Triple negative breast cancer
Triple negative breast cancer is a type of breast cancer. Around 15 out of 100 (around 15%) breast cancers are of this type.
What is triple negative breast cancer?
Triple negative breast cancers are cancers whose cells don’t have receptors for:
- the hormones
oestrogen and progesterone 
- a protein called Human Epidermal Growth Factor Receptor 2 (HER2)
Your doctor uses a sample of your cancer to test the cells for these receptors. You might have this test following a , or after surgery to remove the cancer.
Some women with triple negative breast cancer also have a fault (mutation) in the BRCA1 or BRCA2 genes. BRCA stands for Breast Cancer gene. Everyone has BRCA1 and BRCA2 genes. They stop cells in our body from growing and dividing out of control. If there is a fault in these genes, it means that cells can grow out of control. This can increase your risk of developing breast cancer.
Who gets triple negative breast cancer?
Triple negative breast cancer develops more often in women under 40 years. It is more common in black women compared to white women.
Men can also develop triple negative breast cancer but this is very rare.
Symptoms of triple negative breast cancer
The symptoms of triple negative breast cancer are similar to other breast cancer types. Symptoms can include:
- a lump or thickening in your breast or armpit
- a change in the size, shape or feel of your breast
- skin changes in the breast such as puckering, dimpling, a rash or redness of the skin
- fluid leaking from the nipple in a woman who isn’t pregnant or breastfeeding
- changes in the position of the nipple
See your GP if you notice anything different or unusual about the look and feel of your breasts.
Diagnosing triple negative breast cancer
Your GP refers you to a breast clinic for tests if you have any symptoms that could be due to breast cancer. You may also be referred to a breast clinic if your screening mammogram shows an abnormal area.
You usually have a number of tests to diagnose triple negative breast cancer. This includes:
- a mammogram (an x-ray of the breasts)
- an ultrasound scan of your breast
- taking a sample of tissue from your breast called a biopsy
Your doctor might also refer you for genetic testing. This is to find out if there is a fault in the BRCA genes.
Treatment for triple negative breast cancer
The main treatments for triple negative breast cancer are surgery, chemotherapy and radiotherapy. The treatment you need depends on:
- where the cancer is
- the size of the cancer and whether it has spread (the stage)
- how abnormal the cells look under the microscope (the grade)
- your general health
Surgery and radiotherapy
You might have surgery to remove:
- an area of the breast (breast conserving surgery)
- the whole breast (mastectomy)
When you have surgery, the surgeon usually takes out some of the under your arm. They test these nodes to see if they contain cancer cells. The surgeon might check the lymph nodes closest to the breast using a procedure called sentinel lymph node biopsy. Testing the lymph nodes helps to find the stage of the cancer and decide on further treatment.
After breast conserving surgery you usually have radiotherapy to the rest of the breast.
Chemotherapy
You might have chemotherapy before surgery. This is called neo adjuvant treatment. The aim is to shrink the cancer enough to make the operation possible. Or it might mean that you can have an area of the breast removed, instead of needing a mastectomy.
You usually also have chemotherapy after the operation. This reduces the risk of the breast cancer coming back. You usually have a combination of chemotherapy drugs that might include:
- doxorubicin
- cyclophosphamide
- paclitaxel
- fluorouracil
- docetaxel
- epirubicin
- cisplatin
- carboplatin
- capecitabine
Immunotherapy
Your doctor might suggest you have treatment with pembrolizumab. Pembrolizumab is a type of immunotherapy. It stimulates the body's to fight cancer cells.
You might have pembrolizumab with chemotherapy before surgery. This is to reduce the size of the cancer before the operation. You then continue to have it on its own after surgery.
Drugs that strengthen the bones (bisphosphonates)
You might have drugs to prevent or slow down bone thinning (osteoporosis). These are called bisphosphonates. They can help treat or reduce bone damage caused by breast cancer. You usually have it alongside your cancer treatment.
You may also have bisphosphonates if you have breast cancer that has spread to the bones. This is to prevent any bone problems and reduce pain.
Follow up
You have regular check ups and mammograms after treatment for triple negative breast cancer. How often you have check ups depends on your individual situation.
You usually have a mammogram every year, for at least 5 years after treatment.
It’s important to remember that you can contact your doctor or specialist nurse if you notice a new symptom or have questions. You can also speak to your GP.
Research and clinical trials
Your doctor or nurse might ask you to take part in a trial to improve treatment for triple negative breast cancer.
Researchers are looking at different chemotherapy drugs and also combining them with targeted cancer drugs.
Go to Cancer Research UK’s clinical trials database if you are looking for a trial for triple negative breast cancer in the UK.
Coping with triple negative breast cancer
Coping with triple negative breast cancer can be difficult. There is help and support available to you and your family.
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