Triple Negative Breast Cancer or TNBC is a diagnosis of a type of breast cancer that does not have one of the three most common identifiers. It means that it is negative for the three most common receptors that are typically identified during the testing process to determine which type of treatment is best to fight the cancer. A diagnosis of TNBC means that HER 2 gene is not present, estrogen and progesterone receptors are also not present in the tumor. While it sounds quite awful because of the triple negative factor and it can be a little different to treat it can actually be more responsive in the early stages to chemotherapy than other types of cancers.
Triple Negative Breast Cancer Facts
1. Hormone treatments is not possible with this type of breast cancer.
2. This is a much rarer type of breast cancer (about 10%-20% of all breast cancer cases) that affects a higher rate of Hispanics, African Americans, younger people and people that have a BRACA 1 gene mutation.
3. Approximately 80% of BRACA 1 gene mutation tumors are triple negative.
4. There is a strong correlation between an autosomal inheritance pattern and TNBC but most studies fall short of calling it a causal relationship.
5. This cancer is harder to treat, is more likely to recur in the first five years after treatment and can be more aggressive BUT all of the factors including successful treatment largely depend on the stage in which the cancer is identified and the grade of the tumor.
6. TNBC has a higher recurrence rate in the first five years after remission while other cancers like estrogen receptor positive cancers have much lower rates of recurrence during the first five years of remission.
7. While TNBC recurs at a higher rate in the first five years once the five year mark passes with each additional year of survival the odds of recurrence is drastically reduced.
8. After 5 years the chance of recurrence of TNBC is reduced by 50%.
9. With each year after the 5 year mark the chance of recurrence is reduced by an additional 10%-15%.
10. Long term survivors (longer than 10 years) have almost a 0% rate that the disease will recur. With other breast cancers the recurrence rate climbs after the first 5 years.
A diagnosis of TNBC can present a challenge in treatment options because this is the most aggressive form of breast cancer the treatment has to be just as aggressive. One of the only successful treatment options that can improve the prognosis is chemotherapy ChT. At this time there are no targeted type therapies that are available to treat TNBC.
The stage of the cancer and the grade of the tumor is considered when treatment options are being presented. The treatment will always involve some ChT and typically radical Mastectomy. Breast conserving surgery is not typically recommended because of the high recurrence rate in patients. Depending on the stage and the grade an oncologist may recommend chemotherapy than surgery OR surgery than chemotherapy. In both cases the treatment may be right.
TBNC is actually an umbrella term but there are many different subtypes of this cancer that may require different treatment plans. A recent published study by Vanderbilt was able to identify at least 6 different subtypes of TNBC which means that there may be in the future 6 different protocols for treating this disease.
The best way to treat this type of cancer is by coming up with a treatment plan that is mulch-disciplinarian that includes a team of specialists.
The research into this relatively rare yet deadly cancer is ongoing. The PARP inhibitors are still being looked at as a viable treatment option for those diagnosed with TNBC where the underlying problem can be pinned to the BRACA 1 gene defect.
PARP inhibitors are used to prevent the body from “repairing” broken chains of DNA. Stopping the repair process (which targets both faulty and healthy genes) can help to treat the cancer. The studies are still in clinical trial phase and longevity results have yet to be compiled.
TNBC like most cancers is still quite a mystery to scientists but there are several steps that both health care providers and research teams can agree on. Prevention, early detection and diligence are three key factors in the successful treatment of TNBC.
There is some evidence that a low fat diet can influence the development of all cancers including TNBC. A healthy well rounded balanced diet can help to delay the onset of any cancer. A healthy life style will also help in the treatment of TNBC. If the body is strong it can tolerate treatment better.
Early detection in all breast cancer is a contributing factor to a positive prognosis and treatment. It is estimated that early detection can increase the positive prognosis for long term survival rate by 60%.