Breast cancer receptors

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Some cancer cells have particular proteins called receptors. When certain substances in the body attach to the receptors, they trigger a reaction in the cancer cells that tell them to grow.

• Oestrogen attaches to oestrogen receptors

• Progesterone attaches to progesterone receptors

• Her2 attaches to Her2 receptors

 

Many breast cancers have receptors for one or more of these substances. But triple negative breast cancers don’t have any of them. So hormone treatment and the targeted cancer drug trastuzumab (Herceptin) don't work for people with triple negative breast cancer.

There are other drugs available to treat triple negative breast cancer.

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How common is triple negative breast cancer

Around 15 out of every 100 breast cancers (15%) are triple negative.

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Symptoms of triple negative breast cancer

The symptoms of triple negative breast cancer are similar to other breast cancer types.

Symptoms can include:

• a new lump or thickening in your breast or armpit

• a change in size, shape or feel of your breast

• skin changes in the breast such as puckering, dimpling, a rash or redness of the skin

• fluid leaking from the nipple in a woman who isn’t pregnant or breast feeding

• changes in the position of nipple

 

Make an appointment to see your GP if you notice anything different or unusual about the look and feel of your breasts.

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Diagnosing triple negative breast cancer

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In many women the cancer is found during breast screening. But symptoms such as a breast lump can be a sign of breast cancer. So it is important to get any symptoms checked by your doctor.

If you have symptoms and see your GP they refer you to a specialist breast clinic. At the breast clinic the doctor or breast care nurse takes your medical history and examines your breasts. They also feel for any swollen (enlarged) lymph nodes under your arms and at the base of your neck.

You have some of the following tests:

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• a mammogram (an x-ray of the breasts)

• an ultrasound (you are more likely to have this instead of a mammogram if you are under 35)

• a biopsy – your doctor or nurse take a small sample of cells or tissue from your breast to look at under a microscope

 

Depending on your age and whether other family members have had breast cancer, your doctor might refer you for gene testing. This is to find out if there is a fault (mutation) in the BRCA cancer gene.

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• Find out about breast cancer tests

 

Treatment for triple negative breast cancer

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The main treatments for triple negative breast cancer are surgery, chemotherapy and radiotherapy. The treatment you need depends on:

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• where the cancer is

• the size of the cancer and whether it has spread (the stage)

• how abnormal the cells look under the microscope (the grade)

• your general health

 

Surgery and radiotherapy

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You might have surgery to remove:

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• an area of the breast (called breast conserving surgery)

• the whole breast (called mastectomy)

 

When you have your surgery, the surgeon usually takes out some of the lymph nodes under your arm. They test these nodes to see if they contain cancer cells. The surgeon might check the lymph nodes closest to the breast using a procedure called sentinel lymph node biopsy. Testing the lymph nodes helps to find the stage of the cancer and decide on further treatment.

After breast conserving surgery you usually have radiotherapy to the rest of the breast tissue.

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Chemotherapy

You might have chemotherapy before surgery (known as neo adjuvant treatment). The aim is to shrink a large cancer enough to make an operation possible. Or it might mean that you can have an area of the breast removed, instead of needing a mastectomy.

You usually have chemotherapy after the operation. The chemotherapy reduces the risk of the breast cancer coming back. You usually have a combination of chemotherapy drugs that might include:

• doxorubicin

• epirubicin

• paclitaxel

• docetaxel

• carboplatin

• cisplatin

Researchers are still looking into the best chemotherapy combinations. And they want to find out whether adding other drugs could improve the results of treatment.

Doctors also use chemotherapy for cancer that has spread elsewhere in the body. This is called secondary breast cancer.