While triple-negative breast cancer can be treated, it usually cannot be cured. Triple-negative means that the cancer does not have hormone receptors or only a small amount of a protein called HER2. For this reason, some of the treatments for other breast cancers designed to target these receptors and protein do not work for triple-negative breast cancer.
Treatment for triple-negative breast cancer depends on its stage. Stages are used to describe how much the lung cancer has worsened or spread.
Stages and treatments for triple negative breast cancer are:
Stage 0 – This stage of triple-negative breast cancer is also called ductal cancer in situ, which means that the cancer is still in the breast duct and has not yet spread. Treatment for Stage 0 triple-negative breast cancer may include lumpectomy, which is a surgery to remove only the breast lump; chemotherapy drugs, such as capecitabine; or the immunotherapy drug, pembrolizumab.
Stage IA – In this stage of triple-negative breast cancer, the tumor is 2 centimeters or smaller and has not spread. Treatment for Stage IA triple-negative breast cancer may include lumpectomy, which is a surgery to remove only the breast lump; chemotherapy drugs, such as capecitabine; or the immunotherapy drug, pembrolizumab.
Stage IB – In this stage for triple-negative breast cancer, the tumor is 2 centimeters or smaller and has spread into one to three underarm lymph nodes. Treatment for Stage IB triple-negative breast cancer may include lumpectomy, which is a surgery to remove only the breast lump; chemotherapy drugs, such as capecitabine; or the immunotherapy drug, pembrolizumab.
Stage IIA – In this stage of triple-negative breast cancer, either the cancer has not spread beyond the lymph nodes, or the tumor is 2 centimeters and has spread to one to three underarm lymph nodes. The tumor may also be larger than 2 centimeters but less than 5 centimeters and has not spread to the lymph nodes. Treatment for Stage IIA triple-negative breast cancer may include lumpectomy, which is a surgery to remove only the breast lump; chemotherapy drugs, such as capecitabine; or the immunotherapy drug, pembrolizumab.
Stage IIB – In this stage triple-negative breast cancer, the cancer has not spread beyond the lymph nodes. The tumor is larger than 2 centimeters but less than 5 centimeters and has spread to one to three underarm lymph node, or the tumor is larger than 5 centimeters but has not spread to the chest wall or skin. Treatment for Stage IIB triple-negative breast cancer may include lumpectomy, which is a surgery to remove only the breast lump; chemotherapy drugs, such as capecitabine; or the immunotherapy drug, pembrolizumab.
Stage IIIA – In this stage triple-negative breast cancer, the cancer has not spread beyond the lymph nodes. The tumor is less than 5 centimeters and has spread to four to nine underarm lymph nodes; or the tumor is greater than 5 centimeters and has not invaded the chest wall or skin. Treatment for Stage IIIA triple-negative breast cancer may include lumpectomy, which is a surgery to remove only the breast lump; chemotherapy drugs, such as capecitabine; or the immunotherapy drug, pembrolizumab.
Stage IIIB – In this stage triple-negative breast cancer, the tumor has invaded the chest wall or skin, but has not spread to other parts of the body. The tumor may not have spread to the lymph nodes, or the tumor has spread to one to three underarm lymph nodes. The tumor may also have spread to four to nine underarm lymph nodes, or it has caused swelling in the internal breast nodes. Treatment for Stage IIIB triple-negative breast cancer may include lumpectomy, which is a surgery to remove only the breast lump; chemotherapy drugs, such as capecitabine; or the immunotherapy drug, pembrolizumab.
Stage IIIC – In this stage triple-negative breast cancer, the tumor is any size and has not spread beyond the lymph nodes. The cancer may have also spread to 10 or more underarm nodes. The cancer has spread to the lymph nodes under the collarbone or above the collarbone, or the cancer is found in internal breast lymph nodes. Treatment for Stage IIIC triple-negative breast cancer may include lumpectomy, which is a surgery to remove only the breast lump; chemotherapy drugs, such as capecitabine; or the immunotherapy drug, pembrolizumab.
Stage IV – In this stage of triple-negative breast cancer, the tumor is any size and may or may not have spread to nearby lymph nodes, but it has spread to organs, such as the liver, lung, brain, or bones, or other distant lymph nodes.
There are multiple types of treatment for Stage IV triple-negative breast cancer. These treatments are described more in-depth below.
Surgery
Radiation therapy
Chemotherapy drugs
Targeted Therapy
Some patients with Stage IV triple negative breast cancer may be treated with a combination of immunotherapy and chemotherapy drugs, such as atezolizumab plus paclitaxel, chemotherapy plus pembrolizumab, or the new antibody drug, sacituzumab govitecan-hziy.
Treatments for triple-negative breast cancer may include lumpectomy, which is also called breast conserving surgery; mastectomy, which means complete surgical removal of the breast; breast reconstruction; radiation therapy; chemotherapy; immunotherapy, and targeted therapy.
Lumpectomy, or Breast-Conserving Surgery is a surgical procedure where the breast lump is removed, along with a few nearby lymph nodes to check to see if the cancer has spread. This surgery is usually done for early stage triple-negative breast cancer and may be followed with radiation therapy.
Mastectomy is a surgical procedure where the breast is completely surgically removed, along with nearby lymph nodes to see if the cancer has spread. Some patients may be able to have Breast Reconstruction done at the same time.
Radiation Therapy is often use after lumpectomy, or breast-conserving surgery, to treat triple-negative breast cancer, during which high levels of radiation are used to kill any remaining cancer.
Chemotherapy is the first systemic treatment for triple-negative breast cancer and is used to kill any cancers cells that may have spread elsewhere in the body. Chemotherapy drugs used for the treatment of triple-negative breast cancer include:
The treatment goals of both chemotherapy and radiotherapy are to destroy the cancer cells and to stop the cancer from returning or spreading.
Immunotherapy is a newer treatment for triple-negative breast cancer that helps the patient’s own immune system, or natural defenses, to kill cancer cells. Immunotherapy drugs used to treat triple-negative breast cancer may include atezolizumab used in combination with the chemotherapy drug, nab-paclitaxel or pembrolizumab. The treatment goal of immunotherapy is to increase the ability of the body’s immune system to fight the cancer.
Patients undergoing treatment for triple-negative breast cancer may experience treatment-related side effects, such as swelling in the arm, nausea and vomiting, skin and nail changes, and loss of hair. Treatment for cancer treatment-related side effects is an essential part of breast cancer care.
Targeted therapy is a newer treatment that uses drugs designed to target molecules in or on cancer cells that control the growth and survival of the breast cancer. Targeted therapy drugs for the treatment of triple-negative breast cancer include olaparib and talazoparib. The treatment goal of targeted therapy is to stops the cancer cells and their spread by undoing the processes that allow them to survive.
A new antibody drug, sacituzumab govitecan-hziy, was recently approved (2020) by the FDA for the treatment of triple-negative breast cancer.
In addition to standard treatments, patients with Stage IV triple-negative breast cancer may also be treated with palliative care. Palliative care is used to relieve pain and other symptoms to make a patient more comfortable.
Ongoing, long-term follow-up is an essential part of the treatment for patients with triple-negative breast cancer because the cancer can reoccur even after it has been treated.
This content was written by the MediFind Medical Team. Last updated: 6/9/2022
There are no approved drugs available for this condition. Please check back as new drugs may be approved.