Triple negative early breast cancer

Triple negative breast cancer is a type of breast cancer that does not have any of the three receptors commonly found on breast cancer cells – the oestrogen, progesterone and HER2 receptors. Around 15 per cent of early breast cancers are triple negative. Triple negative "early" breast cancer generally refers to triple negative breast cancer that is stage 1 or 2.

Triple negative breast cancer is an aggressive and fast-growing cancer and therefore early detection is important for optimal outcomes.

Triple negative breast cancer generally responds well to chemotherapy. Five years after diagnosis, people with triple negative breast cancer are no more likely to experience a recurrence of their breast cancer than people with other types of breast cancer. In the longer term (over 10 years), a recurrence is less likely with triple negative breast cancer.

Treatment types

Treatment for triple negative early breast cancer may involve:

Because triple negative breast cancer is usually responsive to chemotherapy, your medical oncologist will most likely develop a chemotherapy treatment plan for you. This treatment plan should take into account your own individual needs and preferences, so speak to your doctor about what you want and need.

Chemotherapy for triple negative breast cancer is often given before surgery. This is called neoadjuvant chemotherapy.

There can be a number of benefits in having chemotherapy before surgery, including:

You can see if the chemotherapy is working (if the tumour shrinks).
You may be able to have breast-conserving surgery instead of mastectomy if the tumour shrinks enough.
It may allow you enough time to have genetic testing done to determine if you have an inherited gene mutation – if the test comes back positive, it may affect your decision around what type of surgery to have.

Treatment for triple negative breast cancer may also include radiotherapy after surgery, especially if you have breast-conserving surgery.

You can also talk to your medical oncologist about any clinical trials that may be suitable for you.

Risk factors

Anyone can get triple negative breast cancer. However, there are some things that increase a person’s risk of triple negative breast cancer.

Having an inherited BRCA mutation

Everyone has BRCA1 and BRCA2 genes. These genes normally prevent cancers from developing. However, if there is a fault (e.g. mutation) in one of these genes, it can increase a person’s risk of developing breast cancer and other cancers, including ovarian cancer and prostate cancer. These gene mutations can be passed down through families.

Around 5 to 10 per cent of all people diagnosed with breast cancer have an inherited BRCA1 or BRCA2 gene mutation.

A BRCA1 mutation is associated with a higher risk for triple negative breast cancer. Not all breast cancers caused by BRCA mutations are triple negative, however, and not all triple negative breast cancers are caused by inherited BRCA mutations.

The BRCA2 mutations are more likely to be present in oestrogen receptor-positive (ER+) breast cancer.

If you have a strong family history of breast and/or ovarian cancer (e.g. three or more people on the same side of the family), it is possible that you and your relatives could carry a BRCA mutation.

For more information, read breast cancer in the family.

Being premenopausal

Premenopausal women have a higher rate of triple negative breast cancer than postmenopausal women.

Scientists do not yet understand why this is the case. However, research is underway in this area. 

Read more about breast cancer in young women.

Getting support

There are many different types of breast cancer, and each one is treated differently. Triple negative breast cancer is a less common form of breast cancer, so 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.

Some people find the support of others who have triple negative breast cancer helpful because they share similar experiences. Our Online Network may help you connect with others in the same situation.

Current research

Research has identified different sub-types of triple negative breast cancer. Identifying these subtypes is a step toward providing opportunities to develop new treatments that target these subtypes.

Targeted therapies are currently being investigated using PARP inhibitors for BRCA-related cancers, PI3K/AKT inhibitors and immunotherapy drugs for other subtypes.

Things you can do now

Watch BCNA's video Ask the expert: Triple negative early breast cancer with Dr. Nick Zdenkowski.
Listen to BCNA’s podcast episode about Young women and triple negative breast cancer.
Read Tasha's story about living with triple negative breast cancer.
Visit National Breast Cancer Foundation's Triple negative breast cancer page.
Download Cancer Council's "Understanding breast cancer" booklet.
Read about immunotherapy and its recommendation on the Pharmaceutical Benefits Scheme for triple negative breast cancer: BCNA celebrates recent PBAC decisions.
Visit My Journey, BCNA’s online tool for information tailored to your diagnosis.
Join our Online Network if you think that talking to others online and sharing experiences will help.
Contact BCNA’s Helpline on 1800 500 258 between 9.00 am and 5.00 pm AEST Monday to Friday, for information about the services and support that may be available for you and your family.