What Are Triple Negative and HER-2 Negative Breast Cancer?
Triple negative and HER-2 negative breast cancers lack certain receptors that contribute to cancer growth. Receptors are proteins found inside and on the surface of cells that receive messages from substances in the bloodstream telling them what to do. (1)
Because many therapies used to treat the more common types of breast cancer target these receptors, these therapies may not work for triple negative and HER-2 negative breast cancers. This can make finding an effective treatment for these subsets of breast cancer more challenging.
The good news is that there are options available, and researchers are working on finding new medicines to target both triple negative and HER-2 negative cancers.
Triple Negative Breast Cancer Lacks Three Key Receptors
Triple negative breast cancer means that the cells in your tumor don’t contain the three most common types of receptors, which are:
- Hormone epidermal growth factor receptor 2 (HER-2)
- Estrogen receptors (ER)
- Progesterone receptors (PR)
Because triple negative breast cancers lack these receptors, typical medicines that target estrogen, progesterone, and HER-2 are ineffective.
Between 10 percent and 20 percent of breast cancers are triple negative. Younger people, Hispanics, African-Americans, and those with a BRCA1 gene mutation are more likely to develop this type of disease. (2)
Triple negative breast cancers are prone to being aggressive. But every case is different, and your prognosis will depend on many factors. (2)
Basal-like tumors have cells that resemble the basal cells that line the breast ducts. Experts believe that most basal-like breast cancers are triple negative. (1)
HER-2 Negative Breast Cancer Is Missing the HER-2 Protein
HER-2 negative breast cancers have cells that contain little or none of the HER-2 protein.
Women with HER-2 negative breast cancer won’t benefit from therapies that target the HER-2 protein, such as the well-known medication Herceptin (trastuzumab). (3)
Knowing your HER-2 status is important, because this information will determine your treatment options.
Studies have shown that some breast cancers that are HER-2 positive can develop into HER-2 negative cancer, and vice versa. It’s also possible that HER-2 test results can come back wrong, so you might want to get evaluated more than once. (4)
Generally, HER-2 positive breast cancers tend to be more aggressive than HER-2 negative breast cancers. (4)
Testing for Triple Negative and HER-2 Negative Cancers
Your doctor can let you know if you have triple negative or HER-2 negative cancer by testing your receptor status.
Typically, this is done with a biopsy. During a biopsy procedure, a surgeon removes a small amount of tissue and sends it to the lab to be analyzed.
A pathologist will examine the tissue and determine its hormone receptor status. Other tests will also be performed to see if it’s HER-2 positive or HER-2 negative. (5)
Treatments and the Treatment Dilemma
If you have triple negative or HER-2 negative breast cancer, many commonly used therapies may not help your disease. If your cancer is HER-2 negative but not triple negative, you are still a candidate for endocrine therapy typically used to treat breast cancer. If your tumor is HER-2 negative and triple negative, there are still treatments available to help your particular type of breast cancer.
Women with triple negative cancer are usually candidates for chemotherapy, surgery, and radiation. In fact, this type of breast cancer may respond better than other types to chemo if it’s treated early on.
Newer therapies, such as PARP inhibitors, VEGF inhibitors, and EGFR-targeted treatments, are also showing promise in helping women with metastatic triple negative breast cancer in clinical trials. (6)
Surgery, chemo, hormone therapies, and some targeted treatments may be options for those with HER-2 negative breast cancer. (3)
Talk to your doctor about what treatments are most effective for your type of cancer.
Clinical Trials for HER-2 Negative and Triple Negative Breast Cancer
Some women with triple negative and HER-2 negative breast cancers choose to partake in clinical trials to test therapies that aren’t yet available to the public. Additionally, clinical trials help researchers determine whether new treatments are safe and effective.
You may want to consider participating in a research study if your cancer isn’t responding to therapy or has spread to other areas of your body. (7)
You can search for a clinical trial in your area at ClinicalTrials.gov.
Your Prognosis Depends on Several Factors
It’s important to remember that your prognosis and treatment plan will depend on many factors, such as:
- The size of your cancer
- Whether your tumor has spread to other areas of your body
- The type of breast cancer you have
- The hormone receptor and HER-2 status of your tumor
- The rate of cell growth
- Your age and menopausal status
- Your general health
(9)
Each person is different, and your doctor will likely run several tests before giving you a formal prognosis.
Generally, women with HER-2 negative breast cancers have a better outlook than those with HER-2 positive breast cancers. HER-2 positive cancers are known to grow faster, spread more quickly, and come back more often. Despite this, HER-2 positive breast cancer treatment outcomes have improved dramatically with the approval of drugs like Herceptin (trastuzumab) and Perjeta (pertuzumab). (5)
On the other hand, survival rates tend to be lower for those with triple negative breast cancer. One 2007 study that looked at more than 50,000 patients with different stages of breast cancer found 77 percent of women with triple negative cancer survived at least five years, compared with 93 percent of those with other forms of breast cancer. (1)
Another study, of more than 1,600 women, found that those with triple negative breast cancer had a higher risk of death within the first five years of diagnosis, but not after that time. (1)
Coping With a Less-Common Diagnosis
Receiving a breast cancer diagnosis can be scary, especially when you hear that your type of cancer may not benefit from standard therapies.
Here are some ways you can cope:
- Learn about your cancer. Staying informed about your type of cancer can help you make treatment decisions. Ask your doctor about suitable resources for information. The American Cancer Society and the National Cancer Institute are good places to start.
- Focus on yourself. A healthy diet, daily exercise, and a good night’s rest are important habits that can equip your body for fighting cancer. Relaxation techniques like yoga and meditation can also help lower your stress levels.
- Ask for help. Don’t try to fight cancer on your own. Ask family members or friends to help with household chores, rides to appointments, or managing paperwork.
- Join a support group. If you don’t have family or friends nearby, a support group can be a great way to connect with others. Many organizations offer online or in-person support groups. The Triple Negative Breast Cancer Foundation’s online discussion forums give women 24/7 access to support.
- https://www.everydayhealth.com/breast-cancer/what-are-triple-negative-her-2-negative-breast-cancer/?xid=tw_
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