Risk & Treatment Triple Negative Breast Cancer

Risk & Treatment Triple Negative Breast Cancer


To understand triple-negative breast cancer, it’s important to understand receptors, which are proteins found inside and on the surface of cells. These receptor proteins are the “eyes” and “ears” of the cells, receiving messages from substances in the bloodstream and then telling the cells what to do.

Basal like tumors consist of cells having features similar to the basal cells that lined the mammary duct. Around 15-20 % of breast cancer is basal like or triple negative and occurs more frequently in African American women of younger age groups. Most of the BRCA1 gene breast cancers are both basal like and triple negative.

Risk & Treatment Triple Negative Breast Cancer

Obesity

A strong link has been found between obesity and the elevated risk of postmenopausal breast cancer. A strong association of estrogen and adipose tissue is known to contribute to this higher risk. On the other hand, greater physical activity is shown to decrease the risk for triple negative breast cancer.

Oral Contraceptives

Risk for triple negative breast cancer increases 2.5 folds in women using oral contraceptives (OCs) for a duration of more than one year, compared to those who used them for lesser than a year or never.

In women with age 40 or below, who used OCs for more than 1 year, the increased risk was found to be 4.2 times higher. There was no risk observed for women using OCs and falling in age group of 41 to 45 years. Both duration of oral contraceptive use and the age group, play a significant role in elevating the risk of TNBC.

common breast cancer signs and symptoms

  • Skin changes, such as swelling, redness, or other visible differences in one or both breasts
  • An increase in size or change in shape of the breast(s)
  • Changes in the appearance of one or both nipples
  • Nipple discharge other than breast milk
  • General pain in/on any part of the breast
  • Lumps or nodes felt on or inside of the breast

Treatment For Triple Negative Breast Cancer

Chemotherapy

Triple negative breast cancers are usually quite susceptible to chemotherapy, but in certain cases, early response may not correlate with an overall survival rate. Hence, it becomes complicated to find an optimal chemotherapy. Addition of taxane to chemotherapy is known to improve the treatment outcomes substantially. BRCA1 related TNBCs are particularly more susceptible to chemotherapy that includes taxanes and platinum based agents.

Surgery

Since the cancer is hormone receptor negative and Her2neu negative, it cannot be treated with hormonal therapies. Hence, the standard treatment remains a surgery performed with adjuvant radiotherapy and chemotherapy.
A variation form called neo-adjuvant chemotherapy is also performed these days to treat triple negative breast cancer. This facilitates an increased rate of breast conserving surgeries and on evaluation of chemotherapeutic response, gives important information about the patient’s responsiveness to chemotherapy treatment.

Use of Novel Trio Drugs

Recent advancement in treatment of TNBCs includes a cocktail of Entinostat (blocks the enzyme unfolding DNA), All Trans Retinoic acid (ATRA) and protein of RARβ gene. Entinostat provides access of genes to regulatory molecules and reactivates the RARβ (retinoic acid receptor beta) gene.

ATRA drug is related to vitamin A that binds to protein synthesized by RARβ. Together, RARβ gene and ATRA drug puts a brake on cancerous cell growth.

Disease free survival from triple negative breast cancer is a short lived scenario in women as the disease does not respond to hormonal drugs and may become resistant to chemotherapy. More research studies are performed to fine tune this fearsome cancer’s properties and bring out a more sensitive and long term treatment for triple negative breast cancer patients.

Romilia