Breast cancer has seen amazing improvements in survival rates thanks to research. But there are many different types of breast cancer and not all have benefitted from these breakthroughs. Triple negative breast cancer (TNBC) is a particularly aggressive type of breast cancer for which more research is urgently needed.
What is triple negative breast cancer?
Triple negative breast cancer is an aggressive type of breast cancer that affects roughly 1 in 5 women with the disease. It tends to be more common in younger people under the age of 40, as well as Black and Hispanic people.
TNBC cells don't have receptors for the hormones oestrogen or progesterone or the protein HER2. Because the TNBC cells test negative for these receptors and don’t grow in response to hormones or HER2, they are “triple negative”.
What makes triple negative breast cancer less survivable?
Unfortunately, TNBC tends to spread earlier and faster to other organs, such as the brain, lung, liver and bones, than other types of breast cancer, and it tends to be a higher grade of tumour when detected. As TNBC is lacking the proteins that are targeted by hormonal and targeted therapies, the treatment options are more limited, and it also has the highest likelihood of coming back within the first 4 years after diagnosis.
What causes triple negative breast cancer?
While anyone can be diagnosed with triple negative breast cancer, genetics do play a role and TNBC can run in families. People with mutations in their BRCA1 or BRCA2 genes are more likely to develop certain types of cancer, including breast cancer. About 70% of breast cancers diagnosed in people with a BRCA mutation are TNBC and BRCA1 seems to play a bigger role than BRCA2 mutations.
Overall, a person has a higher risk of developing TNBC if they:
- Are Black or Hispanic
- Are under 50 years old
- Have a BRCA mutation
- Are not breastfeeding
- Are obese or overweight
- Have high breast density
How is triple negative breast cancer diagnosed and treated?
Triple negative breast cancer is often found during breast screening and has similar symptoms to other types of breast cancers, such as lumps or changes to the breast. Most diagnoses will involve a referral to a specialist breast clinic and potentially mammograms, ultrasounds and a biopsy. During a biopsy, a sample is taken from the tumour and analysed to check for oestrogen receptors, progesterone receptors and HER2 protein – if all three tests come back negative, the diagnosis is usually TNBC.
TNBC is most commonly treated with a combination of surgery, radiotherapy and chemotherapy, but some patients can benefit from immunotherapy. Atezolizumab, the first immunotherapy available on the NHS for certain types of TNBC, helps the immune system to attack cancer cells by blocking an immune system break called PD-L1. Other promising new therapies include PARP inhibitors, such as olaparib, which are already available in the US for certain types of breast cancer with BRCA mutations.
While advanced TNBC is still seen as an incurable disease, new treatment options are starting to change this status quo. We urgently need your help to fund more research that will find new cures for triple negative breast cancer. Together we can save lives - will you join us today?
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