Treatments for triple negative early breast cancer

Triple negative breast cancer has several treatment options. Chemotherapy is the main treatment as it can be very effective.

Other treatments may involve surgery. radiotherapy or immunotherapy.

Drugs used for other types of breast cancer – such as hormone-blocking therapies – won’t be part of your treatment plan. This is because your cancer is not influenced by the hormone oestrogen.

Chemotherapy

People with triple negative breast cancer are usually offered chemotherapy. This is often given before surgery (‘neoadjuvant treatment’).

Your medical oncologist will develop a chemotherapy treatment plan for you. This plan should consider your preferences, so speak to your doctor about what you want and need.

There are several benefits to having chemotherapy before surgery:

• Through scans and physical examinations, doctors can monitor if the tumour is shrinking. If it is getting larger, you and your treating team will discuss a different chemotherapy drug or plan.
• If the tumour shrinks enough, it may mean you can have less tissue or fewer lymph nodes removed.
• You will have time for genetic testing, to know if you have an inherited gene mutation. The result can affect your decision around what type of surgery to have.

Usually, you have a combination of 2 or 3 anti-cancer drugs. The best option depends on:

• the subtype of triple negative breast cancer you have
• whether you are having chemotherapy before or after surgery.

The main groups, or classes, of chemotherapy to treat triple negative breast cancer are:

• anthracyclines such as doxorubicin (Adriamycin)
• mitotic inhibitors such as taxanes, e.g. paclitaxel (Taxol)
• alkylating agents such as cyclophosphamide (Cytoxin)
• platinum-based drugs such as carboplatin (Paraplatin).

Anthracycline and taxane-based drugs are the usual treatments. Platinum-based chemotherapy is often used in neoadjuvant treatment.

Read About chemotherapy treatment.

Surgery

Surgery can be done before or after chemotherapy treatment.

Your breast surgeon will discuss your options with you. This may be:

• lumpectomy (‘breast conserving’) surgery, usually followed by radiotherapy
• mastectomy, with or without immediate breast reconstruction.

For more information, read Surgery options for breast cancer.

Immunotherapy

Immunotherapy uses your body's immune system to help kill cancer cells. It has been used for many years for other types of cancer and is now used for some types of breast cancer.

For triple negative breast cancer, you may have immunotherapy such as pembrolizumab (Keytruda). This is often given in combination with chemotherapy before surgery (neoadjuvant therapy).

Read about Immunotherapy and breast cancer.

Talk to your medical oncologist about whether immunotherapy may be appropriate for you.

Radiotherapy

You will usually be offered radiotherapy treatment after lumpectomy surgery. The aim of radiotherapy is to kill any cancer cells that may be left in the breast or lymph nodes after surgery.

Read about Radiotherapy for early breast cancer.

Support for treatment decisions

Triple negative breast cancer is a less common form of breast cancer. Some people may find it difficult to explain their treatment options to others.

Talking to your treating team for advice and support can be very helpful.

Our Online Network has a group for people with Triple negative breast cancer, where you can ask questions and share your experience.

Clinical trials for triple negative early breast cancer

Researchers are looking for treatments that target subtypes of triple negative breast cancer.

Ask your specialist about any clinical trials that may be suitable for you.