Triple-negative breast cancer (TNBC) is a type of breast cancer that lacks estrogen, progesterone, and HER2 receptors. This means that TNBC does not respond to hormone therapy or HER2-targeted therapies, which makes it more aggressive and difficult to treat than other types of breast cancer. Furthermore, TNBC has a higher recurrence rate, which means that cancer can come back after treatment. 

Risk factors for TNBC recurrence

Several factors can increase the risk of TNBC recurrence, including:

• Lymph node involvement. TNBC is more likely to recur if it has spread to the lymph nodes. The more lymph nodes that are involved, the higher the risk of recurrence.
• Tumour size. Larger tumours are more likely to recur than smaller ones. If the tumour is more than 2 cm in size, the risk of recurrence is higher.
• High-grade tumour. High-grade tumours are more aggressive and more likely to recur.
• Age. Younger women are more likely to develop TNBC, and they are also more likely to experience recurrence.
• BRCA mutation. Women who carry a BRCA1 or BRCA2 mutation have a higher risk of developing TNBC and are more likely to experience recurrence.

Causes of TNBC recurrence

The exact causes of TNBC recurrence are not fully understood, but several factors may contribute to it:

• Residual cancer cells. Even after treatment, some cancer cells may remain in the body, which can lead to recurrence.
• Tumour heterogeneity. TNBC is a heterogeneous disease, meaning that the cancer cells can differ from one another. Some cancer cells may be more resistant to treatment than others, which can lead to recurrence.
• Microenvironment. The microenvironment surrounding the tumour can also contribute to recurrence. For example, the immune system may not be able to detect and destroy cancer cells in the microenvironment, leading to recurrence.

Treatment options for TNBC recurrence

If TNBC recurs, treatment options may include:

• Surgery. Surgery may be necessary to remove the recurrent tumour, especially if it is localised to one area.
• Chemotherapy. Chemotherapy is a common treatment for TNBC recurrence. It may be given as a single drug or in combination with other drugs.
• Radiation therapy. Radiation therapy may be used to treat localised recurrence.
• Immunotherapy. Immunotherapy is a newer treatment option for TNBC. It works by stimulating the immune system to attack cancer cells.

Preventive measures for TNBC recurrence

There are several preventative measures that women can take to reduce their risk of TNBC recurrence:

• Maintaining a healthy lifestyle. A healthy lifestyle that includes regular exercise, a balanced diet, and stress management can help reduce the risk of TNBC recurrence.
• Regular follow-up care. Women who have been treated for TNBC should have regular follow-up appointments with their healthcare provider to monitor for recurrence.
• Genetic testing. Women who have a family history of breast cancer or who have been diagnosed with TNBC should consider genetic testing to determine if they carry a BRCA1 or BRCA2 mutation.
• Adjuvant therapy. Adjuvant therapy is an additional treatment that is given after the initial treatment to reduce the risk of recurrence. Adjuvant therapy may include chemotherapy, radiation therapy, or hormone therapy.

Takeaway

TNBC is a difficult-to-treat form of breast cancer that has a higher recurrence rate than other types of breast cancer. Risk factors for TNBC recurrence include lymph node involvement, tumour size, high-grade tumour, age, and BRCA mutation.

Although the exact causes of TNBC recurrence are not fully understood, residual cancer cells, tumour heterogeneity, and the microenvironment are thought to contribute to recurrence. Treatment options for TNBC recurrence may include surgery, chemotherapy, radiation therapy, and immunotherapy. Women can reduce their risk of TNBC recurrence by maintaining a healthy lifestyle, regular follow-up care, genetic testing, and adjuvant therapy.

TNBC recurrence is a challenging issue that requires ongoing research and attention. Women who have been diagnosed with TNBC or who are at high risk for TNBC should work closely with their healthcare providers to develop a personalized treatment plan and reduce their risk of recurrence. With early detection and effective treatment, it is possible to manage TNBC and improve outcomes for patients.

David Radar, a psychology graduate from the University of Hertfordshire, has a keen interest in the fields of mental health, wellness, and lifestyle.