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Macmillan and Cancerbackup merged in 2008. Together we provide free, high quality information for people affected by cancer through our publications, website and phone service. Find out more|.
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Triple negative breast cancer| is found in about 1 in 5 women with breast cancer (15-20%). Unlike other types of breast cancer, it often affects women in their 30s and 40s.
This type of cancer is called triple negative because it doesn’t have receptors| (proteins on the surface of cells) for the hormones oestrogen and progesterone, or a protein called HER2.
These receptors allow oestrogen, progesterone and HER2 to attach on to breast cancer cells, encouraging them to grow. After surgery, the tissue that is removed from a woman’s breast is tested for receptors. Women whose breast cancers have receptors for hormones are prescribed hormonal treatments|, such as tamoxifen| or Arimidex®.| Women who have receptors for HER2 are treated with a drug called trastuzumab (Herceptin®).|
As your breast cancer has tested negative for oestrogen, progesterone and HER2, these treatments won’t be suitable for you.
Treatment with chemotherapy is much more effective for you.
The term basal cell breast cancer is often linked with triple negative breast cancer.
Basal cell is a type of breast cancer that is identified when the cancer cells are examined under the microscope.
Most triple negative breast cancers are basal cell cancer and basal cancers are usually triple negative.
The risk factors for triple negative breast cancer aren’t clear. Breast cancers that depend on hormones for growth are associated with risk factors, such as when you had your first child and how many children you have. Triple negative doesn’t seem to share these risk factors.
Most women with triple negative breast cancer don’t have a strong history of breast cancer| in their family (hereditary breast cancer). But some women with triple negative breast cancer have a faulty gene called BRCA1. This gene is inherited from a parent and can cause breast cancer to run in families. Most breast cancers caused by BRCA1 are triple negative.
Research shows that triple negative breast cancer is more common in African-American women than in white American women. But more research is needed to find out what this means for women of African ethnicity in the UK.
Triple negative breast cancer is diagnosed in the same way as any other type of breast cancer using the same tests|.
The stage of a cancer is based on its size and how far it has spread. This information helps your specialist decide on the most appropriate treatment for you. Triple negative breast cancer is staged| in the same way as other types of breast cancer.
The grade of a cancer is how the cancer cells look when they’re examined under a microscope. The grade gives an idea of how quickly the cancer may develop. There are three grades|.
Triple negative breast cancer is often (not always) high-grade. This means that the cells look more abnormal than a low-grade cancer and grow more quickly.
Chemotherapy is often more effective against cells that are faster growing, which is why it’s such an important treatment for triple negative breast cancer.
Triple negative breast cancer is often treated with a combination of surgery, radiotherapy and chemotherapy.
The type of surgery you have will depend on the size and position of your cancer. You and your doctor will decide which operation is best for your individual situation:
This is the removal of a breast lump, together with some surrounding tissue. A lumpectomy| is usually followed by radiotherapy treatment to the remaining breast tissue.
Sometimes your surgeon may advise that you have a mastectomy. There are different reasons| for doing this. Your surgeon will explain why they think it’s the best treatment for you.
As part of any operation for breast cancer, the surgeon will usually remove lymph nodes| from under your arm on the same side as the cancer. The lymph nodes are examined to check if any cancer cells have spread into them from the breast.
Some women with early breast cancer have a procedure called a sentinel lymph node biopsy to check the lymph nodes. If the sentinel node (the first node that lymph fluid from the breast drains into) doesn’t contain cancer cells, you won’t need to have any more nodes removed.
Radiotherapy| treats cancer by using high-energy rays to destroy the cancer cells, while doing as little harm as possible to normal cells. Women having radiotherapy usually receive it after surgery| and chemotherapy|.
If part of the breast has been removed (lumpectomy), radiotherapy is usually given to the remaining breast tissue to reduce the risk of the cancer coming back in that area. Radiotherapy to the chest wall may be given if your doctor thinks there’s a risk that any cancer cells have been left behind after a mastectomy.
The treatment is normally given in the hospital radiotherapy department as a series of short daily sessions. The treatments are usually given Monday-Friday, with a rest at the weekend. Each treatment takes 10-15 minutes. A course of radiotherapy for breast cancer usually lasts for three weeks and is usually given to you as an outpatient. Your doctor will discuss the treatment and possible side effects with you.
Radiotherapy to the breast can cause side effects, such as reddening and soreness of the skin. If you're dark skinned your skin may get darker or have a blue or black tinge. Your doctor can prescribe creams to soothe your skin if it becomes sore and flaky. Usually any skin reaction settles down 2-4 weeks after radiotherapy. You’ll be given advice on how to look after your skin.
