Triple-Negative Breast Cancer (TNBC)
What is it, its characteristics, and how is it treated
Triple-negative breast cancer (TNBC) is a distinct and aggressive form of breast cancer, accounting for about 10-20% of all breast cancer cases. It is called “triple-negative” because the cancer cells do not express:
- Estrogen receptors (ER-)
- Progesterone receptors (PR-)
- HER2 protein (HER2-)
These three biomarkers are usually “targets” for hormonal or targeted therapies. The their absence makes TNBC insensitive to standard treatments, such as hormone therapy (tamoxifen or aromatase inhibitors) and immunotherapy with monoclonal antibodies such as Herceptin (trastuzumab).
Characteristics of Triple-Negative Breast Cancer
Triple negative cancer:
- Considered more aggressive than other breast cancer types
- Tends to grow and spread more rapidly
- More common in younger women
- Strongly associated with BRCA1 gene mutations
- Έχει Higher risk of recurrence, especially within the first 3-5 years after diagnosis
How is it diagnosed?
TNBC presents the same symptoms with other forms of breast cancer:
- Palpable mass
- Imaging abnormalities on mammogram or ultrasound
- Skin or nipple changes
Definitive diagnosis is made by biopsy, where the suspicious lesion is examined for receptor expression. When all three receptors (ER, PR, HER2) are negative, TNBC is diagnosed.
What is the treatment?
The treatment of TNBC is usually multimodal:
Surgery
Initial treatment involves either breast-conserving surgery (lumpectomy) or mastectomy, depending on tumor size and location. Axillary lymph nodes are also assessed for metastasis.
Chemotherapy
Due to the lack of hormone receptors, the chemotherapy is the most effective means treatment of TNBC. It is often given preoperative (neoadjuvant) to reduce the size of the tumor and increase the chances of preserving the breast.
Radiotherapy
In cases where the tumor is large, or there is lymph node involvement, the breast radiotherapy helps eliminate residual cancer cells in the surgical area.
Recent Research Highlights
In recent years, research has focused on innovative treatments such as:
- Immune checkpoint inhibitors (immunotherapy)
- PARP inhibitors, particularly for patients with BRCA1 or BRCA2 mutations
- Novel chemotherapy regimens and targeted treatments showing promising results
Bibliography:
- Waks AG, Winer EP. "Breast cancer treatment: a review." JAMA. 2019;321(3):288-300.
- Bianchini G, Balko JM, et al. "Triple-negative breast cancer: challenges and opportunities." Nat Rev Clin Oncol. 2016.
