Essential Insights into Triple-Negative Breast Cancer (TNBC)

Triple-negative breast cancer (TNBC)

Triple-negative breast cancer (TNBC) is an aggressive and less common form of breast cancer, comprising approximately 15–20% of all breast cancer cases. While the symptoms may mirror those of other breast cancers, TNBC stands out due to its unique characteristics and the limited treatment options available.

Understanding Triple-Negative Breast Cancer (TNBC)

TNBC is unique among breast cancers because the cancer cells lack receptors for two main hormones: progesterone and estrogen. Additionally, they do not overexpress the HER2 protein, which is commonly found in other breast cancer types. This absence of hormone receptors and HER2 protein defines the “triple-negative” aspect of TNBC, significantly influencing the treatment approach.

Symptoms of TNBC

Symptoms of TNBC are akin to other forms of breast cancer and include:

  • A new lump or mass in the breast
  • Changes in the size, shape, or feel of the breast (e.g., pitting, swelling)
  • Alterations in skin texture (e.g., an “orange peel” texture, puckering, dimpling, bumps, or rash)
  • Changes in skin color, such as redness or discoloration
  • Nipple discharge that is not breast milk
  • Changes in the appearance or texture of one or both nipples
  • Nipple retraction (the nipple turns inward) that is unusual for you
  • Breast pain, warmth, itchiness, or irritation
  • Swollen lymph nodes around the armpit or collarbone

Causes of TNBC

The exact cause of TNBC remains elusive, but it is closely linked to mutations in the BRCA1 gene. BRCA1 functions as a tumor-suppressor gene by regulating cell growth, and inherited mutations in BRCA1 significantly increase the risk of various cancers, including breast, ovarian, and prostate cancers. Ongoing research is crucial to fully understand the complexities of TNBC.

Diagnosis of TNBC

Early detection of TNBC is vital. If you notice any sudden changes in your breasts or experience new symptoms, it’s essential to consult a healthcare professional. During the visit, your medical history will be reviewed, and a physical examination of your breasts will be conducted to check for lumps, skin discoloration, texture changes, or other indicators of breast cancer. Diagnostic tests may include:

  • A mammogram and/or ultrasound
  • A biopsy of any unusual lumps or masses, tested for hormone and protein receptors (i.e., progesterone, estrogen, and HER2)
  • Genetic tests, especially if there’s a family history of breast cancer (e.g., BRCA gene mutation)

Aggressiveness and Spread of TNBC

TNBC is known for its aggressive nature and higher likelihood of metastasizing (spreading) throughout the body, which complicates treatment. Early detection and intervention are critical. A 2016 study found that, between diagnosis and surgery, TNBC tumors grew by 1% each day, compared to 0.859% for HER2-positive breast cancer tumors.

Risk Factors for TNBC

While TNBC can affect anyone, certain groups are at a higher risk:

  • Black or Hispanic women
  • Individuals with a BRCA1 mutation and/or a family history of TNBC
  • Younger women (under the age of 40)

Treatment Options for TNBC

TNBC poses unique treatment challenges due to the absence of hormone receptors. Consequently, traditional hormone therapies and HER2-targeted treatments are ineffective. However, several treatment options are available:


Chemotherapy remains the most common treatment for TNBC. The type of chemotherapy depends on the tumor’s location, size, stage, grade, and the patient’s overall health and preferences.


For early-stage TNBC, surgery may be an option. This can involve breast-conserving surgery, where only part of the breast tissue is removed (lumpectomy or partial mastectomy), or a mastectomy, where the entire breast is removed.

Neoadjuvant Therapy

In some cases, neoadjuvant chemotherapy is administered to shrink the tumor before surgical removal, followed by additional chemotherapy post-surgery to prevent recurrence. The FDA has approved the immunotherapy drug Keytruda for early-stage and advanced TNBC, to be used alongside chemotherapy.


Radiation therapy may be recommended depending on the type of surgery and tumor characteristics.

Advanced Treatments

If TNBC has metastasized, other treatments such as antibody-drug conjugates, platinum chemotherapy, immunotherapy, or targeted therapies like PARP inhibitors may be used.

Frequently Asked Questions about TNBC

Where does TNBC metastasize?

TNBC metastasis typically occurs in the brain, bone, liver, and lungs.

Can TNBC be cured?

While TNBC can be treated, it is challenging to achieve a complete cure due to its high recurrence rate.

What is the survival rate for TNBC?

According to a 2022 study, the 5-year overall survival rate for TNBC (all stages) is 81%.

In The End

Triple-negative breast cancer (TNBC) is an aggressive form of breast cancer that accounts for around 15–20% of breast cancer cases. It is characterized by the absence of progesterone, estrogen receptors, and HER2 proteins. Symptoms are similar to other breast cancers and include lumps, skin changes, nipple discharge, and breast pain. Despite its aggressive nature, TNBC can be treated through chemotherapy, surgery, radiation, and other targeted therapies. Early detection is crucial for the best possible outcomes. If you experience any symptoms or have a family history of TNBC, consult a healthcare professional promptly.

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