Treatment for Triple Negative Disease
Dear OncoLink "Ask The Experts,"
Are there any specific recommendations for treating triple negative disease? My sister has had conflicting recommendations.
Carolyn Vachani RN, MSN, AOCN, OncoLink's Nurse Educator, responds:
Triple negative breast cancer gets this name because the tumor has tested negative for estrogen receptors, progesterone receptors, and Her-2/Neu receptors. This is identified on the pathology report. It is estimated that triple negative breast cancer accounts for 15% of breast cancer cases, but is most common in young (<40 years old), black, and Hispanic women, despite the fact that breast cancer overall is less common in black women. Researchers are not sure why this happens, but are studying these tumors to learn more.
Triple negative disease was only recently identified to be a unique group of breast cancers, so not a lot is known about how to treat them. One concern is that the lack of receptors makes hormone therapy and therapy with trastuzumab (which targets Her-2/Neu) ineffective in these people. In addition, studies have shown that triple negative tumors lead to poorer survival, regardless of the stage at diagnosis. The survival was poorest among black women with triple negative tumors. This has led some researchers to focus on finding a "target" within this subtype of breast cancer that can be used in treatment (the way Her-2 is in trastuzumab therapy). So, someday these tumors will be positive for something that we can target.
Some studies have shown that these breast cancers may respond better to chemotherapy than others. One study demonstrated a benefit to including weekly Taxol in the regimen. Other studies are looking at including platinum chemotherapies (cisplatin, carboplatin), but results are not available yet. Clinical trials are currently looking at various treatment regimens to determine which is best. Women who are facing this treatment decision should have a conversation with their healthcare team about what is known, what trials are available to them, and the potential risks and benefits of these trials. It is not an easy decision because so little is known, but we hope to change that in the coming years.
Read more about research in the area of triple negative disease at the NCI.