancer refers to cancer that has not tested positive for any of the three other types. It is also the least common form of breast cancer and the hardest to treat.

Unlike the three main types, triple-negative breast cancer has no targeted therapies available, currently. It is also more likely than the other types of breast cancer to spread and recur.

Causes

Currently, researchers are interested in finding out more about some of the risk factors for developing triple-negative breast cancer. Those that researchers have identified so far include:

Obesity and inactivity

People who are obese and have a higher BMI have been found to be more at risk of developing triple-negative breast cancer. These categories tend to include those who are not very active.

Genetics

Individuals with mutated genes are at higher risk for triple-negative breast cancer, as well as other common cancers.

A family history of breast cancer can help determine if a someone is at a higher risk of developing breast cancer in the future.

Age

Some research suggests that age may play a role in increased risk fof developing triple-negative breast cancer.

Premenopausal women have been found to develop triple-negative breast cancer more often than postmenopausal women.

Race or ethnicity

Some studies suggest that certain backgrounds may make people more susceptible to triple-negative breast cancer. A disproportionate numbers of cases of triple-negative breast cancer affect African-American women.

Pregnancy

Some studies suggest that whether a woman has ever been pregnant plays a role in increasing or decreasing her risk of triple-negative breast cancer.

Women who have had children tend to be more at risk than those who have not. Similarly, women who only have one child are less likely to develop triple-negative breast cancer than women with multiple children.

Symptoms

 

The majority of women with breast cancer do not have any signs or symptoms when diagnosed. However, it is possible for women with the disease to experience breast changes or symptoms. Many times, the cause of a symptom may be a different medical condition that is not cancer.

The signs and symptoms that should be discussed with a doctor include:

A lump that feels like a hard knot or a thickening in the breast or under the arm. It is important to feel the same area in the other breast to make sure the change is not a part of healthy breast tissue in that area.

Change in the size or shape of the breast

Nipple discharge that occurs suddenly, is bloody, or occurs in only 1 breast

Physical changes, such as a nipple turned inward or a sore in the nipple area

Skin irritation or changes, such as puckering, dimpling, scaliness, or new creases

Warm, red, swollen breasts with or without a rash with dimpling resembling the skin of an orange, called “peau d’orange”

Pain in the breast, particularly breast pain that does not go away. Pain is not usually a symptom of breast cancer, but it should be reported to a doctor.

If you are concerned about any changes you experience, please talk with your doctor. You doctor will ask how long and how often you have been experiencing the symptom(s), in addition to other questions.

Exams and Tests

Diagnosis of triple-negative breast cancer starts with detection.

As with other breast cancers, a person may feel a small, hard bump on or near their breast. In other cases, a routine scan of the breasts may reveal an area of concern.

Once the growth is detected, a doctor will need to take tissue samples from it. In many cases, this is done with a needle that extracts samples from the suspected lump. The samples are sent to a lab for further testing.

The lab will return a pathology report to the doctor detailing what the growth is made of. In some cases it is benign, meaning there are no cancer cells. Other times, the pathology report indicates that it is cancerous.

What type of breast cancer a person has will be highlighted by the pathology report as well. Someone whose cancer does not fit into one of the three main categories will receive a diagnosis of triple-negative breast cancer.

Treatments

 

Treatment options for triple-negative breast cancer are limited compared to what is available for the other types of breast cancer.

Hormone therapies are found to be less effective because this type of cancer is not influenced by the three hormones associated with other breast cancers.

However, a few different options are available, and researchers are looking for additional medications to help treat this more aggressive breast cancer.

Currently, treatment options for triple-negative breast cancer include:

Surgical options include the partial or full removal of one or both breasts. Someone in the early stages of triple-negative breast cancer may not want to consider a mastectomy, as the first-line of treatment.

In more advanced cases, a doctor may recommend a mastectomy to remove the cancer before it can spread.

Radiation is another potential treatment for people with triple-negative breast cancer. Radiation targets and kills the cancer cells to stop their growth and spread.

Studies suggest that chemotherapy may be the best treatment option for triple-negative breast cancer.

A general treatment plan should be developed between an individual and their doctor. The plan should outline what steps will be taken to treat the cancer, self-care, and what to do if the cancer does not respond to treatment or starts to spread.

An important part of treatment is for a person to remain active and eat a variety of healthy foods. Improving diet and exercise may help someone feel better during treatment.

Possible Complications

Researchers describe the outlook for cancer in 5-year survival rates. In the case of triple-negative breast cancer, people are less likely to survive the first 5 years after the diagnosis than those diagnosed with other types of breast cancer.

However, survival and overall prognosis vary from person to person. Many factors can affect an individual’s prognosis, including:

  • when the cancer was discovered and treated
  • what stage the cancer is and, whether or not it has spread
  • how the cancer responds to treatment

In cases where the cancer is caught in earlier stages and treated effectively, a person has a much higher survival rate than if it is discovered in the later stages, where the cancer has spread or does not respond to treatment.

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Preventions

Cancer prevention is action taken to lower the chance of getting cancer. By preventing cancer, the number of new cases of cancer in a group or population is lowered. Hopefully, this will lower the number of deaths caused by cancer.

To prevent new cancers from starting, scientists look at risk factors and protective factors. Anything that increases your chance of developing cancer is called a cancer risk factor; anything that decreases your chance of developing cancer is called a cancer protective factor.

Some risk factors for cancer can be avoided, but many cannot. For example, both smoking and inheriting certain genes are risk factors for some types of cancer, but only smoking can be avoided. Regular exercise and a healthy diet may be protective factors for some types of cancer. Avoiding risk factors and increasing protective factors may lower your risk but it does not mean that you will not get cancer.

Different ways to prevent cancer are being studied, including:

  • Changing lifestyle or eating habits.
  • Avoiding things known to cause cancer.
  • Taking medicine to treat a precancerous condition or to keep cancer from starting.
  • Risk-reducing surgery.