Triple-Negative Breast Cancer: Causes and Treatment

‘Triple negative’ means the breast cancer isn’t aggravated by three major drivers of the disease: the hormones estrogen, progesterone and a protein called HERs. It’s a medical finding that supports the sort of treatment to apply. This is crucial because triple-negative breast cancer is highly destructive than other forms, possibly spread beyond the breast with a higher risk of reoccurrence within the first 3 years after treatment, and probability of fatality within the first 5 years.  But once you pass those milestones, the chances of beating it are almost the same as any other type of breast cancer.

Another important finding is that this type of cancer doesn’t respond to some of the medications that work for other types.  The good news, however, is that once diagnosed, the doctor will determine with you  the best treatment process.

Causes

Doctors are uncertain about the causes since it only affects about 10% to 20% of those who have breast cancer. But it’s most likely to occur if you:

• Are  African-American or Latina
• Are Young
• Have  an abnormal change in the BRCA1  breast cancer gene (mutation)

Symptoms

The signs are normally the same as those of other kinds, plus:

• A lump or mass in the breast
• Breast pain or redness
• A nipple that turns inward or has a discharge

Diagnosis

A proper check by a doctor will determine the type you have.  A little bit of tissue will be removed from the abnormal breast area and the cells tested (biopsy).

A pathologist will examine the tissue under a microscope to see if the cells are normal, precancerous, or cancerous.  Further tests will be done if cancerous to find out the type. If the cells don’t test positive for estrogen, progesterone, or HER2 receptors, it is triple-negative. Biopsy results take about 2 weeks. The doctor will also determine how much cancer there is and its location in your body.

Questions

• What state is the cancer? (level and scope of spread)?
• What medications should be used?
• Is chemotherapy OK before or after surgery?
• What type of surgery?
• Is radiation treatment necessary?

Treatment

There is no targeted treatment for triple-negative breast cancer yet, but research is underway to find one. For now, doctors use a combination of chemotherapy, surgery, and radiation.

Chemotherapy:  This will probably be the first option. If diagnosed early, triple-negative cancer responds better to chemo than others. If the tumor is large, the doctor may use chemo to shrink the growth making the surgery easier (neoadjuvant therapy). Alternatively he may do surgery first and follow up with chemo.

Surgery: This can be one of two types. First, a mastectomy to remove the entire breast if the cancer is aggressive, which seems to occur when:

• You have many tumors
• The cancer is in your skin
• You have a tumor in your nipple
• You already had cancer in that breast
• The tumor is large
• There are calcium deposits or other abnormal cells in your breast

Second type of surgery is a lumpectomy to remove only the tumour and the tissues around it.  Thereafter is a radiation therapy to destroy any remaining cells in the area. The goal of radiation is to stop cancer reoccurrence. It’s mostly done after a lumpectomy.

Clinical trial: It’s a good idea to ask your doctor if this might be right for you. Clinical trial is very frequently a good way to get a new medicine that isn't available to everyone.

Self-Care

At the end of your treatment, the doctor will want to ensure there isn’t going to be any cancer reoccurrence. In the first 3 years, you'll probably see him every 3 to 6 months.  Two years after that, you'll probably visit every 6 to 12 months. Once you've been identified as cancer-free for 6 years, you'll probably go back only once a year. But don’t hesitate to let your doctor know immediately about any new symptoms or any pain or other problems that relate to your breasts.

Expectations

Treatment may make triple-negative breast cancer go away. It depends on the size of your tumor, how quickly your cancer grows, and whether the cancer has spread to the lymph nodes or other parts of your body. The treatments may cause side effects like nausea, vomiting, fatigue or pain, or mental fuzziness.

Although triple-negative breast cancer reoccurrence in another part of your body is probably high, this risk reduces over time. Five years after diagnosis, about 77% of triple-negative breast cancer patients are still alive.

Support

It’s someone who has this type of breast cancer that will understand what you’re going through.  In addition to information the Triple Negative Breast Cancer Foundation (www.tnbcfoundation.org) can connect you with other  support groups. You can also check online for groups that meet locally, either through a church or community center.

It’s equally important to let the people around you know what’s going on, and to ask for help when you need it. You alone will decide who you tell and when, but the more you share with family and friends, the better equipped they’ll be to give you support when you need it.

Source: Web MD, 2017

Photo: Creative Commons