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Treating TNBC

It’s important to remember that we’re all unique and every case of TNBC is different. Your medical care team will work with you to come up with a plan that makes sense for you based on factors including:

  • The size of your tumour
  • Whether or not your cancer has spread to surrounding tissues and/or outside your breast
  • Your overall health history, and more.

Some of the treatments used for other types of breast cancer are not helpful in treating TNBC. If you have been diagnosed with TNBC, talk with your doctor about your treatment options. Use our helpful patient discussion guide to feel empowered and get the most out of your conversations with your medical care team.

TNBC Outlook

Your TNBC outlook depends on a variety of factors, such as the number and size of tumours, grade, and lymph node involvement.

The survival rate after relapse is shorter than that of other types of breast cancer. Relapse rates are high in the first five years, with a peak at three years post-surgery. After that, the relapse rate declines significantly.1

TNBC is often an aggressive cancer that is difficult to treat. It is also likely to spread and recur more than other breast cancers. But stay hopeful as there are effective treatments available, and researchers are working on medication therapies that target TNBC.

It’s also important to remember that no one, not even your healthcare professionals, can determine exactly how your breast cancer will progress or respond to your treatment. Survival rates are based on statistics, but everybody has an individual experience with the disease that can’t be predicted.

Chemotherapy for TNBC

Chemotherapy is a drugs-based therapy that is designed to destroy cancer cells. Most commonly, chemotherapy is injected into a vein through a drip in the arm or hand. Chemotherapy works by killing the cancer cells that divide rapidly. Unfortunately, many healthy cells such as skin, hair and blood cells also grow rapidly, and chemotherapy can kill these cells too.

Side effects of chemotherapy may include:

  • Hair loss
    Within two to four weeks of starting chemotherapy, you may lose some or all of your hair. Luckily, new treatments may help with hair loss, so speak to your doctor to understand if these treatments are an option for you. Your hair will grow back within four to six weeks after your last chemotherapy treatment.
  • Fatigue
    You may feel tired or have problems with thinking and remembering things after chemotherapy and radiation therapy. Most of those side effects go away a few weeks after therapy ends.
  • Nausea
    Most women feel sick and exhausted for a day or two after each chemotherapy treatment. If you feel queasy, your doctor can give you a prescription for medicine to treat the nausea.
  • Lymphedema
    If you have lymph nodes removed during surgery, or if you receive radiation treatment to your lymph nodes, the lymph fluid may not be able to drain properly. This may cause the fluid to build up under your skin and cause part of your body to swell. This condition is called lymphedema.
  • Skin changes
    On or around the skin where you’ve been treated with radiation, you may get some redness or peeling, kind of like a sunburn. Your doctor will tell you the best way to treat these skin changes.
Surgery for TNBC
Triple-negative breast cancer is a kind of breast cancer that does not have any of the receptors that are commonly found in breast cancer. That means TNBC doesn’t respond to hormonal therapies that target HER2, which is a common form of treatment for other types of breast cancer. Fortunately, surgical procedures can still be a viable option for many patients. The aim of surgery is to remove the cancer cells from the breast. The cancer (tumour) is then sent to a pathologist who will develop a pathology report. This will help your medical team to decide a personalised treatment option for you.2 The two main types of breast cancer surgery are:
  • Breast conserving surgery (also called lumpectomy, partial mastectomy or wide local excision). This involves the removal of the part of the breast affected by the cancer
  • Mastectomy. This involves the total removal of one or both breasts.
If your TNBC tumour is early-stage and small enough to be removed by surgery, then breast-conserving surgery or a mastectomy with a check of the lymph nodes may be done. In certain cases, such as with a large tumour or if the lymph nodes are found to have cancer, radiation may follow surgery. You might also be given chemo after surgery (adjuvant chemotherapy) to reduce the chances of the cancer coming back.1 1 https://www.cancer.org/cancer/breast-cancer/treatment/treatment-of-triple-negative.html 2 https://www.bcna.org.au/understanding-breast-cancer/treatment/surgery/
What is a lumpectomy?
With lumpectomy, a surgeon removes the lump from your breast, also removing nearby lymph nodes (the little oval-shaped organs that are part of your immune system) to see if the cancer has spread. The surgery takes an hour or two. Most women spend the day at the hospital and usually do not need to stay overnight.2 2 https://www.bcna.org.au/understanding-breast-cancer/treatment/surgery/
What is a mastectomy?

For a mastectomy, your surgeon removes the breast and nearby lymph nodes to see if the cancer has spread. Some women choose to have breast reconstruction during the same surgery.

