Triple-negative Breast Cancer – Are You Aware of It?
Triple-negative breast cancer – One of the most aggressive types of breast cancer as it spreads invasively. In addition to its aggressive nature, it is also one of the most difficult to treat breast cancers. The chances of recurrence of triple-negative breast cancer are quite high as it recurs within the first few years after diagnosis.
The targeted medicines (hormones and drugs that target progesterone, estrogen and HER-2 gene) to treat triple-negative breast cancer do not work and the prognosis of cancer is also poor. Therefore, triple-negative breast cancer is one of the most challenging breast cancers. In spite of all these challenges, it is possible to manage triple-negative breast cancer. Let us understand it better.
What is triple-negative breast cancer?
A typical breast cancer cell has these markers or – in other words – surface receptors: 1. ER (estrogen receptor); 2. PR (progesterone receptor); 3. HER2 [hormone epidermal growth factor receptor 2 (HER2 protein – a cell growth factor)]. These cell surface receptors or markers pick up hormonal signals and help in cell growth. Breast cancer cells that possess these markers are called triple-positive breast cancer – and the cells in which these markers are absent are called triple-negative breast cancer cells. Approximately 15 to 20% of breast cancers are triple-negative and are common in women who carry a mutated BRCA1 gene.
Which women are at risk of triple-negative breast cancer?
Triple-negative breast cancer is most commonly detected in young women (younger than age 50 years), Hispanic women, African American women, obese women and women who do not breastfeed. It is also common (up to 70%) in women who carries a mutated BRCA1 gene.
What are the signs and symptoms of triple-negative breast cancer?
The signs and symptoms of triple-negative breast cancer are the same as those of other types of breast cancer including the following:
- Breast pain
- Change in size, shape and appearance of the breast
- A mass or lump in the breast
- Thickening of breast skin
- Scaliness or redness of breast skin
- A nipple that turns inward
- Nipple pain
- Nipple discharge
- Swelling of the breast – a part or all breast
Are there any medicines to treat triple-negative breast cancer?
The medicines commonly used to treat breast cancer are not effective against triple-negative breast cancer. The drugs that target estrogen receptor (ER) and PR (progesterone receptor) and target HER 2 gene do not work against triple-negative breast cancer. But there are some other medicines that can successfully treat this type of cancer.
How is triple-negative breast cancer diagnosed?
Diagnosis of Triple-negative breast cancer: when a woman suspects some abnormalities in her breast after self-breast examination, she will go to a gynaecologist for a clinical breast examination. Based on the signs and symptoms, physical and clinical examination, the gynaecologist, if suspects, breast cancer, she may order a mammogram. If the gynaecologist detects any abnormality in the breast tissue based on the results of the mammogram, she will do a biopsy to confirm breast cancer.
Pathologist observes the cells taken out from the biopsied tissue under a microscope to determine the abnormal, precancerous and cancerous cells. After detection of cancer – oncologist orders more tests, to get clarity about the type of cancer and its grade. Triple-Negative breast cancer is diagnosed if the detected cancer cells test negative for progesterone (PR), estrogen (ER) and HER2 receptors (which means, the cancer cells lacks all these three receptors). Oncologists grade cancer-based on the results of the tests and by taking other factors into consideration.
What is the treatment for Triple-negative breast cancer?
An oncologist diagnoses, grades and stages breast cancer – which is very important as far as the treatment and prognosis of breast cancer is concerned – especially triple-negative breast cancer. Once the diagnosis, grading and staging of breast cancer are done, the oncologist comes out with the best treatment plan – which includes a combination of surgery, chemotherapy and radiation therapy. Early detection of breast cancer ensures successful treatment – as triple-negative breast cancer responds well to treatment in the initial stages.
What is the survival rate of triple-negative breast cancer?
Majority of the women who have been diagnosed with triple-negative breast cancer feel that all the doors of treatment have been closed for them and death is inevitable – but, in reality, it is a myth. Though the five-year survival rate is approximately 70% (low compared to other types of breast cancer), early diagnosis ensures successful treatment with dramatic improvement in survival rate. The five-year survival rate for other types of breast cancers is around 90%.
Dr T. Rajeshwari Reddy
MBBS, MS (OBG), DES (Germany), FAMS (New Delhi), PGPMAX (ISB)
Consultant Obstetrician, Gynaecologist & Laparoscopic Surgeon
Department of Obstetrics and Gynaecology