Learning that you’ve been diagnosed with breast cancer can be life-changing and overwhelming. The breast cancer experts at the OSUCCC – James understand that and recognize that no cancer is a routine cancer for the person experiencing a cancer diagnosis.
We want to walk you through every step of your cancer journey, including making sure you understand your diagnosis, your treatment plan and what might be happening with your body. This means knowing what type of breast cancer you have.
There are various kinds of breast cancer, and the type you’re diagnosed with can influence your prognosis and what therapies might be most effective. Triple-negative breast cancer is a type of breast cancer that can spread rapidly if not caught and managed quickly. The breast cancer experts at the OSUCCC – James specialize in identifying and treating triple-negative breast cancer and are actively researching more targeted treatment options.
What is triple-negative breast cancer?
After cancer cells are removed from the breast during a biopsy or surgery, they are tested for hormone receptors (estrogen and progesterone) and amount of HER2 protein or receptor. Whether they are positive or negative for these receptors can inform your doctor what treatment might be most effective for your particular breast cancer.
Cancer that does not have estrogen or progesterone receptors, as well as doesn’t produce much HER2 protein, is considered a triple-negative breast cancer. It accounts for 10-15% of all breast cancer cases and tends to be more aggressive than other forms of breast cancer.
Who is more at risk to get triple-negative breast cancer?
Anyone can develop triple-negative breast cancer, but there are certain characteristics, many of which you have no control over, that can put you at greater risk for the disease. Those risk factors are:
- Age – Premenopausal women and those under 50 have a greater risk for triple-negative breast cancer.
- Genetics – People with BRCA mutations have an increased risk of this type of cancer.
- Ethnicity – People who are Black or Hispanic have higher rates of triple-negative breast cancer.
Triple-negative breast cancer symptoms
Triple-negative breast cancer has similar symptoms to other types of breast cancer; however, sometimes these can be difficult to discern from symptoms of other conditions, such as hormonal changes. While most women do not have any symptoms, some potential signs of a breast cancer may include:
- A new or growing breast lump
- Swelling or changes in breast size or shape
- Breast or nipple pain
- Nipple discharge
- Nipple inversion or turning in of the nipple
- Thickening of breast or nipple skin
Remember, many of these symptoms may not appear at all or until later stages of the disease, and the best way to catch the disease early is to have regular mammograms. If you’re experiencing any of these symptoms, schedule your mammogram today.
How is triple-negative breast cancer diagnosed?
Triple-negative breast cancer is most often discovered through a physical examination or a mammogram. You might need other tests to identify or confirm a diagnosis. Those diagnostic tools include:
- Diagnostic mammogram – Used to investigate suspicious areas or abnormal screening results, this type of mammogram involves X-rays of different angles, magnification views and sometimes breast tomography, also known as a 3D mammogram.
- Ultrasound – This uses sound waves to examine the breast tissue and other characteristics of the breast.
- Magnetic resonance imaging (MRI) – An MRI of the breast can be especially useful for examining people with an elevated risk for breast cancer.
- Biopsy – If a suspicious area is detected, we’ll take a sample of that breast tissue for trained pathologists to examine under a microscope for signs of abnormal cells. This test can confirm or rule out cancer as well as give us key information about the cancer, if it’s diagnosed.
If cancer is confirmed in the biopsy, the pathologists will then test the biopsy sample to see if it contains the protein receptors estrogen, progesterone or HER2.
What types of breast cancer can immunotherapy be used for?
Download video transcriptTriple-negative breast cancer treatment
This form of cancer can be a bit more difficult to treat than others, because it can spread quickly and may be more advanced when initially diagnosed. Hormone therapy or HER2 drugs won’t work, because there are no estrogen or progesterone receptors and too little HER2 in the cancer. That’s why chemotherapy is often a recommended treatment method.
Treatment for triple-negative is typically broken down based on the stage of cancer.
Treatment for earlier stages of triple-negative breast cancer
For triple-negative breast cancer in stages 1-3, you might be treated with:
- Surgery – If the cancer is found in only the breast or a lymph node in the armpit, a lumpectomy or mastectomy can be performed to remove some or all of the breast tissue.
- Chemotherapy – If the tumor is larger, sometimes chemotherapy is given before surgery, which is called the neoadjuvant setting, to shrink the tumor, allowing us to remove it during surgery and to reduce the chances of the cancer spreading. Sometimes chemotherapy can be given after surgery, which is called the adjuvant setting, to reduce the chances of the cancer returning.
- Radiation therapy – Depending on certain characteristics of the cancer, this might be recommended following surgery.
- Immunotherapy – The immune system is more likely to react to triple-negative breast cancer, so in recent years, immunotherapy has become an important part of treatment for triple-negative breast cancer in the neoadjuvant phase. Immunotherapy is a type of cancer treatment in which the body’s own defense system attacks the cancer cells.
Treatment for later stages of triple-negative breast cancer
For triple-negative breast cancer in stage 4, or metastatic breast cancer, you might be treated with:
- Chemotherapy – It’s often used when cancer has spread to other parts of the body. Possible chemotherapy agents include anthracyclines, taxanes, capecitabine, gemcitabine, eribulin and others.
- Immunotherapy – For many with metastatic triple-negative breast cancer, immunotherapy (for example, pembrolizumab) can play an important role in treatment.
- Targeted therapy – While most targeted therapies won’t work on triple-negative breast cancers, an antibody-drug conjugate, like sacituzumab govitecan (Trodelvy) or trastuzumab deruxtecan (Enhertu), might be an option after two other drug treatments have not worked.
- Clinical trials – New treatments might help extend your life if you have triple-negative breast cancer that has spread. We actively initiate and participate in many clinical trials and studies revolving around this type of cancer, which may significantly improve outcomes.
Surgery and radiation might also be recommended in certain cases of metastatic triple-negative breast cancer, but these treatments are less commonly used in the metastatic setting.
Related Resources
Breast Cancer Prevention and Risk Factors
Breast Cancer Symptoms and Causes
Breast Cancer Diagnosis and Staging
Breast Cancer Treatment
Breast Cancer Treatment Team