If you’ve been diagnosed with breast cancer, one of the first things your doctor will do is determine whether the cancer cells are hormone receptive. Knowing if your cancer responds to certain hormones will help direct your treatment, and it can offer insight about your outlook.
Some cancer cells have
receptors for the hormones estrogen and progesterone, as well as an overexpression of the gene HER2 (human epidermal growth factor receptor 2). If HER2 genes are overexpressed, the cells make too much of the protein HER2.
Hormone receptors tell your cells how to behave. If your cells have the receptors, the hormones they receive will actually support the growth of your cancer cells. But not all breast cancer cells have these receptors and not all cancers overexpress the gene HER2. If your cancer isn’t receptive to these hormones and doesn't have an increased amount of HER2, it’s called triple negative breast cancer (TNBC). TNBC represents about 20 percent of all breast cancers.
Hormone therapy disrupts hormones' ability to cause cancer growth. Because TNBC cells lack estrogen, progesterone, and their HER2 genes aren't overexpressed, the cells don’t respond well to hormone therapy or medications that block HER2 receptors. Instead of hormone therapy, treating TNBC often involves chemotherapy, radiation, and surgery.
Like other types of breast cancer, TNBC can often be treated successfully if it’s caught early. But in general, survival rates tend to be lower with TNBC compared to other forms of breast cancer. TNBC is also more likely than some other types of breast cancer to return after it’s been treated, especially in the first few years after treatment.
The stages of breast cancer are based on the size and location of the tumor, as well as whether the cancer has spread beyond the part of the breast in which it originated. To stage cancer, doctors use a scale of Stage 0 to Stage 4.
Stage 0 breast cancers are isolated in one part of the breast, such as duct or lobule, and show no sign of spreading into other tissue. Stage 1 breast cancer also often means that the cancer hasn’t spread outside of the breast. Stage 1 is typically localized, although further local spread may cause the cancer to move into stage 2.
In stage 3, the cancer has invaded the body’s lymph system. Stage 4 cancer is the most serious. Stage 4 cancer has spread beyond the breast and nearby lymph nodes, and into other organs and tissue of the body.
The prognosis for breast cancer is often described in terms of five-year survival rates. This survival rate represents the percentage of people who are still alive a minimum of five years after their diagnosis. Five-year survival rates tend to be lower for TNBC than for other forms of breast cancer.
A 2007 study of more than 50,000 women with all stages of breast cancer found that 77 percent of women with TNBC survived at least 5 years. Ninety three percent of women with other forms of breast cancer were found to survive at least five years.
A separate study released in 2007 found that after years of their diagnosis, women with TNBC no longer had a higher risk of death.
These survival rates shouldn’t be used to predict your outlook. Your doctor will be able to give you a more precise outlook based on the stage of your TNBC, your age, and overall health. How well you respond to treatment will also determine your prognosis. Some people don’t want to hear about survival odds, while others find the survival rates give them a helpful perspective on their illness.
In addition to stages, breast cancers are given grades based on the size, shape, and activity of the cells in the tumor. A higher-grade cancer means a greater percentage of cells look and act unhealthy, or they no longer resemble normal, healthy cells. On a scale of one to three, with the three being the most serious condition, TNBC is often labeled Grade 3.
Even though TNBC can’t be treated with hormone therapy, new medications called poly ADP-ribose polymerase inhibitors,” or PARP inhibitors, are offering researchers hope. Finding a better treatment for TNBC is a major focus of breast cancer research.
In fact, research has found that there are six different subtypes of TNBC. Each one has its own abnormalities, but drugs geared toward those unique abnormalities are helping people with TNBC. And even though TNBC can be an especially aggressive type of breast cancer, your doctor may or may not recommend aggressive treatment. There is no standard recommendation for treating TNBC.
It’s also important to remember that no one, not even your doctor, can forecast exactly how your breast cancer will progress or respond to treatment. Survival rates are based on statistics, but everybody has an individual experience with the disease that cannot be predicted.