Why Is Triple-Negative Breast Cancer So Hard to Treat?

Oncologists create a personalized breast cancer treatment plan for every patient based on the type of breast cancer, where it’s located in the breast(s), stage, grade and hormone status. Each of these has an impact on which treatments are recommended and in which order.

Types of Breast Cancer

Breast cancer is broadly classified into two types.

Non-invasive cancer – The cancer cells remain within their origin and do not attack the other normal cells.

Invasive cancer - Invasive cancer can spread to the surrounding tissues. It is also called infiltrating cancer.

Triple-negative breast cancer (TNBC) is considered an invasive cancer that can spread faster than other types of breast cancer. Treatment will most likely begin right away.

Hormone Status and Triple-Negative Breast Cancer

Selecting the best breast cancer treatments for a patient is based on whether the cancer is fueled by a hormone such as progesterone or estrogen. When breast cancer is estrogen-positive or progesterone-positive, hormone therapies can be given to reduce hormone levels, essentially cutting off the fuel source for the cancer cells.

Another test performed at the same time is for the presence of HER2 (human epidermal growth factor receptor 2) protein on the breast cancer cells. In about 20% of women, the breast cancer cells have extra copies of the gene that makes the HER2 protein allowing the cancer to grow aggressively. A targeted therapy is typically included in the breast cancer treatment plan for HER2-positive patients. This treatment specifically targets the HER2 receptors on the breast cancer cells, blocking them from accepting the protein that keeps the cancer growing.

For most women with triple-negative breast cancer, these hormone therapies and targeted therapies are less likely to slow the cancer’s growth.

Is Triple Negative Cancer Related to the BRCA gene mutation?

It’s estimated that approximately 70% of patients with a triple-negative breast cancer diagnosis also have the inherited BRCA gene mutation, particularly BRCA1. Because of this, most triple-negative breast cancer patients will be offered genetic testing to see if the BRCA mutation is present. If found, the breast cancer treatment plan decisions may be impacted and you may need a special plan for monitoring for the recurrence of breast cancer.

What is the Recommended Treatment for Triple-Negative Breast Cancer?

Since hormone and targeted therapies aren’t as likely to be effective on triple-negative breast cancer, the oncologist will recommend other treatment options. Some of these treatments are common among most breast cancer patients such as surgery and chemotherapy and/or radiation therapy.

Breast Cancer Removal Surgery

Most women with breast cancer will have surgery to remove it. There are several options which are discussed with the oncologist and the breast cancer surgeon.

Lumpectomy - removes the tumor and a margin of tissue around it. This keeps most of the breast and sensation intact. Radiation is likely to follow for these patients to be sure all the cancer cells in the area have been killed.

Mastectomy - removal of the entire breast is a significant surgery. However, for BRCA positive patients, this may be the preferred surgical treatment to reduce the likelihood of the cancer recurring in the breast. Radiation may still be recommended and reconstructive surgery is an option.

Systemic Therapy for Triple-Negative Breast Cancer

Chemotherapy is considered the most common form of treatment for TNBC. It may be given before surgery is performed, called neoadjuvant chemotherapy. Research is showing that this produces better results that last longer than chemotherapy only after surgery.

PARP inhibitors can be used to treat advanced-stage HER2-negative breast cancer in people with a BRCA1 or BRCA2 mutation. This therapy makes it harder for the cancer cells to survive.

Immunotherapy is a category of drugs that uses your immune system to help fight off cancer cell development.

Radiation Therapy for Breast Cancer

Radiation beams directed at the areas where the breast cancer was removed is a common treatment after surgery. During surgery the doctor does everything possible to remove all of the breast cancer. But there can be some cells left behind. Radiation therapy is applied over the course of several weeks after surgery to be sure any remaining cancer cells are killed. This is common for all types of breast cancer patients.

Extensive Clinical Research is Underway for Triple Negative Breast Cancer Treatments

The treatments currently available are the result of many years of clinical research with triple-negative breast cancer patients. More clinical trials are underway to find more options for treatment.

If you have received a triple-negative breast cancer diagnosis, a clinical trial may be available to you right in our local area of Brevard County, Florida. Talk to your oncologist if you would be interested in participating.

Don’t Miss Your Regular Breast Cancer Screening

Finding breast cancer early is your best opportunity for successful treatment, especially when it’s an aggressive cancer like triple-negative breast cancer. Be sure you follow a regular breast cancer screening schedule. And if you have a family history of breast cancer, tell your doctor so that they can start screening earlier. Most cases of triple-negative breast cancer are diagnosed in patients between 40 and 50 years of age.

Where to Start With a Breast Cancer Diagnosis?

Cancer Care Centers of Brevard cares for triple-negative breast cancer patients every day with a comprehensive treatment plan customized for each person. Our breast cancer specialists are here to help whether you have just been diagnosed with breast cancer, you’d like a second opinion, or your breast cancer has returned. Request an appointment for a consultation.

Categories: Breast Cancer