While the risk of dying from triple-negative breast cancer is relatively low, treatments can be used to help manage symptoms and treat the disease. Depending on the location of the cancer, size of the tumor, growth rate, and spread to the lymph nodes, treatment may help shrink the cancer and decrease the likelihood that it will come back. Treatments may cause side effects, including pain, fatigue, and mental fuzziness. But, with early detection and the right drugs, treatment odds improve.
While the five-year survival rate of patients with triple-negative breast cancer is higher than that of women with distant or regional breast tumors, the likelihood of the disease returning is slightly higher. It peaks around three years after diagnosis, and then drops dramatically. This means that it is important to get screened for triple-negative breast cancer as early as possible. However, it is possible to receive treatments if you’re diagnosed with this type of breast cancer.
As with other types of breast cancer, the signs and symptoms of triple-negative breast cancer are similar. However, doctors use imaging tests or biopsy to determine whether the cancer is triple-negative. A biopsy will reveal whether the cancer cells are positive for the hormones estrogen and progesterone or not. If they don’t, the cancer is considered triple-negative. Depending on the type, treatment may include chemotherapy, surgery, and hormone therapy.
The pCR rate for TNBC is similar to that of ER-positive breast cancer. Patients who have a basal-like tumor have an increased chance of going into remission with treatment. The pCR rate for patients with BL1 or MSL TNBC is higher than that of those with LAR and MSL subtypes. However, the pCR rate is lower in patients with BL2 TNBC.
The evolution of TNBC is complicated by intrinsic evolutional pressure as well as selection pressure from various systemic therapies. Understanding the underlying clonal dynamics can help identify the drug resistance mechanisms, which may evolve in response to time and anatomical location. In the meantime, treatments for this type of cancer must be targeted at improving the prognosis of patients. If this is the case, the most promising treatments will be targeted to these specific cancer cells.
The I-SPY2 study is a phase 2 platform trial that screens therapeutics for phase 3 trials. The study randomized 181 patients with early TNBC to conventional NAC or 69 women with neoadjuvant pembrolizumab. Pembrolizumab had a 60% pCR rate, while conventional NAC had a 20% pCR rate. Both treatments showed high probability of success in a phase 3 confirmatory trial.
