Triple-Negative Breast Cancer Treatment | Dr. Geetha Nagasree
Triple negative breast cancer treatment: Nearly about 15 – 20% of breast cancers are triple-negative. There are many studies and research activities going on across the world to find new, robust and interesting medicines, therapies, modalities, techniques, and ways of treating breast cancers of this type. Researchers are trying to understand the processes that cause triple-negative breast cancer and whether certain medications can interfere with these processes.
Triple-Negative Breast Cancer Facts
Prior to going into more details about triple-negative breast cancer, let us have a look at some of the most common features of this type of breast cancer.
These are the most aggressive types with a poorer prognosis than other types of breast cancer.
They can aggressively spread outside the breast and their recurrence rate is also high.
Targeted medicines to treat this type of breast cancer are very few.
Triple-negative breast cancers are higher grade compared to other types of breast cancer. On a scale of 1 – 3, their grade is often 3.
Most of the triple-negative breast cancers are basal-like, high-grade, aggressive cancers.
Triple-Negative Breast Cancers are Difficult to Treat
Hormonal therapies and HER2-targeted therapies disrupt the effects of Estrogen, progesterone, and the HER2 protein on breast cancer, which can help slow or even stop the growth of breast cancer cells.
Regular breast cancers are susceptible to hormonal therapies and HER2 targeted therapies as these treatment modalities disrupt the effects of HER2 protein, progesterone, and Estrogen hormones on breast cancer. In this way, breast cancer cell growth is slowed down or stopped completely. But the scenario is different with triple-negative breast cancer – owing to the absence of these receptors – Estrogen, progesterone, and HER2. Therefore, triple-negative breast cancer doesn’t respond to hormonal and targeted therapies. Aromatase inhibitors and tamoxifen are ineffective against triple-negative breast cancers. These types of breast cancer are also unlikely to respond to medications that target HER2 protein.
Triple-Negative Breast Cancer Treatment
The treatment of triple-negative breast cancer involves surgery (Lumpectomy or mastectomy), radiation therapy, and chemotherapy.
Lumpectomy: A breast oncoplastic surgeon performs surgery to remove the lump from the breast. She also removes lymph nodes to know whether cancer has spread to such areas.
Mastectomy: This type of surgery involves the removal of the affected breast and nearby lymph nodes. A breast oncoplastic surgeon or a female surgical oncologist who specializes in the treatment and management of breast cancer performs surgery to remove the breast. During the same surgical procedure, she may also perform breast reconstruction or breast conservation surgery.
Radiation Therapy: Radiation therapy is done following lumpectomies or mastectomies. During this procedure, the affected breast is subjected to high-energy radiation to kill the remaining cancer cells.
Surgery, Radiation Therapy, and Chemotherapy
A combination of surgery, radiation therapy, and chemotherapy are used to treat triple-negative breast cancer. Chemotherapy – drugs are medicines or a combination of medicines that are used to kill cancer cells and are the first thing doctors try. It can be put into a vein through a needle or in a or tablet. If these types of cancers are diagnosed early, they may respond better to chemotherapy than others. Your doctor may administer chemotherapy in three ways:
Neoadjuvant therapy includes neoadjuvant chemotherapy, which shrinks the tumour and accelerates the process of killing cancer. This is done before surgery. If you have locally advanced breast cancer, you may prefer this method, when your doctor finds it difficult to operate. It is also preferred when it becomes unlikely that the breast can be saved.
Adjuvant Therapy
Doctors use adjuvant therapy after surgery. If the tumor is large or your lymph nodes are affected, the oncologist may suggest adjuvant therapy. Breast cancer is more likely to relapse. Other types of adjuvant therapy, such as hormone therapy, are not suitable for triple-negative breast cancer. In cases where cancer has spread and surgery is not an option, immunotherapy is used together with chemotherapy.