Understanding Triple Positive Breast Cancer: Causes, Treatment, and Prognosis
Following skin cancer, breast cancer is the second most prevalent form among individuals assigned female at birth.
According to the American Cancer Society (ACS), it constitutes a significant portion, accounting for 30% of newly diagnosed cancers within this demographic every year.
Upon diagnosis, breast cancer is categorized based on its hormone receptor (HR) status and HER2 status.
A positive status for both types of HRs and HER2 characterizes triple-positive breast cancer (TPBC).
This article delves deeper into TPBC, exploring its definition, methods of diagnosis and treatment, and the prognosis for individuals who have received this diagnosis.
What is Triple-Positive Breast Cancer
Triple-Positive Breast Cancer is a subtype of Breast Cancer.
The cancer cells have overexpression of three specific receptors on their surface.
These are,
- Estrogen receptor
- Progesterone receptor
- Human epidermal growth factor receptor 2 (HER2)
The presence of these three receptors makes Triple-Positive Breast Cancer distinct from other breast cancer subtypes.
Triple-Positive Breast Cancer tends to respond more to hormone therapy and targeted therapies.
They can improve patient outcomes.
However, it also presents unique challenges in treatment planning and monitoring.
Following are the three different biomarkers that make up Triple-Positive Breast Cancer.
Estrogen & Progesterone receptor
Normal breast cells naturally possess Estrogen and Progesterone receptors, which can stimulate their growth when bound by these hormones.
However, Breast Cancer cells can transform, leading to the development of these receptors.
This transformation enables them to increase when bound to Estrogen and Progesterone.
In the context of Breast Cancer, cells with Estrogen receptors are classified as ER-Positive, while those with Progesterone receptors are termed PR-Positive.
When a Breast Cancer cell possesses one or both of these receptors, it falls into the category of hormone receptor-positive.
The hormonal therapies for Estrogen and Progesterone work by preventing them from binding to these glands, thereby inhibiting the growth of cancer cells.
HER2 protein
HER2 is a protein that promotes the rapid growth of Breast Cancer cells.
When Breast Cancer cells have an increased amount of HER2, it is called HER2-positive breast cancer.
This overexpression of HER2 can contribute to the aggressive growth and spread of the cancer.
What causes of Triple Positive Breast Cancer
The causes of Triple Breast Cancer are poorly understood, but several factors are thought to contribute to its growth.
As women age, the risk of Breast Cancer increases.
Other strands that may increase the risk of Triple Positive Breast Cancer include a family history of breast cancer, genetic mutations (such as BRCA1 and BRCA2), vulnerability to environmental toxins, and lifestyle components such as alcoholism and obesity.
Symptoms
The symptoms of Triple Positive Breast Cancer are similar to those with the other types of Breast Cancer and may include:
- A distinct lump or thickening of the breast from the surrounding tissue
- Changes in the size, shape, or appearance of the breast
- A newly inverted nipple
Peeling, scaling, crusting, or flaking of the pigmented area of skin surrounding the nipple or breast skin - Changes in the skin covering the breast, such as dimpling
- In addition, Breast Cancer can cause the skin over the breast to become red and pit-like, like orange skin
Women should have regular self-examinations, mammograms, and cancer screenings.
They should see their doctor if they notice any changes or unusual symptoms.
Treatment of Triple Positive Breast Cancer
Treatment for triple-positive Breast Cancer typically involves a combination of various treatment methods tailored to each individual’s specific case.
Surgery to remove the cancerous tissue is usually the first course of action.
This may involve partial or total breast removal, depending on the extent and location of the cancer.
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In addition to surgery, patients may undergo other treatments to shrink the tumor before surgery or destroy any remaining cancer cells after surgery.
These may include chemotherapy, radiation therapy, targeted therapy, or hormone therapy.
A 2018 article highlights the importance of hormone therapy in treating Triple-Positive Breast Cancer.
The choice of hormone therapy for Breast Cancer treatment may vary depending on whether the person has gone through menopause.
For premenopausal individuals, treatment options may include surgical removal of the ovaries (oophorectomy).
Medication to temporarily prevent the ovaries from producing Estrogen (gonadotropin-releasing hormone agonists) or medications such as Tamoxifen that block hormone receptors in breast cancer cells are used.
In postmenopausal individuals, treatment options may include aromatase inhibitors that block the enzyme responsible for converting other hormones into Estrogen.
Treatments for Breast Cancers that overexpress HER2 may involve monoclonal antibody drugs like Trastuzumab or Pertuzumab.
Triple Positive Breast Cancer prognosis
The prognosis of Triple Positive Breast Cancer varies according to many factors.
These include the cancer stage at diagnosis, the tumor’s size and location, and the patient’s overall health.
Triple Positive Breast Cancer has a better prognosis than other Breast Cancer subtypes.
Hormone-receptor-positive tumors generally respond better to hormone therapy with HER2-positive.
The surface of cancer cells allows treatment with HER2-targeted therapies. It significantly improves treatment selection and predictive prognosis.
However, the prognosis can still vary depending on the specific nature of the tumor and the patient’s response to treatment.
According to the American Cancer Society, the 5-year survival rate for Breast Cancer, for a specific stage, is 90%.
This indicates that individuals diagnosed with Breast Cancer have a 90% chance of surviving for at least five years after their diagnosis.
Early diagnosis and treatment are important to improve the chances of a positive outcome.
Conclusion
Triple Positive Breast Cancer represents a unique Breast Cancer subtype characterized by Estrogen, Progesterone, and HER2 receptors.
While its exact causes remain elusive, age, genetics, and lifestyle choices can contribute to its development.
Early detection through regular screenings is crucial, as symptoms may not always manifest visibly.
Treatment strategies are diverse and tailored to individual cases, including surgery, chemotherapy, radiation, and hormone therapy.
Triple Positive Breast Cancer generally carries a more favorable prognosis than other subtypes, with a 90% 5-year survival rate when diagnosed early.
Nonetheless, personalized care and monitoring are essential for improved outcomes.
Frequently Asked Questions
Is Triple-Positive Breast Cancer bad?
Triple-Positive Breast Cancer can be a severe condition. But it tends to have a better prognosis than other Breast Cancer subtypes. Treatment options, including hormone therapy and HER2-targeted therapy, can effectively manage the disease.
Is Triple Positive Breast Cancer hereditary?
Triple-Positive Breast Cancer can be hereditary in some cases. Mutations in specific genes, such as BRCA1 and BRCA2, have been linked to an increased risk of developing Breast Cancer. However, most cases of Triple-Positive Breast Cancer are not hereditary and occur sporadically.
Is Triple-Positive Breast Cancer curable?
Treatment success for Triple-Positive Breast Cancer can vary depending on individual factors and the cancer stage at diagnosis. However, with prior detection and proper treatment, many people with Triple-Positive Breast Cancer can achieve remission and long-term survival.
How common is Triple-Positive Breast Cancer?
Triple-Positive Breast Cancer accounts for about 20% of all cases of invasive Breast Cancer. It is less common than other subtypes of breast cancer. It still affects many individuals yearly, such as Estrogen receptor-positive (ER+) or HER2-positive (HER2+) Breast Cancer.
How fast does Triple-Positive Breast Cancer grow?
Typically, Breast Cancers exhibit a growth rate of doubling in size approximately every 180 days, which equates to around six months. However, it’s essential to recognize that the actual growth rate can vary significantly due to various factors.
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