Triple negative breast cancer

Triple negative is the name given to breast cancer that is:

  • oestrogen receptor negative (ER-)

  • progesterone receptor negative (PR-)

  • HER2 negative

Oestrogen and progesterone receptors

Some breast cancers have receptors within the cell that bind to the hormone oestrogen. When oestrogen binds to these receptors, it can stimulate the cancer to grow.

All invasive breast cancers are tested for oestrogen receptors using tissue from a biopsy or surgery. Tests may also be done for progesterone (another hormone) receptors.

If breast cancer doesn’t have oestrogen receptors, it’s called oestrogen receptor negative (ER -). If it doesn’t have progesterone receptors, it’s called progesterone receptor negative (PR -).

HER2

HER2 is a type of protein found on the surface of cells. Some breast cancer cells have a higher than normal amount of HER2 on their surface. This stimulates the breast cancer to grow.

All invasive breast cancers are tested for HER2 levels. If breast cancer cells have a normal level of HER2 on their surface, they’re known as HER2 negative (HER2-).

If your cancer doesn’t have oestrogen and progesterone receptors and is HER2 negative, it’s called triple negative breast cancer.

Grade

Triple negative breast cancers are often, though not always, high grade.

Some people worry that this means their cancer is more likely to come back after treatment. Research has shown that the risk of triple negative breast cancer coming back is higher than some types of breast cancer in the first few years, but after five years the risks are similar to other types of breast cancer.

How common is triple negative breast cancer?

Around 15% of people with invasive breast cancer have triple negative breast cancer.

Breast Cancer Care’s online Forum has a section for people with triple negative breast cancer, where you can post messages and receive support from other people with triple negative breast cancer.  

Some types of breast cancer are more likely to be triple negative than others. These include medullary and metaplastic breast cancer.

Triple negative breast cancer is more common in:

  • women who have inherited an altered BRCA gene (particularly BRCA1)
  • black African–American women
  • women who have not yet reached the menopause.

Genetic testing

All women under the age of 40 who are diagnosed with triple negative breast cancer should be offered a referral to a specialist genetics clinic to discuss genetic testing, regardless of their family history of breast cancer. This is because women who have an altered BRCA1 gene are more likely to have triple negative breast cancer.

Women over the age of 40 may also be referred to a specialist genetics clinic to discuss genetic testing. If this is appropriate in your situation, your treatment team will discuss this with you.

Treating triple negative breast cancer

Triple negative breast cancer can be treated with a combination of surgery, radiotherapy, chemotherapy and bisphosphonates.

Some breast cancer treatments, such as hormone (endocrine) therapy and trastuzumab (Herceptin), are of no benefit to people with triple negative breast cancer. This is because triple negative breast cancer doesn’t have the hormone receptors or HER2 receptors which these treatments target.

Clinical trials

Clinical trials are trying to find out if different treatments will be helpful in treating triple negative breast cancer. Cancer Research UK has a list of current trials for triple negative breast cancer.

Follow-up

At the end of your treatment, you will continue to be monitored to check how you are recovering. This is called follow-up.

How you are followed up will depend on your individual needs and on the arrangements at the hospital where you have had your treatment.

You may have a lot of different feelings when your treatment finishes. Many women worry about their cancer coming back. Our Moving Forward course provides support and professional guidance on how to adjust to life after breast cancer treatment. Topics discussed may include healthy eating, exercise, signs and symptoms of cancer coming back, managing menopausal symptoms, intimacy and relationships, and emotional wellbeing.

You can read more about follow-up after treatment.

Last reviewed: September 2016
Next planned review begins 2018

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Please note that we cannot respond to comments. If you have any questions about breast cancer please contact the Helpline on 0808 800 6000.

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