What is Triple Negative Breast Cancer and What Does It Mean For Me?

If you have just been told that you have triple-negative breast cancer, your brain is probably trying to understand and come to terms with what this means. The word ‘cancer’ can be scary enough and you may never have heard of triple-negative breast cancer.

The purpose of this page is to explain to your family and friends what triple-negative breast cancer is, how it is different to other forms of breast cancer, and what your treatment might be.

What is triple-negative breast cancer?

Forms of breast cancer are generally diagnosed based on the presence or absence of three ‘receptors’, tiny receivers on the tumour (the cancer growth) for substances in the body that are known to fuel most breast cancer tumours. These substances are oestrogen, progesterone, and human epidermal growth factor 2 (HER2). When a small part of the tumour is removed for analysis – it will have been analyzed to search for these receptors. A diagnosis of triple-negative breast cancer (TNBC) means that all three tests were negative – none of these receptors were found. The tumour is oestrogen-receptor negative, progesterone-receptor negative and HER2-receptor negative.

8000 people, mainly women, are believed to be newly diagnosed with TNBC every year in the UK. Young women under 40, women from certain ethnic minorities and women who have inherited a BRCA gene mutation, are at increased risk of developing TNBC.

What does this mean for me?

Treatment of breast cancer can involve surgery, radiotherapy and anti-cancer drugs. The four different types of breast cancer are treated the same in terms of surgery and radiotherapy; in addition, all of the 4 types can also be treated with chemotherapy, but not necessarily other newer anti-cancer drugs.

Over the last 20 years or so, doctors and scientists, often working with drug companies, have developed ‘targeted’ treatments for the 3 most common forms of breast cancer. These medicines attack the receptors, to prevent, slow down or stop the growth of cancer cells. For example, you may have heard of or know, people who have taken tamoxifen if their cancer had ER and/or PR, or trastuzumab (Herceptin) if their cancer had HER2. These drugs have helped reduce the number of people whose cancer comes back or spreads, so that more people with these commoner types of breast cancer make a full recovery.

Because TNBC cells do not have ER, PR or HER2, drugs that attack these targets do not work for people with TNBC. This means that we do not have as many treatments for TNBC as other types of breast cancer. Because TNBC can often come back and spread, it is sometimes described as more “aggressive”; nevertheless, chemotherapy does reduce the risk of these cancers coming back.

Are there treatments for TNBC?

Yes, there are; most women with TNBC can be cured if their cancer is caught early and treated without delay. Your surgeon and your oncologist (cancer doctor) will discuss with you what treatments are best for you and your particular cancer. If you have just been diagnosed with TNBC, treatment usually involves a combination of surgery, radiotherapy and chemotherapy.

Breast Cancer Surgery-squashed.jpeg — Surgery

Surgery is a “local” therapy that deals with the cancer in your breast. Your surgeon will discuss whether they recommend a ‘lumpectomy’ to remove just the cancer or if a mastectomy is necessary to surgically remove the whole breast. They may also discuss removing one or more lymph glands in the armpit. You might want to discuss breast reconstruction with your surgical team if a mastectomy is planned.

Radiotherapy

This is another local therapy. Most people who have a lumpectomy then have a course of radiotherapy to the breast to reduce the risk of cancer coming back in the breast; some people who have had a mastectomy will also be recommended to have radiotherapy to the chest wall to reduce the risk of cancer coming back there.
Radiation therapy usually follows surgery and is also a local treatment that kills cancer cells in the breast that may have eluded surgery. It may also be used under your arm if the surgeon found cancer in the lymph nodes, which is the pathway that cancer cells can use to enter the body. This treatment is a beam given from outside your body and probably on a daily dosage basis for a few weeks.

Chemotherapy 3-squashed.jpeg — Chemotherapy

This is a systemic therapy, which means the drugs circulate through your body. It is given if the doctors suspect that the cancer may have thrown off seedlings of cancer cells, or metastases, which are too small to be seen but might cause problems in years to come.
This is more likely if the cancer is larger, higher grade and/or has spread to some lymph glands in the armpit. If you would like to know more about chemotherapy please go to our ‘When you are first diagnosed with Triple Negative Breast Cancer’ page on our website.

Metastatic TNBC

Metastatic cancer is used to describe cancer when it has visibly spread elsewhere in the body. This usually happens in people who a few years earlier had the treatments described above, but these treatments failed to stop the cancer returning; less often, the cancer may have already spread and be metastatic when it is first diagnosed. Once metastatic, TNBC can be controlled but not cured. There is an increasing number of drug treatments for metastatic TNBC and radiotherapy may also be used but surgery is not usually helpful. You may want to look in more detail at information specifically about metastatic breast cancer and in particular metastatic TNBC.

Should I think about taking part in clinical trials?

Yes, you should!

There are many different types of clinical trials, looking at different drugs and other treatments. The treatments we have now for those with TNBC are the result of people in previous years taking part in clinical trials; this is how medicine moves forwards and people with cancer benefit.

You might want to think about discussing with your oncologist whether there are trials for which you might be suitable. You may not yourself benefit from taking part in a trial, but you could well help people in the future who are in your situation.

Where can I find support while I undergo treatment?

The focus of the UK Charity for TNBC is to provide information to people with TNBC and fund scientific research into targeted treatments and eventually, a cure for TNBC. We also provide up to date information on our website.

There are many other charities that also provide excellent support, giving advice on a wide range of day to day coping strategies and where to find support for you, your family and friends. Here are some useful contacts: