Triple-Negative Breast Cancer

Triple-negative breast cancer (TNBC) is a rare type of invasive breast cancer. It affects about 13 in 100,00 women in the U.S.

The name triple-negative refers to the difference between TNBC and other types of breast cancers. Breast cancer cells have receptors for estrogen and progesterone. They also have receptors for HER2. This is a protein that manages breast cell growth.

Receptors on cells act like locks that only certain substances can open. Most common breast cancer medications target receptors. TNBC cells don’t have increased expression of receptors. That means that certain drugs that work to treat other types of breast cancer aren’t as effective if you have TNBC. But recent research shows combining certain cancer drugs may help people live longer with triple-negative breast cancer.

Symptoms of triple-negative breast cancer

Triple-negative breast cancer symptoms include:

• A new lump or mass in your breast
• Breast pain or nipple pain
• Dimpled breast skin
• Nipple discharge
• A nipple turning inward
• Nipple or breast skin that’s dry, flaking, thickened or red
• Swelling in all or part of your breast
• Swollen lymph nodes under your arm or near your collarbone.

Having certain symptoms doesn’t mean you have breast cancer. But don’t hesitate to talk to a healthcare provider if you notice changes in your breasts. It’s also important to have regular mammograms that may detect cancer before it causes symptoms.

Triple-negative breast cancer causes

Researchers don’t know the exact cause. But there’s a connection between TNBC and mutations in the BRCA1 and BRCA2 genes. These genes keep cancer from growing. Cancer can develop when genes change for unknown reasons.

Risk factors

Triple-negative breast cancer is more likely to affect females who are:

• Age 40 and younger
• Inherit BRCA gene changes
• Black or Hispanic

How doctors diagnose triple-negative breast cancer

A healthcare provider will examine your breast. They’ll ask if you’ve noticed changes in your breasts. They’ll do tests including:

• Mammogram
• Breast MRI
• Breast ultrasound

A surgical oncologist or a radiologist will do a breast biopsy if imaging tests detect cancer. They’ll do the biopsy to get breast tissue samples. A medical pathologist will examine the tissue under a microscope. They’ll check the status of estrogen receptor (ER), progesterone receptor (PR) or human epidermal growth factor receptor-2 (HER2).

They may do another test to identify any germline mutations. These are mutations that occur in a parent’s reproductive cells (egg or sperm). They change the genetic material that the child receives from their parents (hereditary). You can inherit germline mutations from either parent.

Your cancer care team will use test results to set a cancer stage. Cancer staging information helps them plan treatment.

Treatment

Breast cancer surgery is a common treatment for triple-negative breast cancer. Your oncologist may combine surgery with cancer treatments like:

• Chemotherapy to treat early-stage (Stage I or Stage II) cancer
• Immunotherapy and chemotherapy to shrink cancerous tumors before surgery
• Radiation therapy after surgery to reduce the chance that cancer will come back (recur)
• Targeted therapy, including PARP inhibitors or antibody drug conjugates, to treat TNBC that involves BRCA genetic mutations in select situations

Triple-negative breast cancer is the focus of many clinical trials. These are research studies where experts test potential treatments. A clinical trial may be a chance to receive new drugs or new combinations of drugs. You may want to ask your cancer care team if a clinical trial makes sense for you.

When should I see my healthcare provider?

Breast cancer surgery can cause complications like surgical wound infection or blood clots. Contact your cancer care team if you have infection symptoms like:

• Fever (greater than 101 degrees Fahrenheit or 38.4 degrees Celsius)
• Pus draining from the surgical wound
• Redness or skin discoloration that goes beyond the edge of the incision

Blood clot symptoms include a swollen leg that hurts or trouble breathing. You should also contact the team if cancer treatment side effects are more severe than you expected.

What is the triple-negative cancer survival rate?

The overall relative five-year survival rate is 78%, according to the National Cancer Institute’s Surveillance, Epidemiology and End Results Program. A relative survival rate compares people with the same type and stage of cancer to people in the overall population. In this case, the TNBC overall survival rate means females with TNBC are, on average, about 77% as likely as females who don’t have TNBC to live for at least five years after receiving a diagnosis.

Cancer survival rates are overviews of people’s experiences with cancer. The rates estimate the percentage of people with a specific cancer diagnosis who are alive after a certain time — usually one to five years — after they receive a diagnosis.

The rates don’t predict how long you’ll live with cancer. Survival rate information can be confusing and cause concern. If you have questions, your oncologist will explain what a survival rate means in your situation.

Is there anything I can do to feel better?

Breast cancer treatment can be exhausting. Here are some suggestions that may help:

• Gentle activities like walking and yoga may ease the stress that a cancer diagnosis can cause. And activity may help ease your symptoms.
• Eat well. Fill your plate with lean protein, whole grains, fruits and vegetables. And stay hydrated. Research suggests that staying at a weight that’s healthy for you may help support breast cancer treatment.

And talk to your cancer care team if you have treatment side effects that are more severe than you expect. They’ll do everything they can to support you during your treatment.

Ask them about palliative care or cancer rehabilitation programs. These programs help people with cancer manage symptoms and side effects.