Triple Negative Breast Cancer: Recurrence Risk

In this video, Dr. Margileth defines a triple negative breast cancer as breast cancers that have negative estrogen receptor, negative progesterone receptor and negative HER2/neu gene and describes treatment options and risk of recurrence.

Dr. David A. Margileth A triple negative breast cancer is defined as breast cancers that have negative estrogen receptor, negative progesterone receptor and negative HER2/neu gene. What that means is that we are left only with chemotherapy as a modality to decrease systemic recurrence. In that, anti-estrogen drugs like aromatase inhibitors or Tamoxifen and Herceptin for the HER2/neu gene would not be helpful in decreasing the chance of recurrence of triple negative tumors.

They tend to be more aggressive. They tend to be more common in younger women and they tend to be more common in younger women with what’s called ‘BRCA-1 gene abnormalities’.

The prognosis is a little worse than most cancers and for that reason one takes an aggressive chemotherapy approach to decrease systemic recurrence and the prognosis is most importantly determined by the lymph node status and secondarily the size of the tumor.

The higher the number of positive lymph nodes, the higher the long-term risk of recurrence and obviously, the idea would be to have no positive lymph nodes. With a large number of lymph nodes, unfortunately the prognosis is not great and with over ten positive lymph nodes, the chance of systemic recurrence at some point is probably over 50 or 60%. With negative nodes, the chance of recurrence after appropriate local and systemic therapies might be 10 or 20%.

Dr. David A. Margileth practices medical oncology at St. Joesph Hospital in Orange, CA specializing in oncology, hematology, and internal medicine (board certified). His selected area of interest is breast cancer. Dr. Margileth graduated from Baylor College of Medicine in 1971 and has since spent time treating patients at the National Cancer Institute and Methodist Hospital in Houston, TX.

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