Triple-Negative Breast Cancer

Each kind of breast cancer is based on where it grows in your breast. And each kind can have different subtypes. We identify these subtypes by looking at the cancer cells. “Triple-negative” is the name of one of the subtypes.

Each cell has proteins called receptors on its surface. Receptors attract and connect (bind) with hormones and other proteins. In breast cancer cells, the hormone receptors are estrogen and progesterone. The protein receptor is HER-2.

These receptors influence how breast cells grow, multiply and respond to treatment. So, there’s no single treatment for breast cancer. Instead, we base treatments on the kind of receptors your cancer cells have. But when you have triple-negative breast cancer, it means the cells don’t have any of these three receptors. We don’t necessarily know what’s fueling the cancer. And treatments that work on known receptors may not be as effective with TNBC.

That's why it's important to work with providers who treat rare breast cancers every day. They know what it takes to confirm a diagnosis and craft the best treatment plan.

Diagnosing Triple-Negative Breast Cancer at Cleveland Clinic

Triple-negative breast cancer has the same symptoms as any other kind of breast cancer. You might first find a lump or have breast pain or swelling. You might notice your nipple looks different. Or maybe your breasts are dimpled or dented. All are typical breast cancer warning signs and are good reasons to give us a call.

What to expect at your first visit

Chances are you might be feeling a bit nervous and unsure of what to expect when you meet with us for the first time. That's OK. We’re here to help ease your fears and answer your questions. We want you to feel confident about moving forward with treatment. In fact, when you sit down with your provider, you’ll spend some time getting to know each other. As part of this, they’ll ask you to share your story. They're here to help you feel prepared for what comes next.

Testing for triple-negative breast cancer

If you haven’t had a mammogram, we’ll do one to look at your breast tissue. We may also do a breast ultrasound. Other imaging tests might include:

• CT scan.
• MRI.
• PET scan.

We’ll also do a biopsy to check your breast tissue for cancer cells. And we’ll use these cells to discover if you have triple-negative breast cancer or another type. A biopsy can also help us find out how fast the cancer is growing and if it’s spread. We call this cancer staging. It helps us plan the best treatment for your needs.

Second opinions

You may have a lot of thoughts running through your head when you get a cancer diagnosis. Particularly an aggressive type like triple-negative breast cancer. You may want to confirm that diagnosis and find the best providers to do this before you start treatment. That’s why we encourage second opinions.

We’ll work quickly to schedule an appointment as soon as possible. Our expert breast health providers will listen to your concerns, answer your questions and go over any test results. They’ll also walk you through what to expect from treatment, recovery and follow-up care. A second opinion can help you feel in more control of your health — and cancer journey.

Meet Our Triple-Negative Breast Cancer Team

When you come to Cleveland Clinic, you get a personalized team of expert providers from different specialties on your side. This team works together to confirm your diagnosis and plan the best treatment for your needs. Your care team may include:

• Oncologists.
• Breast surgery specialists.
• Radiation oncologists.
• Radiologists.
• Pathologists.
• Nurse practitioners.
• Genetic counselors.
• Social workers.
• Physician assistants.

Triple-negative breast cancer doesn’t involve receptors like estrogen, progesterone or HER-2. This means we're constantly researching ways to treat this challenging breast cancer. And since no two TNCB diagnoses are the same, you’ll have a highly personalized treatment plan, which may include:

Systemic therapy

You may have chemotherapy before surgery to shrink larger tumors. Or you may have it afterward to kill any cancer cells still in your body. This is known as systemic treatment.

Other treatments also target cancer cells throughout your body. Your providers may recommend immunotherapy to help your immune system fight cancer cells. Or maybe targeted therapy to destroy cells with certain genetic changes (mutations).

Surgery

There are different types of breast cancer surgery. What we recommend depends on things like tumor size and location, how quickly (aggressively) it’s growing and the cancer’s stage.

A lumpectomy removes the tumor and some nearby breast tissue. A mastectomy removes the entire breast. Your care team will go over what they feel is best for you. During surgery, you may also have a sentinel node biopsy. This shows if the cancer has spread into nearby lymph nodes.

Sometimes, when cancer has spread to other distant organs, surgery is only used in certain circumstances.

Radiation therapy

After surgery, your provider may recommend you have radiation therapy. This treatment can kill the remaining cancer cells in your breast or nearby lymph nodes to lower the chance cancer comes back (breast cancer recurrence).

Living with Triple-Negative Breast Cancer

Cancer treatments can make you feel tired and run down. Chemotherapy treatments could affect your appetite. Or you may feel constantly nauseated. If you have surgery, you’ll need time to recover from that. Treatments can also affect your immune system. Rest is important throughout treatment, no matter what your plan includes.

It’s important to understand a cancer diagnosis can affect more than your physical well-being. You may also feel emotionally and mentally drained. And it’s not uncommon to feel anxious or overwhelmed. We can connect you with support groups and counselors to help you with the ups and downs of cancer treatment.

Once treatments are done, you’ll continue to see your care team for follow-up visits and testing. For the first few years, you'll see your care team every few months. Later, you’ll come approximately every six months for a couple more years. We want to make sure your cancer doesn’t return. And if it does, we can catch it early and treat it quickly.

Taking the Next Step

A breast cancer diagnosis is a lot to digest. Especially when you learn it can be challenging to treat. When you have triple-negative breast cancer, you want experts on your side. Our breast health specialists are familiar with treating TNBC, so you can be confident you’re getting the best care. We also know that cancer can be an emotional journey. We’ll make sure you get compassionate support — from the moment you reach out to us.