What is TNBC

Pathology

Estrogen and Progesterone receptors are normal molecules that exist on the surface of normal breast cells. Some breast cancers maintain their ability to make the receptors and some cancers loose that ability. If the cancer does not express those receptors on the surface of its cells and has therefore lost the ability to make those receptors it is Estrogen and Progesterone receptor negative (ER, PR negative).

Demographics

Triple negative breast cancer is most frequent in African American women. Roughly 40% of breast cancers in African American women are triple negative compared to roughly 15% in Caucasian women. Another difference in African-American women who get triple negative breast cancer is that most of them are pre-menopausal.  One other demographic group that is prone to have triple negative breast cancer are women who have BRCA1 mutations.

Genetics

The association between BRCA1 mutations and triple negative breast cancers has led to research looking for a genetic predisposition to develop these types of cancers. Studies have identified specific locations within genes that appear to be abnormal in a higher proportion of cases than in other types of breast cancer. However, other than the BRCA1 gene, a specific gene causing this type of cancer has not been identified. It is likely that a combination of genetic factors located in specific locations within the genome interactively play a role in the development of TNBC. Genetics is an active field of investigation in TNBC.

Biology

Historically, these tumors exhibit an aggressive biologic behavior and are associated with a lower survival, more rapid relapse rate and aggressive behavior. Part of the reason has to do with the fact that hormone blocking agents are not effective due to the lack of estrogen and progesterone receptors.

Prognosis

It is true that Triple Negative Breast Cancer (TNBC) affects young patients, has a more aggressive behavior than other types of breast cancer and has no option for hormonal manipulation. Therefore, you will read many gloom and doom publications about the disease.