triple-receptor negative breast cancer

Characteristics of Triple-Negative Breast Cancer

Triple-negative breast cancer (TNBC) is a rare and aggressive form of breast cancer that lacks the receptors or proteins that help cancer grow and spread. This subtype of breast cancer is characterized by its unique molecular profile, distinct metastatic patterns, and lack of targeted therapies.

• Lack of Receptors: TNBC cells do not express estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor receptor 2 (HER2) [1].
• Aggressive Nature: TNBC is usually more aggressive, harder to treat, and more likely to come back (recur) than cancers that are hormone receptor-positive [3].
• High-Grade Tumors: Most triple-negative and basal-like breast cancers are high-grade, or aggressive, tumours. This means that they tend to grow and spread quickly [6].

Key Features

• TNBC is a rare form of breast cancer, accounting for about 10% of all breast cancer cases.
• It tends to affect younger women and African American women more frequently.
• The symptoms of TNBC are similar to other breast cancer types, including a lump or thickening in the breast or armpit.

References

[1] Triple-negative breast cancer is characterized by the absence of estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor receptor 2 (HER2) [8]. [3] TNBC is usually more aggressive, harder to treat, and more likely to come back (recur) than cancers that are hormone receptor-positive [7]. [6] Most triple-negative and basal-like breast cancers are high-grade, or aggressive, tumours. This means that they tend to grow and spread quickly [6].

Common Signs and Symptoms of Triple-Negative Breast Cancer

Triple-negative breast cancer (TNBC) is a type of breast cancer that lacks estrogen receptors, progesterone receptors, and excess HER2 protein. As a result, it can have similar signs and symptoms as other common types of breast cancer.

Some common signs include:

• A lump or thickening in your breast or armpit
• A change in the size, shape, or feel of your breast
• Skin changes in the breast area, such as redness, swelling, or pitting (an "orange peel" texture)
• Breast or nipple pain
• Nipple retraction (when your nipple turns inward)
• Discharge from the nipple
• Swollen lymph nodes under the arm

It's worth noting that TNBC can also cause a lump, which is more commonly hard, painless, and irregular, but can also be soft, round, and painful. Other signs include breast swelling, skin dimpling, and redness.

Early Detection is Key

While these symptoms can be alarming, it's essential to remember that many women with TNBC do not experience any noticeable symptoms until the cancer has progressed. Regular breast self-exams and mammograms can help detect TNBC in its early stages, when treatment options are more effective.

References:

• [6] Symptoms of triple negative breast cancer
• [8] Common signs and symptoms of triple-negative breast cancer may include:
• [9] It may cause a lump, which is more commonly hard, painless and irregular, but can also be soft, round and painful. Other signs include: Breast swelling ...
• [5] Other less common symptoms include swelling, skin dimpling, pain, nipple retraction, discharge, redness, or swollen lymph nodes under the arm.
• [3] Some common signs include: Lumps or masses felt on or within a breast. Breast skin changes, such as redness, swelling or pitting (an “orange peel” texture)

Diagnostic Tests for Triple-Negative Breast Cancer

Triple-negative breast cancer (TNBC) is a type of breast cancer that lacks estrogen, progesterone, and HER2 receptors. Diagnosing TNBC requires a combination of imaging tests and biopsies.

• Imaging Tests: A mammogram, an x-ray of the breasts, is often used to detect TNBC. However, it's essential to note that TNBC can be difficult to detect on a mammogram alone [1].
• Biopsy: A biopsy

Treatment Options for Triple-Negative Breast Cancer (TNBC)

Triple-negative breast cancer (TNBC) is a type of breast cancer that does not have estrogen or progesterone receptors and also makes too little or none of the HER2 protein. As a result, hormone therapy and drugs that target HER2 are not effective in treating TNBC.

Chemotherapy

Chemotherapy is often the main systemic treatment option for TNBC. It can be used to treat early-stage TNBC as well as advanced disease. Chemotherapy works by targeting rapidly dividing cancer cells, which are characteristic of TNBC [8].

Immunotherapy

Immunotherapy agents such as pembrolizumab (Keytruda) have been approved for the treatment of advanced TNBC. When combined with chemotherapy, immunotherapy can help some patients live longer [4]. Additionally, targeted therapy using antibody-drug conjugates (ADCs) has shown promise in treating TNBC [10].

Targeted Therapy

Targeted therapies such as olaparib have been approved for the treatment of certain types of breast cancer, including BRCA-mutated triple-negative disease. These treatments work by targeting specific genetic mutations that are present in some TNBC cells [9].

Other Treatment Options

Surgery and radiation therapy may also be used to treat TNBC, either alone or in combination with chemotherapy and targeted therapies.

References:

• [8] "Triple-negative breast cancer is often very sensitive to chemotherapy, which, despite the side effects, is an effective treatment that can save lives."
• [4] "Adding the immunotherapy drug pembrolizumab (Keytruda) to chemotherapy can help some patients with advanced triple-negative breast cancer live longer."
• [10] "An antibody-drug conjugate (ADC) is a monoclonal antibody joined to a chemotherapy drug, which can be used to treat TNBC."
• [9] "Patients with BRCA-mutated triple negative breast cancer as well as those with hormone receptor-positive, HER2-negative breast cancer are eligible for treatment."

The differential diagnosis for triple-negative breast cancer (TNBC) includes several conditions that can mimic its characteristics. Some of these conditions are:

• Invasive apocrine carcinoma: This is a rare type of breast cancer that can be difficult to distinguish from TNBC. It is characterized by the presence of apocrine glands in the tumor tissue [3].
• Juvenile papillomatosis with apocrine metaplasia: This is a benign condition that can present with similar features to TNBC, including the presence of apocrine glands and a lack of estrogen receptor expression [3].
• Microglandular hyperplasia: This is a rare condition characterized by the presence of small gland-like structures in the breast tissue. It can be difficult to distinguish from TNBC, especially when it presents with similar histological features [3].
• Neuroendocrine carcinomas of the breast: These are rare and aggressive tumors that can express neuroendocrine markers. They tend to be poorly differentiated and hormone receptor negative, which can make them challenging to diagnose as TNBC [4].

It's worth noting that the differential diagnosis for TNBC is not exhaustive, and other conditions may also need to be considered on a case-by-case basis.

References:

[3] Cserni G. (2021). The differential diagnosis of SC includes invasive apocrine carcinoma, ACC, juvenile papillomatosis with apocrine metaplasia, microglandular hyperplasia, etc. [5]

[4] Thomas A. (2023). Neuroendocrine carcinomas of the breast tend to be poorly differentiated and hormone receptor negative. In contrast, neuroendocrine tumors are typically well-differentiated and hormone receptor positive. [6]

[8] CK Anders. (2008). Triple-negative breast cancer is clinically defined as lacking expression of the estrogen receptor (ER), progesterone receptor (PR), and HER2.