How can my aunt manage triple-negative breast cancer at 59?

Question

Hello doctor,

My aunt has been diagnosed with triple-negative breast cancer, and I am concerned about the severity of this type of cancer.

How aggressive is triple-negative breast cancer compared to other forms, and what factors influence its progression and prognosis?
What are the most effective treatment options available for this type of cancer, including chemotherapy, surgery, or newer targeted therapies?
How do the side effects and outcomes of these treatments compare, and what can we expect in terms of recovery and long-term survival rates?
What steps can be taken to manage symptoms and improve quality of life during treatment?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Your aunt is 59 years old and has been diagnosed with triple-negative breast cancer. Before discussing the management strategy in her case, you need to know the following-

1. The tumor size.

2. Axillary lymph node status.

3. A PET scan (positron emission tomography), to see the metastasis of the tumor or not.

4. Staging of the cancer.

It will be helpful to answer those questions because the management plan will depend on the staging of cancer. In general, triple-negative breast cancer is estrogen-progesterone receptor-negative, HER-2neu epidermal growth factor-negative.

It is an aggressive type of cancer, which needs aggressive chemotherapy followed by an aggressive surgical approach as compared to the HR-positive breast cancer type.

Neoadjuvant chemotherapy will be given for around three to four months, six cycles with different types of regimens, to downstage the cancer. Those medications can be discussed with your oncologist.

The surgical approach will be either breast-conserving surgery (BCS) with radiotherapy or modified radical mastectomy. There are criteria for BCS (lumpectomy):

The size of the tumor is less than 1.57 inches.
Multifocal tumor.
Small tumor with a larger breast.

There are side effects of chemotherapy like fatigue, anemia, and hair loss, which depend on the type of chemotherapy regimen used, and can be managed with proper treatment, by building Hb (hemoglobin) levels, and by giving multivitamins.

The prognosis of triple-negative breast cancer depends on:

If cancer spreads to nearby structures or lymph nodes, then the survival rate for 5 years is about 65 percent.
If cancer has spread further into the body, like the lungs, bones, or liver, then a survival rate of 5 years is about 12 percent.

It all depends on the stage of the cancer, which needs to be determined by doing a PET scan or a bone scan if needed. The risk factors of breast cancer are;

BMI more than 30.
Hormonal replacement therapy for more than 10 years.
Avoid breastfeeding.
First-degree family relatives.
Genetic BRCA1 BRCA2.
Smoking.
Nulliparity.

Treatment should not be delayed; it is better to treat the cancer at its early stages than to treat it at its late stages.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.