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Triple Negative Breast Cancer

Triple negative breast cancer (TNBC) is an aggressive form of cancer accounting for 10 to 20 percent of breast cancers. At the Abramson Cancer Center, our breast cancer team tests all invasive breast cancers to see if the tumor qualifies as triple negative.

What Is Triple Negative Breast Cancer?

At Penn Medicine, a specialized pathologist studies 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 TNBC.

There are no unusual breast cancer symptoms associated with TNBC. It is typically detected during routine breast cancer screening. Like other invasive types of breast cancer, TNBC is more likely to spread beyond the breast (metastatic breast cancer) and recur (return) after treatment. Treatment for TNBC is more limited than other breast cancers. Common breast cancer treatments like hormone therapy and some targeted therapies are typically ineffective.

Cancer Risk Factors Associated With TNBC

Research shows that some people have a greater chance of developing TNBC. Risk factors 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: African American and Hispanic women have a higher rate of TNBC. Approximately 20 to 40 percent of breast cancers diagnosed in African American women are triple negative.

Penn's MacDonald Cancer Risk Evaluation Center can evaluate your breast cancer risk and offers genetic counseling for anyone with an increased risk of TNBC.

Why Choose the Abramson Cancer Center for 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. At the Abramson Cancer Center, 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 our clinical trials, you have access to new and promising therapies.
  • Specialized focus on genetic cancers: Through the Basser Center for BRCA, women at high risk for TNBC find counseling, testing and individualized care.
  • Recurrent cancer care: A TNBC diagnosis puts you at a high risk for cancer recurrence. Our 2PREVENT Breast Cancer Transitional 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 locations. Our breast cancer specialists and providers collaborate across the network to get you the treatment you need, no matter where you live.

Our Approach to Triple Negative Breast Cancer Treatment

Treatment can be challenging for TNBC. Without receptors, triple negative tumors do not respond to common breast cancer treatments used for hormone-positive or HER2-positive breast cancers.

Our specialized providers understand the most effective options for TNBC. We offer you the newest treatments and therapies, as well as standard care. Your treatment for TNBC may include:

  • Surgery, for the removal of either part (lumpectomy) or all (mastectomy) of the breast
  • Breast reconstruction, which surgically recreates the shape and appearance of your breast after breast cancer surgery
  • Chemotherapy, which uses either oral or intravenous (IV) drugs to attack cancer cells
  • Radiation therapy, used after surgery or chemotherapy to kill any remaining cancer cells
  • Immunotherapy, approved for select patients with TNBC whose tumors test positive for PD-L1 protein
  • Targeted therapy, in the form of PARP inhibitors, which treats advanced-stage HER2-negative breast cancer in people with a BRCA1 or BRCA2 mutation
  • Clinical trials, which give you access to promising breast cancer treatments for TNBC