From the Guidelines
Intraductal carcinoma that is triple negative on biopsy indicates a specific type of breast cancer that grows within the milk ducts and lacks receptors for estrogen, progesterone, and HER2 proteins, which tends to be more aggressive and have a poorer prognosis compared to other types of breast cancer. This diagnosis is significant because triple negative breast cancers cannot be treated with hormone therapy or HER2-targeted drugs, limiting treatment options to chemotherapy, surgery, and radiation 1. The treatment typically involves surgical removal of the tumor (lumpectomy or mastectomy), followed by chemotherapy regimens such as anthracycline-based treatments (like doxorubicin) combined with taxanes (like paclitaxel), often given for 3-6 months.
Key Characteristics of Triple Negative Breast Cancer
- Higher recurrence rates in the first 3-5 years after diagnosis 1
- Higher likelihood of spreading beyond the breast
- Associated with African-American race, deprivation status, younger age at diagnosis, more advanced disease stage, higher grade, high mitotic indices, family history of breast cancer and BRCA1 mutations 1
Diagnosis and Treatment
- The triple negative status is determined through immunohistochemistry testing of the biopsy sample, which shows the absence of these three important receptors that would otherwise provide additional targeted treatment options 1
- Radiation therapy usually follows surgery, especially after lumpectomy
- Regular follow-up appointments every 3-6 months for the first few years after treatment are essential for monitoring It's worth noting that while the study from 2012 1 provides valuable insights into the epidemiology and characteristics of triple negative breast cancer, the more recent guidelines from 2019 1 offer a clearer definition of the surrogate definitions of intrinsic subtypes of breast cancer, including triple negative breast cancer.
From the Research
Definition and Characteristics
- Intraductal carcinoma refers to a type of cancer that occurs within the ducts of the breast [(2,3,4,5)].
- Triple negative breast cancer (TNBC) is a subtype of breast cancer that lacks estrogen, progesterone, and HER2 receptors [(2,3,4,5)].
- TNBC accounts for 10-20% of all breast cancer cases and is associated with an aggressive evolution and poor outcomes [(2,3)].
Treatment Options
- Chemotherapy remains the mainstay of treatment for TNBC, as it is not responsive to hormonal or anti-HER2 therapies [(2,3,4,5)].
- Recent advances have been made with novel agents, such as immunotherapy, which have shown promising results in clinical trials [(2,3)].
- Other potential treatment options include targeted molecular strategies, such as poly (adenosine diphosphate ribose) polymerase (PARP) and epidermal growth factor receptor (EGFR) inhibitors, and antiangiogenic agents [(4,5)].
Prognosis and Outcomes
- TNBC is associated with a poorer prognosis compared to other breast cancer subtypes, with higher recurrence and mortality rates [(2,3,4,5)].
- The 2-year disease-free survival rate for TNBC patients has been reported to be around 87.5% in some studies 6.
- Further research is needed to identify unique genetic characteristics of TNBC and develop targeted molecular chemotherapy treatment options 5.