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Triple-Negative Breast Cancer: What You Need to Know

07 Apr, 2023

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Triple-negative breast cancer (TNBC) is a type of breast cancer that accounts for 10-20% of all breast cancer cases. Unlike other types of breast cancer, TNBC does not respond to hormone therapy or targeted therapies that target HER2 receptors. This makes TNBC a more aggressive and difficult-to-treat form of breast cancer. In this blog, we will discuss what you need to know about TNBC, including its causes, symptoms, diagnosis, and treatment options.

Causes of TNBC

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The exact causes of TNBC are not yet fully understood, but there are several risk factors associated with the development of this type of breast cancer. These include:

  1. Age: Women who are over 40 years old are at a higher risk of developing TNBC.
  2. Genetics: Some genetic mutations, such as mutations in the BRCA1 and BRCA2 genes, increase the risk of developing TNBC.
  3. Race: African American women are more likely to develop TNBC than women of other races.
  4. Obesity: Women who are overweight or obese have a higher risk of developing TNBC.
  5. Previous Radiation Therapy: Women who have had radiation therapy to the chest area for a previous cancer are at higher risk of developing TNBC.

Symptoms of TNBC

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The symptoms of TNBC are similar to those of other types of breast cancer, and may include:

  1. A lump or mass in the breast or underarm area.
  2. Swelling or thickening of the breast.
  3. Breast pain or tenderness.
  4. Nipple discharge or retraction.
  5. Skin changes, such as dimpling or redness.
  6. Enlarged lymph nodes in the armpit area.

It is important to note that not all breast lumps are cancerous, and many women with TNBC may not experience any symptoms at all. That is why regular breast cancer screenings are so important, especially for women with a family history of breast cancer or other risk factors.

Diagnosis of TNBC

TNBC is diagnosed using a combination of imaging tests and a biopsy, which involves removing a small sample of breast tissue for analysis. The most common imaging tests used to diagnose TNBC include:

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  1. Mammogram: A mammogram is an X-ray of the breast that can detect abnormalities, such as lumps or masses.
  2. Ultrasound: An ultrasound uses sound waves to create images of the breast tissue and can help distinguish between a solid lump and a fluid-filled cyst.
  3. Magnetic Resonance Imaging (MRI): An MRI uses a magnetic field and radio waves to create detailed images of the breast tissue and can help detect small tumours that may be missed by other imaging tests.

If imaging tests show a suspicious mass or abnormality, a biopsy will be performed to determine whether it is cancerous.

There are two main types of breast biopsy:

  1. Fine-needle aspiration biopsy: This involves inserting a thin needle into the breast tissue to remove a small sample of cells for analysis.
  2. Core biopsy: This involves using a larger needle to remove a small sample of breast tissue for analysis.

Once the biopsy results are available, a pathologist will examine the tissue to determine the type and stage of cancer.

Stages of TNBC

TNBC is staged based on the size and location of the tumour, whether cancer has spread to nearby lymph nodes, and whether it has metastasized (spread) to other parts of the body. The stages of TNBC are:

  1. Stage 0: Abnormal cells are present, but they have not invaded nearby breast tissue.
  2. Stage I: The tumour is less than 2 cm in size and has not spread to nearby lymph nodes.
  3. Stage II: The tumour is between 2-5 cm in size and may or may not have spread to nearby lymph nodes.
  4. Stage III: The tumour is larger than 5 cm in size and has spread to nearby lymph nodes or surrounding tissues.
  5. Stage IV: Cancer has metastasized to other parts of the body, such as the lungs, liver, or bones.

Treatment options for TNBC

Treatment for TNBC typically involves a combination of surgery, chemotherapy, and radiation therapy. Because TNBC does not respond to hormone therapy or targeted therapies, these options are not effective for treating this type of breast cancer.

  1. Surgery: The main surgical treatment for TNBC is a lumpectomy or mastectomy. A lumpectomy involves removing the tumour and a small amount of surrounding tissue, while a mastectomy involves removing the entire breast. In some cases, lymph nodes may also be removed to determine whether cancer has spread.
  2. Chemotherapy: Chemotherapy is often used to shrink the tumour before surgery, or to kill any remaining cancer cells after surgery.
  3. Radiation therapy: Radiation therapy uses high-energy X-rays to kill cancer cells and is often used after surgery to destroy any remaining cancer cells. It may also be used to treat cancer that has spread to other parts of the body.
  4. Clinical trials: Clinical trials are research studies that test new treatments or procedures for cancer. Patients with TNBC may be eligible to participate in clinical trials to test new drugs or therapies that are specifically designed to treat this type of breast cancer.

Prevention of TNBC

While there is no guaranteed way to prevent TNBC, there are certain lifestyle changes that may reduce a woman's risk of developing this type of breast cancer. These include:

  1. Maintaining a healthy weight: Women who are overweight or obese are at an increased risk of developing TNBC, so maintaining a healthy weight through diet and exercise may help to reduce this risk.
  2. Limiting alcohol consumption: Drinking alcohol has been linked to an increased risk of breast cancer, so limiting alcohol consumption may help to reduce the risk of developing TNBC.
  3. Getting regular exercise: Regular exercise has been shown to reduce the risk of breast cancer, so incorporating physical activity into your daily routine may help to reduce the risk of developing TNBC.
  4. Breastfeeding: Women who breastfeed their babies for at least six months have been shown to have a reduced risk of developing breast cancer, including TNBC.
  5. Regular breast cancer screenings: Regular breast cancer screenings, including mammograms and clinical breast exams, can help to detect abnormalities early on when they are most treatable.

Conclusion

Triple-negative breast cancer is a challenging and aggressive form of breast cancer that requires a comprehensive treatment approach. It is important for women to be aware of the risk factors associated with TNBC and to undergo regular breast cancer screenings to detect any abnormalities early on. If you are diagnosed with TNBC, it is important to work closely with your healthcare team to determine the best treatment options for your individual needs. With the right treatment and support, it is possible to overcome TNBC and live a full and healthy life.

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FAQs

Triple-negative breast cancer is a type of breast cancer that is characterised by the absence of three hormone receptors: oestrogen, progesterone, and human epidermal growth factor receptor 2 (HER2). This makes it more difficult to treat with hormone-based therapies, which are often effective for other types of breast cancer.