Triple Negative Breast Cancer

Triple negative breast cancer is actually defined by what it's not. The tumor tissue does not over-express the hormones estrogen or progesterone (ER/PR) and also doesn't over-express the oncogene Her2/neu. There are targeted treatments available to block the estrogen receptor (ie: Tamoxifen, etc) and also targeted therapies to inactivate the Her2/neu oncogene (ie: Herceptin & Tykerb). These targeted therapies are not options for those with triple negative breast cancer. This means that chemotherapy agents are the primary treatment for those patients. Much of the medical literature indicates that triple negative breast cancers have a better response to chemotherapy but also have a higher recurrence rate in the years immediately following initial treatment. Triple negative breast cancers tend to be more aggressive in nature, are more common in younger women, and appear to be more common in African American women.

The term triple negative just refers to those three specific markers, not to other specifics of the cancer. Breast cancer is also defined as either ductal, lobular, mucinous, inflammatory, or other such distinctions. All of these types of breast cancer can be triple negative.

Triple negative breast cancers are receiving more attention in the research community and hopefully there will be specific drugable targets identified in this tumor group to improve prognosis. Triple negative breast cancer is actually defined by what it's not. The tumor tissue does not over-express the hormones estrogen or progesterone (ER/PR) and also doesn't over-express the oncogene Her2/neu. There are targeted treatments available to block the estrogen receptor (ie: Tamoxifen, etc) and also targeted therapies to inactivate the Her2/neu oncogene (ie: Herceptin & Tykerb). These targeted therapies are not options for those with triple negative breast cancer. This means that chemotherapy agents are the primary treatment for those patients. Much of the medical literature indicates that triple negative breast cancers have a better response to chemotherapy but also have a higher recurrence rate in the years immediately following initial treatment. Triple negative breast cancers tend to be more aggressive in nature, are more common in younger women, and appear to be more common in African American women.

The term triple negative just refers to those three specific markers, not to other specifics of the cancer. Breast cancer is also defined as either ductal, lobular, mucinous, inflammatory, or other such distinctions. All of these types of breast cancer can be triple negative.

Triple negative breast cancers are receiving more attention in the research community and hopefully there will be specific drugable targets identified in this tumor group to improve prognosis.

Interestingly, triple negative breast cancer (ER/PR/HER2 negative) is more than one disease. While some subsets reveal exquisite sensitivity to drugs like Cisplatin, other tumors may have features that render them better targets for agents that inhibit signaling pathways like AKT/mTOR. There may be other triple negatives for whom androgen therapy could hold benefit. Our experience with the Cisplatin/Gemcitabine doublet in this group, a regimen that we originally developed (Nagourney et al, J Clin Oncol 2000) is one example of good outcome with a appropriately selected chemotherapy. Interestingly, triple negative breast cancer (ER/PR/HER2 negative) is more than one disease. While some subsets reveal exquisite sensitivity to drugs like Cisplatin, other tumors may have features that render them better targets for agents that inhibit signaling pathways like AKT/mTOR. There may be other triple negatives for whom androgen therapy could hold benefit. Our experience with the Cisplatin/Gemcitabine doublet in this group, a regimen that we originally developed (Nagourney et al, J Clin Oncol 2000) is one example of good outcome with a appropriately selected chemotherapy.

This is a very controversial topics. Triple negative breast cancer does not mean automatically chemotherapy. The very very small tumors with no lymph node many not have an indication of chemotherapy depending on the patient's general health condition or age. So question is what is small small? This is where split opinions do exist. This is something that we can not truly discuss unless we see each case in the clinic. This is a very controversial topics. Triple negative breast cancer does not mean automatically chemotherapy. The very very small tumors with no lymph node many not have an indication of chemotherapy depending on the patient's general health condition or age. So question is what is small small? This is where split opinions do exist. This is something that we can not truly discuss unless we see each case in the clinic.