You’re likely to feel tired| during treatment and this may continue for a month or two after it. Get plenty of rest, but balance this with gentle, regular exercise such as short walks, which will give you more energy.
Side effects usually gradually disappear once your treatment has finished.
We have more information on radiotherapy for breast cancer|, including when it’s used and possible side effects.
After surgery, chemotherapy| is the main treatment for triple negative breast cancer. Chemotherapy is the use of anti-cancer drugs to destroy cancer cells. It’s given to reduce the chance of the cancer coming back (known as adjuvant therapy).
In other types| of breast cancer (non-triple negative), chemotherapy may be given to women whose cancer has spread to the lymph nodes, is large or is high-grade.
However, women with triple negative breast cancer will usually be given chemotherapy even if their cancer is low-grade or hasn’t spread to the lymph nodes.
Chemotherapy drugs are given by injection into a vein (intravenously) or as tablets. Chemotherapy into the vein is given as a session of treatment, usually over a few hours. This is followed by a rest period of a few weeks, which allows your body to recover from any side effects of the treatment.
Chemotherapy can cause side effects but these can often be well controlled by medicines and usually improve when treatment is over. Some of the side effects the drugs may cause are lowered resistance to infection|, tiredness|, feeling sick (nausea|) and hair loss|.
Always let your doctor or nurse know about any side effects you have. There are usually ways in which they can be controlled or improved.
Our section on chemotherapy| discusses the treatment and its side effects in more detail.
Triple negative breast cancer responds well to chemotherapy but we don’t yet know exactly which chemotherapy drugs are the most effective. There are many research trials| trying to find out which drugs are the most effective for women with breast cancer.
The standard chemotherapy for women with early breast cancer is one of a group of drugs called anthracyclines (such as doxorubicin| or epirubicin|). If you have triple negative breast cancer you may also be given another type of chemotherapy drug called a taxane. Studies have shown that chemotherapy that includes a taxane drug such as docetaxel (Taxotere®)| or paclitaxel (Taxol®)| gives some women with early breast cancer more protection. But we don’t yet know which group of women is most likely to benefit from this.
Research trials are trying to find new and better treatments for triple negative breast cancer.
The Triple Negative Trial (TNT) is for women whose triple negative breast cancer has come back or spread after treatment. It’s comparing the chemotherapy drugs carboplatin| and docetaxel|. Docetaxel is already used for women whose breast cancer has spread. Carboplatin is an established chemotherapy drug used to treat many types of cancer. The TNT trial aims to find out if carboplatin is better at slowing down the growth of triple negative breast cancer than docetaxel.
Biological therapies| are drugs that work in a different way to chemotherapy, targeting specific abnormalities in cancer cells. A number of early clinical trials have suggested these agents might be very effective in treating triple negative breast cancer. However, more recent results have been less encouraging. There is still a lot of research being done using different biological therapies so they may be used as part of treatment in the future.
You may experience many different emotions, including anxiety| and fear.
These are all normal reactions and are part of the process many people go through in trying to come to terms with their condition. You may find it helpful to talk things over with your doctor or nurse, or with one of our cancer support specialists|. Close friends and family members can also offer support.
After your treatment, you'll need regular check-ups (which will include a physical examination) and mammograms. These check-ups are usually frequent at first but will eventually lessen to once a year.
Your appointments are a good opportunity to talk to your doctor about any concerns you may have. But if you notice any new symptoms or are worried about anything in between appointments you can contact your doctor or nurse for advice.
At the end of treatment you may still feel tired. This will gradually improve and it’s important to give yourself time to recover.
You may find that you still have a lot of different feelings and worry about your cancer coming back. This usually gets easier with time as the focus of your life shifts back to the day-to-day things that occupied you before.
Although triple negative is sometimes described as a faster growing type of breast cancer, the risk of it coming back depends on the same factors as other types of breast cancer. It is suggested that if triple negative breast cancer doesn’t come back within five years after diagnosis, there may be a lower chance of it coming back compared to some other types of breast cancer.
After treatment some women find it helpful to make positive choices about their lifestyle. These can include eating a healthier diet,| keeping to a healthy weight, exercising or stopping smoking|.
All these can reduce your risk of other health problems and make you feel and look better.
This section is based on our Triple negative breast cancer factsheet which has been compiled using information from a number of reliable sources, including:
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.