Triple-negative breast cancer (TNBC) is a subtype of breast cancer, which is not a single disease, but an umbrella term for many different kinds of cancer that affect the same part of the body. About 15 to 20 percent of breast cancers are triple-negative, and TNBC can be aggressive, with a higher likelihood of recurrence.
Doctors identify different types of cancer and which treatments will be most effective based on the presence or absence of receptors, proteins that live inside or on the surface of a cell and bind to something in the body to cause the cell to react. You might think of them as doors that scientists can unlock to discover the secrets of the cell: how to turn it on, turn it off, or kill it if it becomes cancerous.
Generally, breast cancer treatments target three receptors found in tumors: estrogen, progesterone and HER2-neu, which were all discovered at different times over decades of research. When a tumor tests positive for one or more of these receptors, treatment includes medicines that prevent, slow or stop cancer growth by targeting them: for example, tamoxifen targets the estrogen receptor and trastuzumab (Herceptin) targets HER2. As scientists discovered these three different receptors and started testing them, they found that some cancers were negative for all three and the shorthand term “triple-negative” became popular.
About 70 to 90 percent of triple-negative breast cancers have a basal-like genetic pattern, which means that the breast cancer cells look somewhat like the cells that line the breast ducts, the tubes in the breast where milk travels. Basal-like breast cancers tend to overexpress, or make too much of, certain genes that encourage cancer growth. This distinction may allow for more individualized treatment options in the future, but for now, these are research questions that have no bearing on treatment.
Researchers are still learning why some people are more likely than others to develop triple-negative breast cancer. Research supports a relationship between risk and your genes, age, race and ethnicity, but researchers do not yet understand why these correlations exist.
Triple-negative breast cancers affect people of all races and 70 percent of TNBC patients are caucasian. But research has indicated that African-American women who develop breast cancer are more likely to get this type than any other type, and they are 20 to 40 percent more likely to have the triple-negative subtype than white women.
Across the board, TNBC patients have a 77 percent survival rate compared to other types at 95 percent, but this number is lower among Black and Hispanic women, who are likely to get more aggressive forms of the disease. African-American women are more often diagnosed at a younger age, at a later stage of the disease and with more aggressive forms of breast cancer.
Because triple-negative breast cancers (TNBC) are estrogen receptor-negative, progesterone receptor-negative and HER2-negative, women with this diagnosis statistically have fewer options for additional treatment after their tumors are removed. TNBC has a high recurrency rate for the first three years after successful treatment, but survivors rarely see recurrence after the five-year mark. While many triple-negative cancers are aggressive, each case is unique and there are some very effective treatments for TNBC.
As of now, chemotherapy is the primary treatment for TNBC, and there are many different kinds of chemotherapy to choose from depending on several factors. Since this treatment doesn’t target a specific receptor, it does have a higher incidence of recurrence and is more likely to spread to other body parts. But a doctor’s prediction of how well treatment will work depends on the tumor size and whether the cancer has traveled to the lymph nodes, small glands in the armpit and other areas near the breast, just as much as it does on its triple-negative status.
Researchers are working to find targets for triple-negative breast cancers, and clinical trials are an important part of this research. A clinical trial is a research study that investigates new or emerging treatments for a disease and compares these treatments to established protocol to determine their effectiveness, safety or new usage. For triple-negative breast cancer patients, there may be times when a clinical trial offers the best opportunity for new or emerging therapies.
Several new treatments show promise for triple-negative breast cancer but are not yet FDA approved. Laini Fluellen Charities proudly supports clinical trials through the Community Cancer Research Foundation and the University of Chicago. Over the last ten years, our advocacy fundraising efforts have directly resulted in five new studies in the Northwest Indiana and Chicago area. Check out our resource page to learn more about new treatments in clinical trials including PARP Inhibitors, Platinums and Immunotherapy.
In addition to funding for clinical trials to research new treatments for TNBC, there is also a gap in advocacy and awareness at community hospitals across the country. After a new treatment is discovered, it takes about years for that information to spread to the entire medical community and become common practice. We have built relationships with community hospitals in the Northwest Indiana and Chicago area to help provide their doctors with the latest research on new treatments for TNBC.
Because TNBC typically affects young women who have not yet had their first mammogram, it’s also part of our mission to raise awareness and promote early detection among Black and Hispanic women who are more likely to have this kind of cancer. Through our partnerships with local hospitals, we subsidize mammograms for people who are uninsured or whose insurance doesn’t cover the type of mammogram they need and provide treatment planning resources to newly diagnosed breast cancer patients. We also run local awareness campaigns and events throughout the year.
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Hearing that you or a loved one has TNBC is frightening at the very least, and it can unleash a million worries and uncertainties about your future. But a TNBC diagnosis does not automatically mean a difficult treatment or a shorter life expectancy. You will likely have to take in a lot of new information and make some big decisions in a short window of time, and it can be a very lonely process if you try to manage it alone. Empathy, support and stories of resilience are all necessary healing elements, and it’s an amazing source of hope when you know you’re not alone. You deserve that kind of hope and recognition in your fight against TNBC.
There is an incredible amount of information on the variations in different kinds of cancer and the available treatments, but you should by all means feel empowered to do your own research and get a second opinion if you can. Understanding your specific case and the treatments available for it will help you make more confident decisions. Ask lots of questions and take notes when you speak with your doctors, and keep all of your medical information in one place, like a journal or a folder. Evaluate sources of information by determining how recent they are and if the publisher is affiliated with a medical institution.
Check out this brochure on understanding your TNBC diagnosis from Living Beyond Breast Cancer.
Self-care for your physical, mental and emotional wellbeing will make you feel a bit stronger and a little less overwhelmed during this tough time. Part of your treatment should include consultation with a nutritionist who has experience with cancer patients.
Exercise is important for overall health, and it can be a great way to take care of yourself after treatment. Try to make it a priority in your daily routine, but don’t force yourself to do more than you can handle. Yoga, tai chi and reiki are good for stretching your body and relaxing, especially if you aren’t quite ready for other exercise.
We provide Beth’s Bags to newly diagnosed breast cancer patients. Each one includes a comprehensive medical planner and journal to help navigate your treatment process.
Take a look at our upcoming events to see if there’s one coming up near you.
Hear from others who have received the same diagnosis about their journey through treatment and recovery.
TNBC Foundation and Living Beyond Breast Cancer are both reliable and user-friendly sources of information. View our News & Resources page for information on support groups, clinical trials and more.
We want to hear your story. Please send us a message and tell us a little about yourself.
Though triple-negative breast cancer is an aggressive disease, it can be overcome. These women are living proof. Their stories are a source of hope, inspiration and practical advice for those affected by TNBC.
Are you a TNBC survivor? We want to hear from you! Get in touch with us to share your story.