Understanding Triple Negative Breast Cancer: An Overview
The term “triple negative” might sound like a complex code, but in the world of breast cancer, it has a specific meaning. Unlike most breast cancers, Triple Negative Breast Cancer (TNBC) doesn’t rely on the usual fuel sources for growth. This unique characteristic exhibits both challenges and opportunities.
It’s like a puzzle with key pieces missing; TNBC lacks the estrogen, progesterone, and HER2 receptors, which makes it particularly elusive and harder to treat with standard hormonal therapies. Yet, understanding TNBC symptoms is crucial as it opens doors to tailored treatments and innovative research.
Join us as we unravel the mysteries of TNBC breast Cancer as well as explore the advancements that offer hope and healing.
What is Triple Negative Breast Cancer?
Triple-negative breast cancer is a form of breast cancer in which the cancer cells do not express three common receptors typically found in breast cancer: the hormones estrogen and progesterone and the protein HER2. These receptors usually promote breast cancer growth, allowing for treatments like hormone therapy and targeted drugs. However, the absence of these receptors in triple-negative breast cancer means that fewer treatment options are available.
This type of breast cancer is more aggressive compared to other forms. It is often more advanced at the time of diagnosis and has a higher likelihood of recurrence within the first three years post-treatment. Additionally, the risk of fatality is higher within the first five years. However, after surpassing these critical milestones, the chances of long-term survival become similar to those with other types of breast cancer.
Risk Factors /Causes of TNBC
Research indicates that certain risk factors can increase the likelihood of developing triple-negative breast cancer.
These risk factors include:
- Age: Premenopausal women and those under the age of 50 are at a higher risk of developing TNBC.
- BRCA1 Gene Mutation: Approximately 70 per cent of breast cancers diagnosed in women with an inherited BRCA1 mutation are triple-negative.
- Ethnicity: African American and Hispanic women have a higher incidence of TNBC. Around 20 to 40 per cent of breast cancers diagnosed in African American women are triple-negative.
What are the symptoms of Triple Negative Breast Cancer?
Following are some of the most typical TNBC symptoms:
- A lump or mass in the breast
- Pain or redness in the breast or nipple
- An inward-turning nipple or nipple discharge
- Swelling in all or part of the breast, even without a detectable lump
- Dimpled skin that may resemble an orange peel
- Dry, flaking, thickened, or red skin on the nipple or breast
- Swollen lymph nodes under the arm or sometimes near the collarbone
- Warmth, itchiness, or irritation in the breast
- Changes in breast size, shape, or symmetry
What are the various stages of TNBC?
The stages of TNBC are as follows:
- Stage 0: Noninvasive; cancer remains within breast ducts.
- Stage I: Cancer has spread to nearby breast tissue.
- Stage II: Tumour is either under 2 cm and spread to underarm lymph nodes or over 5 cm without spreading to lymph nodes. Tumours can also be 2-5 cm with or without lymph node involvement.
- Stage III: In stage 3 triple negative breast cancer, the cells have spread to nearby tissues and lymph nodes but not distant organs, also known as “locally advanced breast cancer.”
- Stage IV: This stage is also known as triple negative metastatic breast cancer as the cancer has metastasised to distant or other organs such as bones, liver, lungs, or brain.
Triple-negative Invasive Ductal carcinoma (TN IDC): The Most Aggressive Form/Type of Breast Cancer
Triple-negative invasive ductal carcinoma (TNBC) is a sub-type of breast cancer identified by the absence of estrogen receptors, progesterone receptors, and HER2, making it unresponsive to hormonal therapies and HER2-targeted treatments. Originating in the milk ducts, this invasive subtype of TNBC spreads to surrounding breast tissue and is known for its aggressive nature and higher recurrence rates, particularly within the first few years post-treatment.
So, TN IDC is an aggressive form of breast cancer where the cancer cells grow independently of hormones and a specific protein, making it trickier to treat with some common therapies.
Prognosis and Diagnosis
What is the prognosis of TNBC?
The triple negative breast cancer prognosis is steadily improving due to advancements in treatments such as immunotherapy and PARP inhibitors, as well as innovative uses of existing therapies. On average, about 91% of women with localized triple-negative breast cancer survive for five years post-diagnosis.
However, the stage of cancer at diagnosis significantly influences prognosis. For instance, if cancer has spread to nearby lymph nodes (regional, indicated by a number after the N in the TNM staging), the five-year relative survival rate drops to around 65%. If the cancer has metastasized to distant parts of the body (M1 in TNM staging), the five-year relative survival rate is approximately 12%.
Diagnosis
Triple-negative breast cancer is often detected through a mammogram or other diagnostic tests prompted by symptoms. It, along with invasive ductal carcinoma (IDC), can also be discovered during a breast examination.
If a mammogram indicates potential cancer, a biopsy is typically performed to analyze the cells in a pathology lab, advancing the diagnostic process for breast cancer.
What is the treatment for TNBC?
TNBC treatment may involve the following approaches:
Radiation Therapy
Post-lumpectomy radiation therapy is commonly recommended. For mastectomy patients, radiation may or may not be advised depending on specific cancer traits.
Chemotherapy
Our oncologist, Dr Rajeev Kaushal, may use one or more drugs to slow or halt the growth of cancer cells while treating the stages of TNBC. It can be carried out before surgery (neoadjuvant chemotherapy) or after surgery (adjuvant chemotherapy).
- Neoadjuvant Chemotherapy involves administering chemotherapy drugs before the surgical removal of a tumour. This approach aims to shrink the breast cancer tumour, providing more surgical options for treatment.
- Adjuvant Chemotherapy is a supplementary cancer treatment given following the primary treatment to reduce the risk of cancer recurrence. It can include chemotherapy, radiation therapy, hormone therapy, targeted therapy, or biological therapy.
Immunotherapy
These medications boost the body’s immune system to fight cancer cells. Keytruda (pembrolizumab) is used to treat early-stage triple-negative breast cancer with a high risk of recurrence and PD-L1-positive metastatic triple-negative breast cancer.
Surgery
Based on the cancer’s characteristics, such as size, grade, and stage, your doctor might suggest either a mastectomy or a lumpectomy to eliminate the tumour.
Get in touch with Oncologist Dr Rajeev Kaushal for Targeted Triple Negative Breast Cancer Treatment
If you’ve been diagnosed with Triple Negative Breast Cancer, you deserve the most up-to-date and targeted treatment options available. Dr Rajeev Kaushal, a leading oncologist, can create a personalized treatment plan tailored to your specific needs.
His expertise and commitment to utilizing the latest advancements in cancer treatment ensure that patients receive the best possible outcomes.
Schedule a consultation today to discuss your treatment options and take the first step towards a healthier future.