Triple-negative breast cancer (TNBC) is an aggressive form of invasive breast cancer. Unlike other types of invasive breast cancer, TNBC tends to grow and spread more rapidly, has fewer treatment options, and generally has a worse prognosis.
The term “triple-negative” refers to the absence of three common receptors found in breast cancer cells: estrogen receptors (ER), progesterone receptors (PR), and the HER2 protein. When these receptors are not present, the cancer is classified as triple-negative.
TNBC accounts for approximately 10-15% of all breast cancers. It is more commonly diagnosed in women under the age of 40, Black women, and those with a BRCA1 gene mutation.
The signs and symptoms of TNBC are similar to those of other breast cancer types. Diagnosis involves imaging tests and a biopsy, followed by testing the cancer cells for specific proteins. If the cells lack ER, PR, and HER2, the cancer is confirmed as triple-negative.
TNBC is known for its rapid growth and higher likelihood of spreading at the time of diagnosis. It also has a higher chance of recurrence after treatment compared to other breast cancer types. Consequently, the survival rates for TNBC are generally lower.
Survival rates provide an estimate of the percentage of people with the same type and stage of cancer who are still alive after a certain period, usually five years. These rates are based on large groups of people and cannot predict individual outcomes. It’s important to discuss these statistics with your doctor to understand how they apply to your specific situation.
The American Cancer Society uses data from the SEER (Surveillance, Epidemiology, and End Results) database to provide survival statistics. The SEER database categorizes cancer stages as localized, regional, and distant:
– Localized: Cancer has not spread outside the breast.
– Regional: Cancer has spread to nearby structures or lymph nodes.
– Distant: Cancer has spread to distant parts of the body, such as the lungs, liver, or bones.
For women diagnosed with TNBC between 2012 and 2018, the 5-year relative survival rates are as follows:
– Localized: 91%
– Regional: 66%
– Distant: 12%
– All stages combined: 77%
These numbers may be more optimistic for women diagnosed today, as treatments continue to improve. However, survival rates are only one aspect of the prognosis and do not account for individual factors such as age, overall health, and how well the cancer responds to treatment.
Treatment options for TNBC are limited compared to other types of breast cancer. Since TNBC cells lack ER, PR, and HER2, hormone therapy and targeted HER2 drugs are ineffective. Chemotherapy is often the primary treatment option.
If the cancer has not spread to distant sites, surgery may be performed. Chemotherapy might be administered before surgery to shrink a large tumor, and it is often recommended after surgery to reduce the risk of recurrence. Radiation therapy may also be considered, depending on the tumor’s characteristics and the type of surgery performed.
For metastatic TNBC (stage IV), treatment options may include platinum chemotherapy, targeted drugs like PARP inhibitors or antibody-drug conjugates, and immunotherapy combined with chemotherapy.
Taking care of yourself is crucial when dealing with TNBC. Self-care can help you regain a sense of control. Consider joining TNBC support groups to connect with others who understand your experience. Accept help from friends and family, and communicate your needs to them.
If you require surgery, ask your healthcare provider about the recovery process and any follow-up treatments. Managing stress through activities like meditation, relaxation exercises, or deep breathing can be beneficial. Maintaining a healthy diet and consulting a nutritionist can help manage chemotherapy-related appetite changes. Plan for rest during radiation treatment, as it can cause fatigue.
Regular follow-up care with your healthcare providers is essential. They will likely schedule physical examinations every three to six months for the first three years after treatment, then every six months in the fourth and fifth years.
Be aware of potential side effects from cancer treatment and seek emergency care if you experience severe symptoms, such as a high fever, chills, a productive cough, stomach pain, persistent diarrhea, or nausea and vomiting.
Prepare questions for your doctor to better understand your diagnosis and treatment options. Some questions to consider include:
– What is triple-negative breast cancer?
– What is the cancer stage, and has it spread?
– What treatments do you recommend and why?
– What are the side effects of these treatments?
– Will I need surgery, and if so, what type?
– Do I need genetic testing?
– What is my prognosis?
– Are there clinical trials available for me?
Triple-negative breast cancer is challenging to treat, but effective treatments are available, including immunotherapy, chemotherapy, surgery, and radiation. Researchers are continually learning more about TNBC, which can lead to better treatment options in the future. If you have concerns about your diagnosis or treatment, discuss them with your healthcare provider.
Source: American Cancer Society, Cleveland Clinic, Mayo Clinic
