Triple negative breast cancer (TNBC) is the next frontier in the march towards finding a cure for breast cancer. Most breast cancers we can treat, because most breast cancers have a target we can exploit, that is the estrogen receptor, the progesterone receptor or the HER2/neu receptor. In these breast cancers we can shut down these receptors with certain kinds of drugs to stop the growth and kill the cancer. Triple negative breast cancers do not express these receptors and therefore early detection and surgery become the main stay of therapy for this type of breast cancer.
Not all triple negative breast cancers are the same, however. There are many other subtypes of triple negative breast cancer and research is intense on trying to find a cure. Some triple negative breast cancers exhibit a receptor that will respond to an antiestrogen therapy and other types of triple negative breast cancer will exhibit will exhibit a Her2/neu type of growth and pattern and will respond to anti-Her2/neu medical treatment.
Many triple negative breast cancers grow by a mechanism that we just do not understand at this point and are thus very difficult to treat. We use standard breast cancer therapy to treat triple negative breast cancer and fortunately over half the time triple negative breast cancers will respond and go away. For those triple negative breast cancers that are completely killed by standard chemotherapy, we now have second line therapies that are able to kill a few more of these triple negative breast cancers.
Triple negative breast cancers that are greater than 1inch approximately, or have spread to the lymph node, should be treated with chemotherapy prior to any surgical treatment. If a triple negative breast cancer goes away after receiving chemotherapy, then we know that the risk of recurrence is very low. However, if the cancer does not go away, there are options for another form of chemotherapy agent, which I will expand upon in the next blog. The only way to know if you need another form of therapy is to monitor the response of your triple negative breast cancer to standard chemotherapy.
Obviously, the best way to treat triple negative breast cancer is to detect the cancer early and cut it out before it reaches approximately one inch. Your annual mammogram is your best defense against triple negative breast cancer.