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What is Triple-Negative Breast Cancer

What is Triple-Negative Breast Cancer?

So, here’s the fun little twist my body decided to throw at me: triple-negative breast cancer (TNBC). Sounds fancy, right? More like scary. This type of breast cancer is a bit of a rebel. Unlike other breast cancers, it doesn’t have any of the three main “receptors” (think: targets for treatments) that doctors typically use to fight the disease. Those targets are estrogen, progesterone, and HER2. So, triple-negative means it’s missing all three of these, which makes it tougher to treat—like bringing a spoon to a knife fight.


How TNBC Stands Out (And Not In a Good Way)

What sets TNBC apart from other types of breast cancer? Well, besides being stubborn and more aggressive, it also tends to grow and spread faster. And because it lacks those key receptors, some of the usual hormone therapies or HER2-targeted treatments just don’t work. Instead, treatment usually involves chemotherapy, surgery, and sometimes radiation. The treatment plan isn’t exactly "one size fits all" because TNBC doesn’t play by the typical breast cancer rulebook.


Fighting TNBC: What’s the Outlook?

The good news? With the right treatment, many people manage to send TNBC packing. My case—invasive ductal carcinoma in situ (DCIS), 3.7 cm, stage 2, and grade 3—means the cancer has spread out of the ducts but not yet made it's way to lymph nodes. For localized TNBC, the five-year survival rate is still a solid 91%, but if it spreads to nearby tissues (in my case, yes) or lymph nodes (in my case, not no), that drops to 66%, and if it reaches distant organs, it’s down to 12% (an unpromising outlook).


TNBC tends to be a bit of a comeback queen, especially in those first three years after initial diagnosis. But the good news is that with newer treatments, like immunotherapy, the outlook is getting better. It’s not an easy journey, but I’m here for the fight.


Note: Staging often isn’t really determined until after surgery, when the full extent of the cancer’s spread can be assessed with more tests. Doctors admit to it being a guessing game prior to surgery.


Hope on the Horizon: TNBC Treatment Advances

Here’s where things get a little brighter. The past few years have seen some cool advancements, like immunotherapy—teaching your own immune system to attack the cancer cells (superhero style). Researchers are also diving into personalized treatments that target specific mutations in TNBC. In short, there’s more hope on the horizon than ever before. Emotional plea: If you have the means and opportunity, please donate to the American Cancer Society to help research and advancements continue in the name of TNBC. 


What’s the Treatment for Triple-Negative Breast Cancer?

TNBC doesn’t play by the same rules as other breast cancers, so the treatment is unique. The approach for early-stage TNBC typically starts with neoadjuvant chemotherapy (chemo before surgery) to shrink the tumor. After surgery, we hit it again with postoperative systemic treatment to help reduce the risk of recurrence.


Now, let’s get specific about my chemo cocktail. It’s an all-star lineup of hard-hitting drugs: pembrolizumab, carboplatin, and paclitaxel for the first 4 cycles. Then, we switch to pembrolizumab (because why not double down?) along with doxorubicin and cyclophosphamide for the last 4 cycles.


Each drug has its own story. Pembrolizumab is an immunotherapy drug that's only been around for about 5 years, and it's pretty cool—it helps your immune system recognize and attack cancer cells. Paclitaxel is derived from the bark of the Pacific yew tree (thanks, nature!). Carboplatin and cyclophosphamide are tough on dividing cancer cells, and then there’s doxorubicin—aka the "red devil" for its bright red color and potent side effects.





Side Effects? Oh, We’ve Got Those.

The common side effects of this chemo regimen are, well, not subtle. Hair loss (obviously), nausea, fatigue, and that lovely feeling of your taste buds turning into cardboard. And let’s not forget the immune system hit, which, thanks to starting treatment in September, lines up with the holidays. While everyone else is sipping eggnog and giving hugs, I'll be dodging handshakes like an Olympic sport. But hey, with TNBC, we bring out the big guns, and these drugs are designed to be just that.


Fun Facts about TNBC (Because Why Not?)

  • TNBC tends to show up in younger women (hello, 40s club!) and especially those with BRCA1 mutations. Yet, I don’t have the BRCA1 gene—another plot twist!


  • It’s more common in women of direct African descent. And yet, here I am, not fitting that mold either, although I'm sure there's research to counter argue myself.


  • TNBC is part of a pretty exclusive “club,” affecting only 10-15% of breast cancer patients. Small club, tough crowd!


  • There’s a 60% cancer recurrence rate within 3 years (eek, let’s not dwell on that).


  • Despite its challenges, there’s a fierce community of survivors and thrivers taking TNBC head-on (hi, that’s me!).



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