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Triple Negative Breast Cancer (TNBC) is the most aggressive type than others – with a faster growth rate and higher risk of metastasis. Experts say it is called triple-negative because the cancer cells do not have estrogen or progesterone receptors. TNBC is often detected during routine breast cancer screenings, such as mammograms, even before symptoms appear.
Doctors say it accounts for at least 15 per cent of all invasive breast cancer cases in the West. “Studies have shown that their pooled estimate of prevalence in India is up to 24.04 per cent. In accordance with the GLOBOCAN data (2018), 1,62,468 new cases were reported with the death occurrence of 87,090 cases,” Dr. Viju Murthy, MS, DNB, MCh, MD, HCG Cancer Center, told Times Now.
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- Premenopausal women – who are less than 50 years of age
- Women with BRCA 1 mutation account for 70 per cent of breast cancer in women having inherited BRCA1 mutation
- Black and African American women
How is triple-negative breast cancer diagnosed?
According to Dr. Murthy, around 80-90 per cent of patients with triple-negative breast cancer are diagnosed at Stage I, II, or III. “This is when the disease can potentially be cured. Feeling of a lump in the breast, skin/nipple changes, or abnormalities in the screening mammogram will be the typical presentation, followed by a biopsy which will confirm the presence of invasive cancer and the triple negative status,” he said.
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Mostly, the treatment for this cancer targets estrogen receptors, progesterone receptors, and the HER2 protein, where these three markers behave like locks on a cancer cell.
There are specific drugs, or ‘keys,’ we can use to unlock these locks. “But these keys will not work on triple-negative breast cancer, which can make it harder to treat. So, we have to use other strategies to treat it,” said Dr. Murthy.
Ways to treat triple-negative breast cancer
Dr. Murthy says the treatment for this cancer depends on the stage at diagnosis. “Most patients with Stage I disease are treated with surgery first followed by chemotherapy. For patients with stage II or III disease, standard treatment includes six months of chemotherapy plus immunotherapy, then surgery and possible radiation,” he said.
Most patients will get six months of immunotherapy after surgery.
What is the survival rate for triple-negative breast cancer?
The survival rate for TNBC depends on several factors, a few of which include:
- How the cancer has spread
- How well the tumour responds to treatment
- The patient's overall health
Dr. Murthy says the average survival for patients newly diagnosed with metastatic or triple-negative breast cancer is about one-and-a-half to two years. However, these estimates do not reflect the impact of newer treatments or include patients diagnosed in the last few years.
Patients with earlier-stage disease who respond well to treatment tend to have a much higher chance of survival. Each patient’s circumstances are unique, so it’s important to discuss your prognosis with your doctor.
What is the research being done to advance TNBC treatment?
Platinum chemotherapy, targeted drugs like a PARP inhibitor or antibody-drug conjugate, or immunotherapy with chemotherapy are being currently used in Triple-negative cancers. Dr. Murthy says research now also looking at antibody-drug conjugate to treat the advanced stage of this disease.