Triple negative breast cancers are:
There are several subsets of triple negative breast cancer. One subset is basal-like. Basal-like tumors have cells with features similar to those of the outer (basal) cells surrounding the mammary ducts.
Most triple negative tumors are basal-like and most basal-like tumors are triple negative.
However, not all triple negative tumors are basal-like and not all basal-like tumors are triple negative (see figure below).
About 15-20 percent of breast cancers are triple negative or basal-like [56-59,66-67].
These tumors tend to occur more often in younger women and Black/non-Hispanic black/African-American women (more on race/ethnicity and subtypes of breast cancer) [58,64,66-68]. They may also be more common among Hispanic women compared to white/non-Hispanic white women [59,68-69].
Most breast cancers related to a BRCA1 gene mutation are both triple negative and basal-like [58,70-72].
Triple negative breast cancers may also be related to a BRCA2 gene mutation .
People diagnosed with triple negative breast cancer at age 60 or younger are recommended to get genetic testing for BRCA1 and BRCA2 gene mutations .
Learn more about genetic testing.
Triple negative tumors are often aggressive and have a poorer prognosis than ER-positive breast cancers (at least within the first 5 years after diagnosis) [57-58,63,67].
However, after about 5 years, this difference begins to decrease and eventually goes away .
Triple negative tumors are aggressive, but they can be treated successfully. They are usually treated with some combination of surgery, radiation therapy and chemotherapy.
Triple negative tumors cannot be treated with hormone therapy or HER2 targeted therapies such as trastuzumab (Herceptin) because they are ER-negative and HER2-negative.
Whether platinum-based chemotherapy drugs are more effective than other chemotherapy drugs at treating triple negative breast cancers is under study [16,73-76]. Platinum-based chemotherapy drugs include carboplatin and cisplatin.
Learn more about breast cancer treatment.
Learn about emerging areas in chemotherapy for early and locally advanced breast cancer.
Learn about emerging areas in the treatment of metastatic breast cancer.
Clinical trials are studying which treatments are the most effective for triple negative breast cancer.
After discussing the benefits and risks with your health care provider, we encourage you to consider joining a clinical trial.
BreastCancerTrials.org in collaboration with Susan G. Komen® offers a custom matching service to help you find a clinical trial on triple negative breast cancer.
Learn more about clinical trials.
Prevalence rates of some molecular subtypes of breast cancer differ by race.
Triple negative/basal-like tumors appear to be more common among Black/African-American women (especially before menopause) compared to women of other ethnicities [58-60,66-67,77-78].
Triple negative/basal-like tumors may be more common among Hispanic women compared to white/non-Hispanic white women [59,68-69].
Although the reasons for racial/ethnic differences in rates of triple negative breast cancer are not clear, some lifestyle factors may play a role [77,79].
Compared to white/non-Hispanic white/Caucasian women, Black/African-American women tend to have lower rates of breastfeeding and tend to carry excess weight in the abdomen area [67,79-87]. Each of these factors may increase the chances of having triple negative breast cancer [67,79-87].
Certain reproductive and lifestyle factors may protect more against ER-positive breast cancers than ER-negative breast cancers, including triple negative breast cancers. So, even though African-American and Hispanic women may be more likely than white women to have these protective factors, the factors may not lower the risk of triple negative breast cancers.
For example, African-American and Hispanic women are more likely than white women to [79-92]:
Although these factors lower the risk of breast cancer, this benefit may be limited to ER-positive breast cancers [67,81-83,86,91-93].
There is even some evidence these factors may increase the risk of triple negative breast cancers [67,81-83,87,91-93].
These topics are under active study.
Higher rates of triple negative/basal-like tumors may explain, to some degree, the poor prognosis of breast cancers diagnosed in younger Black/non-Hispanic black/African-American women [68,77].
Also, luminal A tumors, which have the best prognosis of the subtypes, occur less often in premenopausal non-Hispanic black women compared to postmenopausal non-Hispanic black women and compared to non-Hispanic white women of either menopausal status [68,78].
*Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date at this time.
Triple Negative Breast Cancer
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