What is Triple Negative Breast Cancer?

Triple-negative breast cancer is a type of invasive (infiltrating) ductal carcinoma (IDC) in which three of the most common receptors known to “fuel” breast cancer, estrogen, progesterone, and the HER-2/neu gene, are not present.

Invasive ductal carcinoma starts in a milk duct, breaks through the wall of the duct, and invades the tissue of the breast. Invasive ductal carcinoma is the most commonly diagnosed breast cancer, accounting for about eight 8 out of 10 of all cases of invasive breast cancers.

Invasive ductal carcinoma may feel like a hard, bumpy, irregularly shaped lump in the breast. The most common symptoms of IDC are a change in the look or feel of the breast or the nipple anda breast mass or a suspicious finding on a mammogram. Less common signs of IDC may include nipple discharge.

Triple-negative breast cancers are usually IDCs, whose cells lack certain receptors and tend to grow and spread more quickly than other types of breast cancer.

Treatment for Triple-Negative Breast Cancer

Like other breast cancers, women with triple-negative breast cancer will have surgery to remove the tumor and may require additional treatment such as chemotherapy.

Breast surgeons at Penn Medicine deal almost exclusively with breast cancer and disorders of the breast. They have popularized the concepts of breast conserving therapy and are pioneering the use of vaccines and immune-based therapies for the treatment of breast cancer. Penn is also a leader in the use of oncoplastic surgery, which uses techniques to remove the tumor and preserve or restore the breast's shape or appearance at the same time.

Breast-conserving surgery removes only the part of the breast affected by cancer and a surrounding margin of normal tissue. How much tissue is removed depends on the size and location of the tumor and other factors. Partial mastectomy, quadrantectomy, and lumpectomy are all types of breast-conserving surgery.

A mastectomy involves removing all of the breast tissue, sometimes along with other nearby tissues. In a simple or total mastectomy, the surgeon removes the entire breast, including the nipple, but does not remove underarm lymph nodes or muscle tissue from beneath the breast.

A radical mastectomy is an extensive operation where the surgeon removes the entire breast, axillary lymph nodes, and the pectoral (chest wall) muscles under the breast. This surgery was once very common, but a modified radical mastectomy has proven to be just as effective without the disfigurement and side effects of a radical mastectomy. Radical mastectomy may still be done for large tumors that are growing into the pectoral muscles under the breast.

Breast reconstruction may be an option at the time of a lumpectomy or mastectomy, or after surgery to treat breast cancer.

Since the tumor cells lack the necessary receptors, common treatments like hormone therapy and drugs that target estrogen, progesterone, and HER-2 are ineffective. However, using chemotherapy to treat triple negative breast cancer is an effective option.

Who is At Risk for Triple-Negative Breast Cancer?

Breast cancers with these characteristics tend to occur more often in younger women and in African-American women.

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