Triple Negative Breast Cancer

What Is Triple Negative Breast Cancer?

Triple-negative breast cancer is a sub-group of breast cancer. The name of the condition denotes a characteristic feature of the diagnosis. Three important breast cancer features, which are common in other subtypes of breast cancer is absent in Triple Negative Breast Cancer.

Estrogen, progesterone, and the HER-2/neu gene are the three primary receptors stimulate the growth of the breast cancer. When clinical investigative result showed all these three related tests are negative in the breast cancer tumor progressive report then the condition is termed as Triple-negative breast cancer.

The clinical importance of categorizing Triple negative breast cancer in a special type due to all usual therapies for breast cancer like hormonal therapy and/ or medicines act on the target receptors (estrogen, progesterone, and HER-2) are unsuccessful in treating Triple-negative breast cancer. The treatment option for Triple negative breast cancer is chemotherapy and incorporation of the treatment at an early stage provides good prognosis^1,5.

Stages

The stage determination of any type of cancer is a significant predicting factor for the treatment plan, the treatment prognosis and expected survival rate of the affected individual.

Size and location of the tumor with metastasis nature of the tumor are the three factors to decide the stage of the breast cancer. The oncology department usually using a scale of 0 to 4 for breast cancer staging purpose.

Stage 0

When the cancerous tumor growth is only restricted to one location in the breast and no stalk of cancerous cells like any lobule or duct spread to other breast tissues (precisely, it does not show any sign of spreading), then that cancerous growth is defined as Stage 0.

Stage 1

If the cancerous growth is only restricted to breast no adjoin or distant organ tissue get affected with metastasis of the cancer is defined as stage 1.

Stage 2

The cancerous growth of stage to also localized to breast, as in stage one, but extend to more area than in stage 1 is defined as stage 2.

Stage 3

The cancerous breast cancer cells invade to lymph system in stage 3.

Stage 4

When cancerous cell growth is spread to adjoin lymph nodes, and from there spreading to other distant organs and tissue of the body is defined as stage 4.This is the most severe stage of TNBC².

Predominance

In comparing with total estimated breast cancer incidence rate, it has found that approximately 15% of affected individual suffer from triple negative breast cancer. The metaplastic and medullary breast cancer have the risk to form triple negative breast cancer. Some factors which influence to cause Triple negative breast cancer are as follows³:

• Inherited alteration of BRCA gene, specifically women have the BRCA1 erratic mutation.
• Race is another factor, which insists to development of TNBC like American women
• Pre- menopausal stage of women

Genetic testing

Below 40 years age of all women should go for genetic testing without concerning about the family history of breast cancer incidence. The specific genetic testing for BRCA1 gene is required to estimating the risk of development of TNBC in a woman, as altered mutation of BRCA1 gene is responsible for the development of triple-negative breast cancer. Positive findings of altered BRCA1 genetic test result assist to the women to discuss her condition with a genetic counselor for the planning of future treatment³.

Treatment

The usual breast cancer therapy which targets the three common receptors causing breast cancer is not useful to treat Triple Negative Breast Cancer. The available treatment option is a combination of surgery, radiation, and chemotherapy. The result of providing chemotherapy to treat Triple Negative Breast Cancer is more effective than other breast cancer types.

Adjuvant chemotherapy therapy

In adjuvant chemotherapy therapy, the application of chemotherapy is provided after surgical intervention for better healing and reduce the risk of recurrence.

Neoadjuvant chemotherapy

In neoadjuvant chemotherapy, the commencing of chemotherapy is applied before surgical intervention. This may adequately reduce the size of the tumor to get the success of lumpectomy.

Lumpectomy

This is a surgical process to operate the tumor present in the breast. The aim of this invasive surgery is the removal of the total mass of tumor. This method is successful if the tumor is not extended to distant part of the body.

It is always advisable that patient should maintain the follow-up therapy in case of chronic treatment recommendation or even after completion of treatment. In follow-up, the patient is closely monitored for recovering rate or any symptoms of relapsing cancer. This helps to improve patient survival rate and quality of life also^3,4.

Survival rate

The early diagnosis and immediate treatment of chemotherapy have a good prognosis and survival rate. Therefore, stage and degree of the metastasis and commencement of treatment are important factors for survival of the disease.

The survival rate for Triple Negative Breast Cancer is less due to its aggressive nature. The usual recurrence of tumor occurs within a few years after the treating the triple negative breast cancer^2,3.

Prognosis

Prognosis depends upon stage and degree of metastasis of the triple negative breast cancer. The risk of spreading of triple negative breast cancer is more than other subtypes of breast cancer and more aggressive in nature. The usual breast cancer treatment is ineffective to treat the condition and chance of recurrence of the triple negative breast cancer more ^{2, 3}.

Triple Negative Breast Cancer Clinical trial

Ongoing clinical trial tried to investigate effectiveness and safety of different possible treatment for future use and also has several clinical trials in the pipeline. The patient can also enroll their name in these trials to get novel therapies and also assist in research by providing the data to the research team. The different research aim is different, some are investigating new therapies to treat the patient, whereas some drugs may use in preventive therapy. Name registration for a clinical trial is the first step to enrolling name to the research^3,4.

References

1. Triple Negative Breast Cancer; Johns Hopkins Medicine; National Breast Cancer Foundation; Online available at http://www.nationalbreastcancer.org/triple-negative-breast-cancer
2. Heidi Godman; Triple Negative Breast Cancer Outlook: Survival Rates; Online available at http://www.healthline.com/health/triple-negative-breast-cancer-outlook-survival-rates-stage#Overview1
3. Triple negative breast cancer; Breast Cancer Care; Online available at https://www.breastcancercare.org.uk/information-support/facing-breast-cancer/diagnosed-breast-cancer/primary-breast-cancer/triple-negative-breast-cancer
4. Triple Negative Breast Cancer; Susan G. Komen Breast Cancer Foundation, Inc; Online available at https://ww5.komen.org/uploadedFiles/_Komen/…
5. Triple-Negative Breast Cancer; Breast Cancer Org; Online available at http://www.breastcancer.org/symptoms/diagnosis/trip_neg

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