Triple Negative Breast Cancer: What you need to know

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06/23/23

We teach you why Triple Negative Breast Cancer is threatening. Learn how it is treated, and it's link to the BRCA genetic mutation.

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Questions for your Breast Surgeon and Medical Oncologist:

1. What exactly is triple negative breast cancer?
2. Will I need Chemotherapy?
3. What are the benefits of Neoadjuvant Chemo?
4. Isn’t Neoadjuvant Chemo recommended more now?
5. Do I qualify for BRCA genetic testing?
6. Should I consider a Clinical Trial?
7. What is “Triple Negative” breast cancer?

“Triple Negative” breast cancers are fast growing tumors that more frequently spread beyond the breast to other parts of the body. Because of this, they are a bigger threat to your life than most other types of cancers of similar size with a different receptor pattern. These cancers are called “triple negative” because the three most important breast cancer “receptors” on the surface of the cells are not present (negative). When present, these receptors are used as targets to attack the cancer with medications. When absent, the main medical therapy is chemotherapy.

Your Breast Surgeon will know your “receptor pattern” within days after your initial breast biopsy. These results are often not communicated to you early on in your decision process. Although only 15% of breast cancers are “triple negative,” it is imperative that you specifically ask your surgeon immediately, and well before surgery, “What are my receptor results?”

“Triple Negative” is treated with Chemotherapy

These cancers are often sensitive to chemotherapy and it is offered to almost everyone healthy enough to tolerate it. Chemotherapy is obviously a more intense cancer treatment than hormonal therapy (pills). But unfortunately, since triple negative cancers do not have “Estrogen receptors” (ER negative), hormonal therapy is not helpful at all. The time to cure triple negative cancer is now, not when it recurs later. Chemotherapy and surgery is the standard for treating triple negative breast cancer.

Ask about the benefits of “Neoadjuvant Chemo”

What is often overlooked are the benefits of offering neoadjuvant chemotherapy for patients with triple negative, “Early-Stage” (I & II) breast cancer. There may be distinct advantages (listed below) to having chemotherapy before surgery, not after surgery if you have a triple negative tumor. The decision to consider neoadjuvant chemotherapy always begins with your breast surgeon. You must address this “cutting edge” treatment option well before surgery to benefit from neoadjuvant chemotherapy. Do not be afraid to ask. This is a very important question.

The Potential Benefits of Neoadjuvant Chemo:

*Begin life-saving chemotherapy earlier
*Reduce the need for a mastectomy
*Improve cosmetic outcomes with a lumpectomy
*Reduce the need for an “Axillary Dissection”
*Allows more time for BRCA genetic testing
*More time to think about “lumpectomy vs. mastectomy”
*Shows your cancer team if the chemo is working
*Can sometimes eliminate all cancer cells before surgery
*May reduce the need for radiation after a mastectomy

Ask for BRCA Genetic Testing

Triple negative breast cancers can be associated with inherited genetic mutations. Any woman who has ever been diagnosed with a triple negative breast cancer at age 60 or younger is at a high risk for carrying the BRCA mutation. If you also have a strong family history of breast or ovarian cancer you are at an even higher risk. Unfortunately, genetic testing is often not offered for triple negative breast cancer patients. It is important to ask for BRCA Genetic Testing in this situation.

The BRCA (Breast Cancer) gene is commonly referred to as “The Breast Cancer Gene.” If someone inherits a broken version (mutation) of this gene at conception, they carry a very high lifetime risk of breast cancer and ovarian cancer.

African Americans are a higher risk for Triple Negative

African American and women of West African descent are at a higher risk of developing triple negative breast cancers than most other ethnic groups. Thirty percent (30%) of all breast cancers in this group are triple negative.

Younger women are at a higher risk for Triple Negative

Women diagnosed with invasive breast cancer before 40 are at a higher risk for having triple negative disease when compared to older women. Any women diagnosed before the age of 50 qualifies for genetic testing and should consider genetic counseling.

Ask if you would benefit from a Clinical Trial

New therapies must be studied in clinical trials to make sure they are safe and effective at treating breast cancer. Ask your medical oncologist if they offer or recommend you participate in a clinical trial.