Triple Negative Breast Cancer

HomeTriple Negative Breast Cancer
Overview

Triple-negative breast cancer (TNBC) is a specific subtype of breast cancer characterized by the absence of estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor receptor 2 (HER2). This means that TNBC does not respond to hormonal therapy or medications targeting HER2, which are commonly used in other types of breast cancer. TNBC accounts for about 10-15% of all breast cancers and tends to be more aggressive and have a higher risk of recurrence compared to other subtypes.

There are different types of TNBC based on their molecular characteristics. These subtypes include:

  1. Basal-like TNBC: This is the most common subtype and is characterized by the expression of basal markers such as cytokeratins 5, 6, 14, and 17. It is associated with a higher grade, larger tumor size, and higher risk of metastasis.
  2. Mesenchymal-like TNBC: This subtype is characterized by the expression of genes associated with epithelial-to-mesenchymal transition (EMT), a process involved in cancer progression and metastasis.
  3. Immunomodulatory TNBC: This subtype is characterized by the presence of immune-related gene signatures and an increased presence of tumor-infiltrating lymphocytes (TILs).

The exact causes of TNBC are not fully understood, but certain risk factors have been identified. These include:

  1. Age: TNBC tends to occur at a younger age compared to other breast cancer subtypes. Women under the age of 40 have a higher risk.
  2. Family history: Having a family history of breast or ovarian cancer, especially in first-degree relatives (mother, sister, daughter), increases the risk.
  3. BRCA1 mutation: Women with an inherited mutation in the BRCA1 gene have a higher risk of developing TNBC. BRCA1 mutations are also associated with an increased risk of ovarian cancer.
  4. African American ethnicity: African American women have a higher incidence of TNBC compared to women of other ethnic backgrounds.
  5. Obesity: Being overweight or obese, particularly after menopause, is a risk factor for TNBC.
  6. Reproductive factors: Early onset of menstruation, late menopause, and having the first full-term pregnancy at a later age can increase the risk.

It’s important to note that while TNBC is more aggressive, there have been significant advancements in treatment options, including chemotherapy, targeted therapies, and immunotherapy. Clinical trials and ongoing research are focused on finding more effective treatments specifically for TNBC, and early detection through regular breast screenings remains crucial.

The symptoms of triple-negative breast cancer (TNBC) are similar to those of other types of breast cancer. These symptoms may include:

  1. A lump or thickening in the breast or underarm area: This is the most common symptom of breast cancer. It may feel different from the surrounding breast tissue and does not usually cause pain.
  2. Changes in breast size or shape: TNBC may cause the breast to appear swollen, larger, or differently shaped compared to the other breast.
  3. Breast pain or tenderness: Some women with TNBC may experience pain or discomfort in the breast, although breast cancer typically does not cause pain in the early stages.
  4. Skin changes: These may include redness, dimpling, or puckering of the breast skin, resembling an orange peel.
  5. Nipple changes: Any changes in the nipple, such as inversion (turning inward), scaling, crusting, or discharge (other than breast milk), should be evaluated by a healthcare professional.
  6. Enlarged lymph nodes: In some cases, TNBC may cause the lymph nodes in the underarm area or around the collarbone to become swollen or tender.

It is important to remember that these symptoms can also be caused by non-cancerous conditions. However, if you notice any changes in your breast or experience any of these symptoms, it is essential to consult a healthcare professional for further evaluation and appropriate diagnostic tests, such as mammography, ultrasound, or biopsy. Early detection and prompt medical attention are key in improving the prognosis and treatment outcomes for TNBC.

The diagnosis of triple-negative breast cancer (TNBC) involves several steps to determine the presence of cancer and its specific subtype. Here is an overview of the diagnostic process:

  1. Clinical evaluation: Your healthcare provider will conduct a thorough physical examination of your breasts, including checking for any lumps or abnormalities.
  2. Imaging tests: Mammography is typically the initial imaging test used for breast cancer screening. If an abnormality is detected, additional imaging tests such as ultrasound or magnetic resonance imaging (MRI) may be performed to obtain more detailed information about the breast tissue.
  3. Biopsy: If an imaging test reveals a suspicious area, a biopsy will be performed to obtain a sample of the breast tissue for examination under a microscope. There are different types of biopsies, including:

– Fine needle aspiration biopsy (FNAB): A thin needle is used to extract a small sample of cells from the breast lump.

– Core needle biopsy: A larger needle is used to remove a small cylinder of tissue from the breast lump.

– Surgical biopsy: This involves removing a larger portion of the suspicious tissue through a minor surgical procedure.

  1. Pathological analysis: The biopsy sample is sent to a pathology laboratory where it is examined by a pathologist. They will analyze the tissue for the presence of cancer cells, evaluate the tumor’s characteristics, and determine if it is triple-negative breast cancer.
  2. Molecular profiling: In some cases, additional tests may be performed on the tumor sample to determine its molecular characteristics. This can help identify specific genetic mutations or gene expression patterns that may guide treatment decisions.

Once a diagnosis of triple-negative breast cancer is confirmed, further staging tests may be done to determine the extent of the cancer’s spread. These tests may include imaging scans (such as a CT scan, PET scan, or bone scan) and blood tests.

It’s important to work closely with your healthcare team throughout the diagnostic process to ensure a comprehensive evaluation and develop an appropriate treatment plan tailored to your specific situation.

The treatment for triple-negative breast cancer (TNBC) often involves a combination of different approaches, including surgery, chemotherapy, radiation therapy, and targeted therapies. The specific treatment plan will depend on various factors, such as the stage of the cancer, the size of the tumor, and the individual’s overall health. Here are some common treatment options for TNBC:

  1. Surgery: The main surgical treatment for TNBC is typically a lumpectomy (removal of the tumor and a small margin of surrounding tissue) or a mastectomy (removal of the entire breast). In some cases, lymph nodes in the underarm area may also be removed and examined for cancer cells.
  2. Chemotherapy: Chemotherapy is an essential part of the treatment for TNBC. It is usually given after surgery (adjuvant chemotherapy) to destroy any remaining cancer cells and reduce the risk of recurrence. Neoadjuvant chemotherapy may also be used before surgery to shrink large tumors and increase the likelihood of breast-conserving surgery.
  3. Radiation therapy: Following surgery, radiation therapy may be recommended to target the remaining breast tissue or lymph nodes to further reduce the risk of local recurrence.
  4. Targeted therapies: Although TNBC lacks expression of hormone receptors (ER, PR) and HER2, researchers are investigating targeted therapies that specifically target other biological pathways. For example, some TNBC patients with BRCA mutations may benefit from targeted therapies like PARP inhibitors.
  5. Clinical trials: Participation in clinical trials is another treatment option for TNBC. These trials explore novel treatments, immunotherapies, or combination therapies that may offer improved outcomes for TNBC patients.
  6. Supportive care: Supportive care plays a crucial role in managing the side effects of treatment and supporting overall well-being. This may include medications for symptom management, counseling, support groups, and lifestyle modifications.

It’s important to consult with a multidisciplinary team of healthcare professionals, including surgeons, medical oncologists, radiation oncologists, and other specialists, to develop an individualized treatment plan based on your specific diagnosis and circumstances. Regular follow-up appointments and monitoring are essential to assess treatment response and detect any signs of recurrence.

Get in Touch:

Mail Us:

info@lenusoncology.com

X