Delhi/NCR:

MOHALI:

Dehradun:

BATHINDA:

BRAIN ATTACK:

Triple-Negative Breast Cancer: Symptoms, Stages and Treatment | Max Hospital

All You Need to know about Triple Negative Breast Cancer

By Dr. Meenu Walia in Medical Oncology , Breast Cancer , Cancer Care / Oncology

Oct 23 , 2023 | 7 min read

Breast cancer is the leading cause of untimely deaths in women around the world. The cases of women with breast cancer are rising rapidly every year, and this is no less than a cause for worry. There is no doubt that a breast cancer diagnosis can shake anyone's spirit. However, timely diagnosis can indeed cure a person of breast cancer.

What Is Breast Cancer?

Dr. Meenu Walia, Vice Chairman - Medical Oncology (Breast, Gynaecology, Thoracic), Max Super Speciality Hospital, Patparganj and Vaishali, says breast cancer, as the name implies, is cancer that develops in the breast. The cells and tissues of the breast get affected, causing a mass or lump inside the breast. Nipples can retract, skin colour can change, and there is usually redness or thickness of the breast skin. Even though most people associate breast cancer with women as it is highly prevalent, it can also affect men.

Breast Cancer Screening

Breast cancer is often stated as a single condition. However, there are many subtypes of breast cancer. All tumours inside the breast are tested for oestrogen, progesterone, and HER2 receptors. In case the results are positive from the tests, it means there are receptors present inside a tumour. In case of negative results, it means there are none or few receptors inside a tumour.

All the tumours with positive results are treated with their respective therapies. For example, tumours with oestrogen or progesterone-positive receptors are treated with hormone therapy, and HER2-positive ones are treated with anti-HER2 targeted therapy.

Read more - Top 10 Myths about Breast Cancer

What Is Triple-negative Breast Cancer?

Before understanding Triple-negative breast cancer (TNBC), it is important to know the three major types of receptors present in breast cancer.

  • Oestrogen receptors
  • Progesterone receptors
  • HER-2-Neu receptors

TNBC refers to cancer that has not tested positive for any of the three aforementioned types. It is the least common type of breast cancer and the hardest to treat since no targeted therapies exist.

TNBC poses a higher risk of spreading and recurring compared to other breast cancer types. The treatment options and prognosis after recurrence depend on various factors, including the stage and location of the recurrent tumour.

What Are the Signs and Symptoms of Triple-negative Breast Cancer?

Triple-negative breast cancer (TNBC) shares several common symptoms with other forms of breast cancer. Recognising these symptoms is crucial for early detection and timely treatment. Here are the typical signs and symptoms of TNBC:

  • Lump or Mass: A new lump or mass in the breast is a common indicator of triple-negative breast cancer.
  • Swelling in All or Part of a Breast: Swelling in any part of the breast, whether localised or widespread, should be examined by a healthcare professional.
  • Dimpled Skin: If you notice dimpling or skin changes on the breast, it's essential to have it evaluated.
  • Pain in Breast or Nipple: Unexplained breast or nipple pain should be investigated, as it can be associated with TNBC.
  • Nipple Retraction: When the nipple turns inward (nipple retraction), it can be a sign of underlying breast issues, including TNBC.
  • Changes in Nipple or Breast Skin: Be vigilant for dry, flaking, thickened, or red skin on the breast or nipple area.
  • Nipple Discharge: Any nipple discharge that is not breast milk should be reported to a healthcare provider.
  • Swollen Lymph Nodes Under the Arm or Near the Collarbone: It can indicate that breast cancer has spread to these areas.

What Are the Stages of Triple-negative Breast Cancer?

Doctors rely on the 'TNM' cancer staging system to determine the appropriate treatment for breast cancer. In this system, 'T' represents tumour size, 'N' indicates the presence of cancer in lymph nodes, and 'M' signifies metastasis, which is when cancer has spread to other parts of the body. Breast cancer is categorised into several stages:

  • Stage 0 (In situ): TNBC is localised and has not invaded nearby tissues. It is often referred to as ductal carcinoma in situ (DCIS) for non-invasive cancer.
  • Stage 1: At this stage, TNBC is small, typically less than 2 cm in size, and has not spread to distant sites or nearby lymph nodes.
  • Stage 2: Stage 2 is divided into two subcategories:
    • Stage 2A: TNBC may be ~than 2 cm but less than 5 cm and has not spread to lymph nodes.
    • Stage 2B: TNBC may be smaller than 2 cm but has spread to nearby lymph nodes, or it may be larger than 5 cm but has not spread to lymph nodes.
  • Stage 3: In Stage 3, TNBC has typically spread to nearby lymph nodes and may be one of the following:
    • Stage 3A: The tumour is larger than 5 cm and has spread to nearby lymph nodes, or it is any size and has spread to multiple lymph nodes.
    • Stage 3B: The tumour may be of any size and has invaded nearby tissues such as the chest wall or skin, but it has not spread to distant organs.
    • Stage 3C: TNBC has spread to nearby lymph nodes and may involve extensive lymph node involvement, such as large clusters of cancer cells.
  • Stage 4 (Metastatic): TNBC has spread to distant organs, such as the lungs, liver, bones, or brain. Stage IV TNBC is considered advanced, and the focus of treatment shifts towards managing the disease and controlling symptoms.

