A slightly more aggressive type of breast cancer: Let's talk about Triple-Negative Breast Cancer (TNBC)

We have all heard more or less about breast cancer. But did you know that there are different types of breast cancer? Some types are a little easier to treat, but some types are a little more severe and severe. Today we are going to talk about a type of breast cancer that is a little more severe, but can be controlled if properly understood and treated. This is what doctors call "Triple-Negative Breast Cancer" or `(Triple-Negative Breast Cancer - TNBC)`.

What is this Triple-Negative?

Simply put, there are three main things that help breast cancer cells grow. They are the hormones estrogen and progesterone, and a protein called HER2. Think of these as "doors" on cancer cells. Doctors give the "keys" (i.e., medications like hormone therapy) that fit these "doors" and stop the cancer from growing.

However, in triple-negative cancer, the cancer cells do not have all three of these doors (estrogen, progesterone, HER2). This means they are 'negative'. Because those doors are missing, things like hormone treatments that are usually given do not work for this type of cancer. For this reason, this type of cancer is considered to be more aggressive, spreading a little faster than other types.

What are the symptoms of this cancer?

The symptoms of triple-negative breast cancer are often similar to those of other types of breast cancer. If you experience any of these symptoms, don't ignore them and see a doctor right away.

Who is at higher risk of developing this cancer?

Doctors don't yet know the exact cause of this type of cancer. It's also relatively rare, affecting only 10%-20% of women who develop breast cancer. However, some people are at higher risk.

• Women under 40 years of age .
• People with a BRCA gene mutation , specifically the BRCA1 gene. This is a genetic change that is passed down through generations.
• Women who are overweight and do not exercise after menopause (the cessation of menstruation) .

How do you know for sure if you have cancer?

Only a doctor can tell you exactly what type of cancer you have. This involves several tests.

1. Mammogram and ultrasound scan: These can detect lumps or abnormalities inside the breast.

2. Biopsy: This is the most important and crucial test . Here, a very small piece of tissue is taken from the suspicious lump under anesthesia and sent to a specialist doctor who examines the tissue.

3. Tissue test: The tissue sample is examined under a microscope to determine whether it is cancerous or not. If it is cancerous, it is checked for the "doors" we talked about earlier called estrogen, progesterone, and `HER2`. If all three are negative, it is diagnosed as triple-negative cancer.

Determining the stage of cancer

After the cancer is diagnosed, the doctor will determine its "stage." This means how large the cancer is and how far it has spread. This may involve tests such as MRI, CT scan, and PET scan.

The `TNM` system is a globally accepted method.

• T (Tumor): How big is the tumor? (A score from 0-4)
• N (Nodes): Has the cancer spread to nearby lymph nodes? (A score of 0-3)
• M (Metastasis): Has the cancer spread to distant organs such as the lungs, liver, or bones? (0 or 1)

It is based on this stage that the doctor will decide what treatment is best for you.

What are the treatments?

A combination of treatments is usually used for triple-negative cancer.

1. Chemotherapy

This is the main and most important treatment for this type of cancer. It involves giving the body powerful drugs that kill cancer cells. If detected early, this cancer responds very well to chemotherapy.

• Neoadjuvant Chemotherapy: Chemotherapy given before surgery to shrink the tumor and make the surgery easier.
• Adjuvant Chemotherapy: Chemotherapy given after surgery to destroy any remaining cancer cells.

2. Surgery

There are two types of surgery.

• Lumpectomy: Removal of the cancerous lump and a small amount of tissue around it.
• Mastectomy: Removal of the entire breast. Because this cancer is quite aggressive, doctors often recommend removing the entire breast (mastectomy).

3. Radiation Therapy

After surgery, this treatment is given to destroy any cancer cells that may remain in the area and prevent the cancer from coming back.

4. Immunotherapy

This is a new treatment method. What we do here is stimulate our body's own immune system , helping it recognize and attack cancer cells. This is a very successful treatment for triple-negative cancer.

5. Targeted Therapy

This is also a new treatment method. It's like a "smart bomb." What these drugs do is directly find cancer cells, attach to them, and deliver the chemo directly to the cancer cells. This is also called an `Antibody-drug conjugate (ADC).' This causes very little damage to healthy cells.

Chances of recovery and relapse

This is a big question for many people. It's hard to give a single answer because it varies from person to person. The chances of recovery depend on how early the cancer is detected and how the body responds to treatment.

• For localized breast cancer, the relative chance of surviving 5 years is as high as 91%.
• If it spreads to nearby tissues (regional), that figure is about 65%.
• If it spreads to distant organs, that figure drops to 12%.

Triple-negative cancer has a risk of recurrence within the first 3 years after treatment. However, that risk decreases rapidly after 5 years. Therefore, it is essential to continue to have follow-up tests as directed by your doctor after treatment.

Breast Cancer, Triple Negative, Cancer Symptoms, Cancer Treatment, Chemotherapy, TNBC Sinhala, Women's Health