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Triple negative breast cancer

What is triple negative breast cancer. What treatment can I have?


What triple negative breast cancer is

Triple negative breast cancers are cancers that don’t have receptors for oestrogen, progesterone or Her2. During a biopsy or surgery for breast cancer, your doctor will take a sample of cells so they can be tested for these receptors. The results help your doctor to decide on the most suitable treatment for you. A type of breast cancer known as basal type breast cancer is usually triple negative. Some women with triple negative breast cancer have a BRCA1 gene fault.


Breast cancer receptors

Receptors are proteins that some cancer cells have. When specific substances in your body attach to specific receptors, they trigger a reaction in the cell. When they are triggered, oestrogen receptors, progesterone receptors and Her2 receptors can tell breast cancer cells to grow.

Oestrogen attaches to oestrogen receptors. Progesterone attaches to progesterone receptors. And Her2 attaches to Her2 receptors. Some breast cancers have one or more of these receptors. Triple negative breast cancers don’t have any of them.


How common triple negative breast cancer is

Only around 15 out of every 100 breast cancers (15%) are triple negative. Doctors and researchers have only recently found out about triple negative breast cancer. They are continually finding out more about what makes cells grow and how best to treat particular types of breast cancer.

American researchers have found that triple negative breast cancer is more common in African and Hispanic American women than white American women. Researchers are not sure why this is. Overall, breast cancer is actually less common in African American women than in white American women. The researchers suggest that it is a combination of genetic factors as well as sharing a similar lifestyle that increases the risk of this type of cancer in this group of women. We need more research to find out.


Chemotherapy for triple negative breast cancer

Following surgery to remove the cancer, chemotherapy is the best choice of treatment to try and stop triple negative breast cancer coming back.

Some commonly used breast cancer treatments such as hormone therapy or Herceptin don’t work for triple negative breast cancer. These treatments need to attach to particular receptors. The triple negative breast cancer cells don't have the right receptors.

The main chemotherapy treatment for triple negative breast cancer is usually a combination of chemotherapy drugs. The combination should include a type of chemotherapy drug called an anthracycline, such as doxorubicin or epirubicin.

There isn’t yet a particular chemotherapy combination that doctors recommend for triple negative breast cancer. Because it is a recent finding, researchers are still looking into the best chemotherapy combination.

Early research suggests that triple negative breast cancers may be more sensitive to particular types of chemotherapy than other types of breast cancer. Doctors are looking into using chemotherapy drugs that aren’t usually used for early breast cancer, such as platinum drugs and taxanes. Early research in America suggests that having cisplatin before surgery works better than other treatments. Another type of chemotherapy researchers are looking into is ixabepilone. 

The Triple Negative Trial (TNT) is looking at chemotherapy for women with triple negative breast cancer that has spread to another part of the body. It is comparing the chemotherapy drugs carboplatin and docetaxel. The trial has closed and it will be some time before we get the results of this trial.

The tnAcity trial is looking at nab-paclitaxel alongside gemcitabine or carboplatin for triple negative breast cancer that has spread. Nab-paclitaxel (Abraxane) is paclitaxel chemotherapy combined with a protein called albumin. This form of the drug can be given at higher doses and may work differently to paclitaxel (Taxol). The women taking part have not had any other treatment for breast cancer that has spread, so doctors call this first line treatment. This trial has now closed and we are waiting for the results.

We have detailed information about chemotherapy for breast cancer

We also have information about chemotherapy trials for breast cancer on our clinical trials database.


Biological therapy for triple negative breast cancer

Researchers are looking into biological therapy for triple negative breast cancer. In a randomised phase 3 trial, the monoclonal antibody bevacizumab (Avastin) and chemotherapy drug paclitaxel (Taxol) appeared to control advanced breast cancer for a time in some women with triple negative breast cancer. Researchers are currently studying various types of biological therapy including olaparib.

The PAKT trial is looking at a new biological therapy drug called AZD5363. It is using it with paclitaxel (Taxol) chemotherapy for triple negative breast cancer that has come back after treatment or spread to other parts of the body (advanced cancer).

Another trial is looking at a new drug called cobimetinib with paclitaxel for locally advanced and advanced triple negative breast cancer.

The KEYNOTE 086 trial is looking at pembrolizumab for triple negative breast cancer that has spread to other parts of the body.

You can find details of biological therapy trials for breast cancer on our clinical trials database. If you want to see all the trials, tick the boxes for closed trials and trial results.


More about breast cancer

If you would like more information about any aspect of breast cancer, you can phone the Cancer Research UK nurses on freephone 0808 800 4040. The lines are open from 9am to 5pm, Monday to Friday. They will be happy to answer any questions that you have.

Our breast cancer organisations page gives details of other people who can provide information about breast cancer and its treatment. Some organisations can put you in touch with a cancer support group. They often have free factsheets and information which they can send to you. There are also books, booklets, CDs and other resources available. Some of these are free. Look at our breast cancer reading list for details.

If you want to find people to share experiences with online, you could use Cancer Chat, our online forum.

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Updated: 14 August 2014