What Are the Causes of Triple-negative Breast Cancer?

The exact causes of triple-negative breast cancer (TNBC) are not fully understood, and it is believed to be a complex disease influenced by various factors. While researchers have identified several potential contributing factors, it's important to note that not everyone with these factors will develop TNBC, whereas many individuals with TNBC have no known risk factors.

What Are the Risk Factors for Triple-negative Breast Cancer?

There are many risk factors that doctors have associated with TNBC. Some of them are as follows:

  • Genetics: Individuals (both men and women) with mutated genes carry a higher risk of developing triple-negative breast cancer. A first-degree relative with TNBC also increases the chance of developing this type of breast cancer.
  • Obesity and Sedentary Lifestyle: Obese people with a high BMI are at an elevated risk of developing triple-negative breast cancer. Also, people who have a sedentary lifestyle and are seldom active also carry a higher risk.
  • Age: Premenopausal women are more likely to develop triple-negative breast cancer than postmenopausal women.
  • Pregnancy: According to studies, pregnancy plays a role in the risk of triple-negative breast cancer. Women who have been pregnant and had children are at a higher risk of developing TNBC than those who have never been pregnant.

Read more - Navigating the Journey: Unique Challenges Faced by Pregnant Women Diagnosed with Breast Cancer

Diagnosis of Triple-negative Breast Cancer

In line with other forms of breast cancer, Triple-Negative Breast Cancer (TNBC) is typically detected by identifying a breast lump or mass. However, regular check-ups, especially at reputable breast cancer hospital in India, can help identify potential breast tumours. When doctors suspect a growth, they perform a tissue biopsy by inserting a needle into the lump. Based on the biopsy results, the tissue is classified as either benign or malignant (cancerous). The report will also specify the breast cancer subtype if the tumour is malignant.

Treatment of Triple-negative Breast Cancer

Triple-negative breast Cancer Treatment is limited when compared to other subtypes of breast cancer. Hormone therapy is not used as a treatment option, as triple-negative breast cancer remains unaffected by hormones.

  • Surgery: In case of surgery, a breast cancer specialist will remove the breast, either partially or entirely. It is done to remove as many cancer cells as feasible.
  • Chemotherapy: Triple-negative breast cancer responds well to chemotherapy. When chemotherapy is given before surgery, it is called neoadjuvant surgery, as it can shrink a tumour enough for a lumpectomy (breast-conserving surgery).
  • Radiation Therapy: Radiation therapy uses X-rays to target the tumour site to kill the cancer cells precisely. It works well in combination with chemotherapy.

Triple-negative breast cancer (TNBC) is a less common but particularly aggressive form of breast cancer. Early diagnosis, awareness of potential side effects, and timely treatment are crucial factors that can significantly improve a patient's chances of survival.

Preventing Triple-negative Breast Cancer

Taking preventive measures is essential for individuals who are concerned about their risk of developing triple-negative breast cancer (TNBC). Here are the key steps:

  • Maintaining a Healthy Weight: A nutritious diet and regular exercise can help achieve and sustain a healthy weight.
  • Regular Exercise: Engaging in at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity aerobic activity each week contributes to overall fitness and may lower the risk of breast cancer.
  • Understanding Family Medical History: Those with a family history should discuss it with their healthcare provider for appropriate screenings and genetic testing recommendations.
  • Regular Breast Health Monitoring: Regularly monitor breast health through self-exams, clinical breast exams, and mammograms as a healthcare provider advises.
  • Genetic Testing for BRCA Genes: If there is a family history of related cancers, individuals should consult their healthcare provider about genetic testing for BRCA genes to assess their cancer risk.

Read More - Ignoring the Silent Threat: Don't Let Breast Lumps Sneak Up on You!

When to Consult a Doctor

Triple-negative breast lacks oestrogen receptor, progesterone receptor, and HER2/neu receptor expression. It is diagnosed through a biopsy and specialised testing. Therefore, if you or someone you know notices any of the symptoms of TNBC, and they persist, it is important to make an appointment with a healthcare professional as soon as possible.