A Quick Guide to Understanding Triple-Negative Breast Cancer By MSD in the Philippines

Triple-negative breast cancer (TNBC) is the type of breast cancer that tests negative for the hormones commonly found in other types of breast cancer.¹ The term “triple-negative” refers to the fact that the cancer cells of TNBC test negative on all three tests for estrogen receptors (ER), progesterone receptors (PR) as well as the human epidermal growth factor 2 (HER2) protein.¹

TNBC is a type of invasive breast cancer that is more aggressive and more challenging to treat.¹ This is because triple-negative breast cancer has a poorer prognosis compared to other types of breast cancer.¹ It grows and spreads faster; hence, the cancer is more likely to have spread by the time it is found.¹ It can also reoccur or come back after treatment.¹

But despite, having a poor prognosis, women may have a better outlook when the cancer is found and treated at least four or five years earlier.¹

By understanding who is at risk of TNBC, the signs and symptoms to watch out for, and how to prevent or control the disease, you can have better control of their health and fight against TNBC.

Who is at risk of Triple-Negative Breast Cancer?

Anyone can be at risk of triple-negative breast cancer, but this disease is more likely to affect people younger than 50, Black and Hispanic women, and women with a BRCA1 gene mutation.²

TNBC Signs and Symptoms

Triple-Negative Breast Cancer symptoms are the same as the symptoms of other breast cancer types. ¹  Here are some of the breast cancer symptoms you need to be aware of: ³

• swelling of the breast
• skin irritation or dimpling on the skin of the breast
• breast pain or nipple pain
• nipple retraction (nipple turning inward instead of sticking out)
• redness, flaking, or thickening of the breast skin or nipple
• nipple discharge other than breast milk
• a lump near the underarm

TNBC Prevention

You can prevent triple negative breast cancer by:

Conducting a Breast Self-Exam

A breast self-exam (BSE) enables you to inspect and be familiar with your breasts and underarms for lumps and changes³, to recognize what’s normal and what’s not. 

Routine BSE may be included in your breast awareness strategy.³ Here is how you perform a breast self-exam:

1. Begin to inspect your breasts visually by sitting or standing shirtless and braless before a mirror.³ 

First, inspect your breasts with your arms at your sides; next, with your hands pressed on your hips; and, lastly, with your arms raised over your head. Check for changes in size, symmetry, and shape, visuals of dimpling or puckering on the skin of the breast, and if your nipples are inverted (turned inward).³ 

2. Examine your breasts using your hands.³

You can use your palm, finger pads, or the back of your fingers to feel the breast tissue and check for lumps. You can perform this part of the breast self-exam while lying down, which helps make the breast tissue spread out; hence, making it thinner and easier to feel. Subsequently, you can also do this in the shower. Lathering your fingers and breast with soap can enable you to feel your breasts smoothly.³  

Additional Tests and Procedures

If you discover lumps or changes in your breast, additional tests and procedures may be needed to check these abnormalities.³ 

Imaging tests, such as a diagnostic mammogram or a breast ultrasound, and biopsy, which is a procedure to remove breast tissue for examination, can enable your doctor to check if the lump is cancerous or noncancerous.³ They can also check if the cells do not have ER, PR, or HER2 protein to determine the breast cancer type you have.¹ 

Once the tests have been carried out and you receive a diagnosis, the next steps are to:

Understand your test results as well as your breast cancer diagnosis.

Upon the availability of your laboratory test results, your doctor will explain them to you to help you understand your breast cancer diagnosis or the status of your disease.

Learn more about available treatment options for TNBC.

Since triple-negative breast cancer tests negative for ER, PR, and HER2, it does not respond to hormonal therapy or medicines that target receptors for HER2 protein.² 

Here are the common treatments for TNBC:⁴ 

Lumpectomy – This is the treatment that surgeons do to remove the lump from the breast. In a lumpectomy, the nearby lymph nodes are also removed if cancer has spread to them.

Mastectomy – A treatment that requires the entire breast and nearby lymph nodes to be removed.

Radiation Therapy – Radiation therapy usually follows lumpectomies to kill any remaining cancer cells in the breast.

Chemotherapy – This treatment kills cancer cells from the lump that may have spread in other parts of the body.

Ask about cancer medical assistance.

The national government has medical and financial assistance for Filipinos diagnosed with cancer. There are also breast cancer organizations that provide awareness and financial assistance to breast cancer patients, like the ICanServe Foundation, Philippine Cancer Society, Philippine Foundation for Breast Cancer, and Philippine Breast Cancer Society.

In addition, various local initiatives such as MSD’s Hope From Within and their Cancer Game Plan PH are also available for patients who need information that can assist them with their journey to fight cancer.

Conclusion

Breast cancer awareness in the Philippines starts with understanding breast cancer, its types, and its symptoms. It continues with knowing more about the available screening and treatment options for every type of breast cancer. Better awareness may give women a better outlook with early diagnosis and intervention, particularly when diagnosed with triple-negative breast cancer.

Hope From Within has a breast cancer map to guide the breast cancer patient journey, from prevention to treatment.

Consult your doctor as soon as possible if you notice any breast cancer signs and symptoms.

REFERENCES

1 Triple-negative Breast Cancer. (2021, January 27). Retrieved from American Cancer Society: https://www.cancer.org/cancer/breast-cancer/about/types-of-breast-cancer/triple-negative.html. Accessed on August 12, 2021.

2 Triple-Negative Breast Cancer. (2021, July 29). Retrieved from Breastcancer.org: https://www.breastcancer.org/symptoms/types/triple-negative. Accessed on August 12, 2021.

3 Breast self-exam for breast awareness. (2020, June 9). Retrieved from Mayo Clinic: https://www.mayoclinic.org/tests-procedures/breast-exam/about/pac-20393237. Accessed on August 12, 2021.

4 Triple-Negative Breast Cancer. (2020, September 14). Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/cancer/breast/triple-negative.htm. Accessed on August 12, 2021.