Triple negative breast cancer (TNBC) is an aggressive form of breast cancer accounting for 10 to 20 percent of breast cancers. It is called "triple-negative" because the tumor cells lack the three most common receptors known to fuel breast cancer growth.
At Penn Medicine, we leave nothing to chance. Our dedicated breast cancer care team automatically tests all newly diagnosed invasive breast cancers to determine their specific receptor status. Accurately identifying TNBC right from the start allows us to fast-track your care, build a tailored treatment strategy, and open doors to innovation as part of your care plan.
What is triple negative breast cancer (TNBC)?
When diagnosing breast cancer, pathologists test all breast tumors for three receptors (proteins) known to fuel breast cancer growth. If the cancer cells test negative for both estrogen (ER) and progesterone (PR) hormone receptors as well as human epidermal growth factor receptor 2 (HER2), the diagnosis is referred to as triple negative breast cancer.
Triple-negative breast cancers tend to grow and spread more quickly than other types of breast cancer. Because of this, triple-negative breast cancer is considered to be more aggressive than other forms of breast cancer.
Like other invasive types of breast cancer, TNBC is more likely to spread beyond the breast (metastatic breast cancer) and return after treatment. Treatment for TNBC is more limited than other breast cancers.
Symptoms of triple negative breast cancer
There are no unusual breast cancer symptoms associated with a triple negative breast cancer diagnosis. It is typically detected during routine breast cancer screening (on a mammogram) prior to presenting any symptoms. However, some individuals may have symptoms including:
- Changes in breast shape
- Mass or suspicious finding on a mammogram
- Breast or nipple pain
- Discharge from the nipple
- Nipple inversion
- Swelling of the breast
- A lump
- Thickening of the nipple skin
- New crease in the breast
Risk factors associated with TNBC cancer
Research shows that some people have a greater chance of developing TNBC if you are subject to certain risk factors. These risks include:
- Age: Premenopausal women and those under the age of 50 have an increased risk of TNBC.
- BRCA1 gene mutation: About 70 percent of the breast cancers diagnosed in women with an inherited BRCA1 mutation are TNBC.
- Ethnicity: People assigned female at birth who are African American or Hispanic have a higher rate of TNBC. Approximately 20 to 40 percent of breast cancers diagnosed in African Americans are triple negative.
Penn’s MacDonald Cancer Risk Evaluation Center can evaluate your breast cancer risk and offer genetic counseling for anyone with an increased risk of a triple negative breast cancer diagnosis.
Diagnosing and testing for TNBC
Triple negative breast cancer is most commonly seen on a mammogram, or through other tests ordered when symptoms are present. Triple-negative breast cancer may also be found on breast examination.
If cancer is suspected on a mammogram, a biopsy may be ordered to test the cells in a pathology laboratory to further your breast cancer diagnosis journey.
Triple negative breast cancer prognosis
Because triple negative breast cancer lacks the receptors that other types of breast cancer have, some treatment options may be less effective. Size and spread of TNBC will determine a prognosis. And like other types of breast cancer, catching TNBC early through routine cancer screening can help improve prognosis.
As technology and treatments continue to develop, we hope to see the prognosis for all breast cancer, including TNBC, improve. Your health care provider can discuss your specific prognosis with you based on your diagnosis and treatment options.
Triple negative breast cancer treatment
Treatment can be challenging for TNBC. Without receptors, triple negative tumors do not have the proteins they need to respond to common breast cancer treatments like hormone therapy and targeted therapy used for hormone-positive or HER2-positive breast cancer.
This leaves chemotherapy and immunotherapy as the primary treatment options for triple negative breast cancer. For TNBC breast cancer that is in stage I through stage III, removing a tumor by surgery (before or after chemo) is sometimes an option if the tumor is small enough. Stage IV TNBC treatment often depends on the patient’s specific circumstances, such as the presence of a BRCA gene mutation, which proteins the cancer cells do have, and other genes.
Our specialized providers understand the most effective options for TNBC. We offer you the newest breast cancer treatments and therapies, as well as standard care.
The Penn Medicine approach to treating TNBC
Our breast cancer providers are leaders in their field. They have in-depth knowledge of TNBC and implement the latest research findings and treatments into your care. Through the Breast Cancer Program at Penn Medicine, you’ll find:
- Expert diagnosis: Our specialized breast cancer pathologists quickly and accurately identify every tumor’s receptor status. A precise diagnosis means you get personalized treatment quickly.
- Leading edge treatment: We offer advanced treatment for TNBC, including immunotherapy. Through clinical trials for breast cancer, you have access to new and promising therapies.
- Specialized focus on inherited cancers: Through the Basser Center for BRCA, women at high risk for TNBC have access to genetic counseling, testing, and individualized care.
- Recurrent cancer care: A TNBC diagnosis puts you at a high risk for cancer recurrence. Our 2PREVENT Breast Cancer Translational Center of Excellence works to prevent, identify, and treat recurrent cancer.
- Care close to home: You’ll find expert breast cancer care at all Penn Medicine breast cancer locations. Our breast cancer specialists and staff collaborate seamlessly across the network to get you the treatment you need, no matter where you live.
Rated “exceptional” by The National Cancer Institute
Penn Medicine’s Abramson Cancer Center is a world leader in cancer research, patient care, and education. Our status as a national leader in cancer care is reflected in our continuous designation as a Comprehensive Cancer Center by the National Cancer Institute (NCI) since 1973, one of 7 such centers in the United States. The ACC is also a member of the National Comprehensive Cancer Network, one of a select few cancer centers in the U.S., that are working to promote equitable access to high-quality, advanced cancer care.
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