What is Triple Negative Breast Cancer?

Center for Cancer Care / What is Triple Negative Breast Cancer?

Triple Negative Breast Cancer

When a breast cancer is diagnosed the tumor is studied to identify the presence or absence of proteins referred to as receptors that live inside a cell or on a cell’s surface which binds to something causing a reaction in the cell.

Estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor (HER-2 neu) are the three most common types of receptors that fuel the growth of breast cancer.  A diagnosis of triple negative breast cancer (TNBC) means that the ER, PR, and HER2 receptors are not present in the breast cancer tumor.  In ER, PR, and HER2 positive breast cancer the growth of cancer can be stopped or slowed through treatments that target those receptors.  A TNBC requires different types of treatment due to the receptors of estrogen, progesterone, and HER2 being negative.

Risk Factors

Research studies propose that being pre-menopausal, African-American, Hispanic or Caribbean increases the risk of developing TNBC.  There is an estimated 20-40 % chance of the development of TNBC among African-American women.  It is not yet understood by researchers why some ethnic groups of women, and those who are pre-menopausal, have higher rates of TNBC than women of other groups.

Each person has breast cancer genes (BRCA1 and BRCA2) that we get from our parents.  These genes prevent the development of cancers when they work properly.  Still, less than 10% of people diagnosed with breast cancer areborn with an abnormality, or mutation, in BRCA1 or BRCA2.

If a BRCA1 or BRCA2 gene mutation exists there is an increased risk for the development of breast, ovarian, and other cancers during your life.  Risks begin to increase at age 30 if there is a BRCA1 mutation.  There is a lifetime risk of 60-70% for breast cancer and 40-50% for ovarian cancer. 

Scientists are trying to determine why BRCA1 mutations increase the risk of developing TNBC.  It is important to know that not all breast cancers which have a BRCA mutation are triple-negative.  It is reported that BRCA2 mutations are more likely to be present in ER positive breast cancer. 

A genetic test may be recommended for someone based on their own, or their family’s cancer history.  This test provides information about the risk of additional breast or ovarian cancer.  If a BRCA mutation is identified, options to manage risks include removal of both breasts and/or ovaries prior to another cancer developing, or more intense screening to detect a new cancer at an early stage.

Treatment Options

Surgery

Treatment is based on several factors: if the cancer has traveled to the lymph nodes, the size of the tumor, and the tumor grade (how quickly the cancer cells are dividing).  Surgery, either a lumpectomy (breast-conserving) or mastectomy will be discussed.  It is important to note that all breast cancers do not require a mastectomy and that prognosis can be the same with either surgery.  A person’s options and recommendations depend on their individual situation and considerations.

Chemotherapy

Due to the fact that TNBC is an aggressive type of breast cancer chemotherapy is the most effective treatment.  Chemotherapy works better to kill cells that divide quickly which commonly occurs in triple-negative disease.  There are various types of chemotherapy treatments that the medical oncologist will discuss and recommend during a consult.

Radiation

Radiation is a local therapy that kills any cancer cells remaining after surgery in the area where the breast cancer was found.  This form of treatment helps to protect from cancer returning in the same place, also referred to as a local recurrence.  Following a lumpectomy radiation is given to destroy any cancer cells remaining in the breast and sometimes in the axilla, or armpit.  Radiation may also be recommended following a mastectomy by healthcare providers.

Healthy Lifestyle

Taking care of your health is important for cancer prevention. Limit your fat intake. Fill up on cancer–fighting foods such as fruits and vegetables; eat red meat sparingly.

Maintain a healthy body weight 
There is a clear link between obesity and breast cancer due to the excess estrogen production in fatty tissue. Maintaining a healthy weight is one of the most important actions you can take to reduce your risk.

Nutrition
Research has shown that certain foods can actually help decrease your risk of developing cancer. These cancer-fighting foods (see below) are not only nutritious—they are usually inexpensive and a natural way to take action and manage your health.

Vitamin A
Researchers have found that this vitamin can actually reduce the risk of developing breast cancer in those who have a family history of the disease. Carrots, sweet potatoes, dried herbs, and leafy greens are all rich in vitamin A.

Vitamin E
Clinically proven to slow the growth of cancer cells in the ovaries by reducing the production of telomerase, a ribonucleoprotein that can increase the risk of developing ovarian cancer. Foods rich in vitamin E include leafy greens such as swiss chard, spinach, and kale, as well as nuts, wheat, and tropical fruits.

Vitamin D
Help reduce the incidence of breast and ovarian cancer by slowing the growth of cancer cells.  The best way to get more vitamin D in your diet is by eating fatty fish (such as salmon), but it can also be found in milk, fortified cereal, orange juice, and eggs.

Fiber
This nutrient found in whole grain, flax, certain cereals, beans, and vegetables has been shown to reduce estrogen levels, which in turn can slow the growth of cancer cells in the breasts. When shopping, swap your white bread with whole grain bread, white rice with brown rice, and sugary cereal for a cereal rich in fiber and the vitamins listed above.

Fruits and Vegetables
These carry the vitamins and nutrients that can help lower your risk of developing breast and ovarian cancer.  Aim for at least five servings a day, and try to include lots of cruciferous vegetables like broccoli and cauliflower, and dark, leafy greens like kale and spinach.

Exercise daily
Regular exercise for 30 minutes or more on most days can reduce the risk of developing breast cancer. Other benefits include reducing stress and lowering the risk for heart disease.

Cut back on cocktails
There appears to be some link between alcohol and breast cancer, although scientists do not really know how strong. Stay on the safe side and limit your alcohol consumption (that includes beer, wine, and liquor) to one drink per day or eliminate it completely.

Don’t smoke
There is research that suggests smoking cigarettes may be linked to breast and ovarian cancer, there is a direct link between tobacco use and many other cancers (not just lung or other oral cancers).  A Smoking Cessation Program is available at the Knox County Health Department 740.392.2200.

Know your family history

Inquire about health problems within your family and identify any history of any type of cancer.  Share this information with your healthcare provider.

What Can I Do?

A - Annual screening mammogram beginning at age 40
B-  Breast Self-Awareness Exam monthly
C - Clinical breast exam annually

Main Care or Service Page: 
Center for Cancer Care
Sub-Care Page A