Radiotherapy
Radiation is used to kill any cancer cells that might have been left behind after surgery. This is where high-energy radiation beams are targeted to the area where cancer was found to kill any remaining cancer cells. It usually takes about 20 minutes per day. Most women go in four to five days a week for about six weeks. You’ll see a radiation doctor to have this done.2 Side effects of radiation therapy may include:
  • Sunburn-like skin colour and irritation
  • Dry, itchy skin
  • Fatigue
2 https://www.bcna.org.au/understanding-breast-cancer/treatment/surgery/
Clinical Trials

If you have been diagnosed with breast cancer and are interested in finding out about clinical trials that may be open to you, you can ask your doctor if they know of a trial that might suit you.

Your doctor may also discuss clinical trials that may suit you during your treatment discussions.

You can also search for trials on the Breast Cancer Trials Australia website or the Australian Government’s Australian Clinical Trials website and talk to your doctor about whether particular clinical trials may be relevant and appropriate for you.

More information direct from BCNA:

BCNA's position statement on clinical trials.

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Glossary of Key Terms

These are explanations of terms that medical professionals and others may use when discussing your TNBC.

Advanced breast cancer

A commonly used term for secondary, metastatic or stage 4 breast cancer

Adjuvant therapy/treatment

Treatment (e.g. chemotherapy) given after surgery.

Alopecia

Hair loss

Areola

The area around the nipple

Axillary dissection/clearance

The removal of some or all of the lymph nodes from the armpit to see if the breast cancer has spread beyond the breast.

Benign

Not cancerous

Biopsy

The removal of cells or tissue from the body to see if they are cancer cells

BRCA1 and BRCA2

Women with a fault, or mutation, in one of these genes have a higher than normal chance of developing breast or ovarian cancer

Breast conserving surgery

Surgery to remove breast cancer and a small area of healthy tissue around the cancer. Also known as lumpectomy.

Chemotherapy

Treatment for cancer using drugs

Clinical trials

Studies involving patients to see if a new treatment is better than an existing one

Complementary medicines

Complementary medicines are products that are used in addition to conventional medical treatments (e.g. chemotherapy and hormone therapies). Complementary medicines include vitamin and mineral supplements, such as fish oil capsules or vitamin D tablets, and herbal medicines.

Complementary therapies

Complementary therapies are practices that are used in addition to conventional medical treatments (e.g. chemotherapy and hormone therapies).Some examples of complementary therapies often used by women with breast cancer include massage, yoga, acupuncture and reflexology.

Double mastectomy

Removal of both breasts during breast cancer surgery

Ductal Carcinoma In Situ (DCIS)

Non-invasive breast cancer confined to the ducts of the breast

Early breast cancer

Breast cancer that has not spread beyond the breast or lymph nodes under the arm

Early menopause

Menopause occurring in women under 45 years of age. Early menopause is often a side effect of some common treatments for breast cancer.

Lymph nodes

Glands in the armpit and other parts of the body that filter and drain lymph fluid, trapping bacteria, cancer cells and any other particles that could be harmful to the body

Lymphoedema

A condition that sometimes develops when lymph nodes have been removed during breast cancer surgery and the lymph fluid no longer drains freely, causing swelling in the arm, hand or breast

Lumpectomy

Another name for breast conserving surgery

Mastectomy

The removal of the whole breast during breast cancer surgery

Metastatic breast cancer

Another term for secondary, advanced, or stage 4 breast cancer

Multidisciplinary Team

Often abbreviated to MDT. A team of health professionals who work together to manage a patient’s treatment and care

Neoadjuvant chemotherapy

Chemotherapy treatment given before breast cancer surgery (sometimes used to reduce the size of the tumour to make it easier for the surgeon to operate)

Oestrogen

A type of female hormone

Partial mastectomy

Another term for breast conserving surgery

PBS (Pharmaceutical Benefits Scheme)

A scheme funded by the Australian Government to subsidise the cost of certain drugs for eligible consumers

Progesterone

A type of female hormone

Radiotherapy

Treatment for cancer using X-rays that target a particular area of the body

Secondary breast cancer

Breast cancer that has spread from the breast to other, more distant parts of the body, most commonly the bones, lungs, liver and sometimes the brain. Also known as advanced, metastatic, or stage 4 breast cancer.

Sentinel node biopsy

identification and removal of the first lymph node to which the breast cancer may have spread for testing by a pathologist

Seroma

Fluid that collects in or around a scar after surgery

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