What is triple-negative breast cancer?

Breast cancer remains to be one of the most prevalent forms of cancer globally, with the World Health Organization reporting 2.26 million cases and up to 685,000 deaths in 2020¹.

A significant public health problem, breast cancer is the leading cause of mortality for all cancers in the country (over 27,000 new cases in 2020)². While the female gender is the strongest risk factor¹, breast cancer is also highly linked to one’s age, medical history, and lifestyle choices.

Though the disease is common knowledge, with efforts to raise awareness around and fight this disease through the years, many may also not be aware of one specific subtype that greatly affects younger adult women.

Triple-Negative Breast Cancer (TNBC) is one of 4 subtypes of breast cancer afflicting one in every five women.³ This is characterized by the absence of estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor receptors 2 (HER2) protein that are usually found in breast cancer cells. Simply put, cancer growth is not caused by any of these receptors.

TNBC is less common but more aggressive. The telltale signs and symptoms of TNBC are similar to other breast cancer types, including the presence of a lump, a change in the appearance of the breast or nipple, discharge for women who are not breastfeeding, swelling, and discomfort. The good news is that heeding the symptoms, asking your doctor about suspected cancers, and catching the disease early (early diagnosis) help increase the chances of survival! Because of their similarities to other less-aggressive breast cancer types, when one finds a lump, it is important to know the next steps and act fast.

Preventive care

Here are three key things adult women should integrate in their lifestyle to keep in tune with their breast health:

Start by familiarizing yourself with breast self-examination. It’s free and more helpful than you think! There are many resources available online on how to do it properly, and your doctor can help provide the basic steps. The goal is to know how your breasts normally look and feel, and to consult a doctor if anything seems amiss .

Start with a visual examination in front of the mirror. Put your arms on your hips and check for swelling, discoloration, or discharge. Repeat with your arms raised up. Then go over your breast and armpit areas with the pads of your fingers, applying varying pressures at different points to note any mass, thickening, etc. Do the second step while standing/sitting and lying down. It is recommended to take note of your findings especially if you’re just starting. Do this at least once a month.

While not all lumps are automatically cancerous, it’s still wise to consult a healthcare professional. A clinical breast exam may be administered by a trained doctor to spot any unusual mass. According to the American College of Obstetricians and Gynecologists, women aged 40 above with a possible risk of breast cancer may be offered clinical breast exams annually, succeeding counselling.⁴

Your doctor may ask you to undergo further screening through a mammogram, which is an imaging test for your breasts. A diagnostic mammogram follows to further evaluate any abnormality that was detected during the screening. Women in their 40s and up are recommended to get a mammogram once a year or once every two years.⁴

An ultrasound, MRI, and/or biopsy may also be ordered by your doctor for confirmation.

What to do after diagnosis

After diagnosis, patients should discuss all available treatment options for their condition. Because each cancer case is unique, a cancer care team, which may consist of several specialists such as an oncologist and a breast surgeon, plus your family members, will all work together to come up with an individualized treatment plan with you. Know who is on your own multidisciplinary team — they are your allies on your cancer patient journey.

As your multidisciplinary team assesses your condition, several treatment options are available to help fight TNBC, depending on the stage and grade of cancer. These treatment options may include surgery, chemotherapy, immunotherapy, or a combination of these treatments.

Avenues for medical assistance

Cancer patients and their families face emotional and financial burdens in the course of cancer care. Savings may not be enough for the costly out-of-pocket fees for consultations, medicines, treatment, hospitalization, and surgery.

Some institutions that people can go to ask for aid include:

Department of Social Welfare and Development (DSWD) or Persons with Disability Affairs Office.
Social Security Service (SSS)
Philippine Health Insurance Corporation (PhilHealth) Z Benefit Package.
The Philippine Charity Sweepstakes Office (PCSO)’s Individual Medical Assistance Program
Various foundations and private groups also assist breast cancer patients.

More information on how to apply for cancer medical assistance in the Philippines can be found here.

Initiatives and advocacy campaigns also exist to help advocate for the further improvement of patient access in the continuum of cancer care. One example is the multi-stakeholder initiative Cancer Game Plan PH. This campaign advocates to help patients, along with their loved ones, win against the disease by keeping patient needs at the center and encourage different LGUs to “create and implement equitable cancer programs within a service delivery network.”⁵

Cancer patients, caregivers, survivors, and advocates can help make a difference and petition for more equitable access to cancer care by signing the PSMO petition here.

The importance of support

Throughout the entirety of the breast cancer patient journey, particularly a battle against a more aggressive subtype, a hand to hold can mean the difference between carrying on and letting go.

Depression, for instance, is a common psychiatric diagnosis among breast cancer patients which has been associated with poorer treatment compliance, more physical distress, and an overall decline in quality of life.⁶ Familial support, like mental and emotional support from a spouse, lessen depressive and anxiety symptoms⁶ and help reinforce the fact that patients need not go through the journey alone.

Having a strong support system to encourage, uplift, and fight alongside patients — from preventive care, to screening and early diagnosis, to accepting the disease and learning about it through the multidisciplinary team, to discussing treatments, all the way to survivorship and palliative care — can help patients keep the hope from within alive, looking towards more hopeful tomorrows.

To learn more about Hope From Within’s breast cancer patient journey map, visit https://hopefromwithin.org/home and Hope From Within on Facebook.

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References

World Health Organization. “Breast Cancer.” WHO | World Health Organization, 26 Mar. 2021, https://www.who.int/news-room/fact-sheets/detail/breast-cancer. Accessed May 25, 2021.

Global Cancer Observatory. “Fact Sheets: Philippines (2020).” https://gco.iarc.fr/today/data/factsheets/populations/608-philippines-fact-sheets.pdf. Accessed May 25, 2021.

Hope From Within. “What Is Triple Negative Breast Cancer?” YouTube, 30 Mar. 2021, https://www.youtube.com/watch?v=24DxwGTJ51c. Timestamp 1:15:00. Accessed May 25, 2021.

Centers for Disease Control and Prevention USA. “Breast Cancer Screening Guidelines for Women.” 22 Sep. 2020. https://www.cdc.gov/cancer/breast/pdf/breast-cancer-screening-guidelines-508.pdf. Accessed May 25, 2021.

Hope From Within: Cancer Game Plan PH. Quote from Ms Fatima “Girlie” Lorenzo (President, Philippine Alliance of Patients Organization). https://hopefromwithin.org. Accessed May 25, 2021

National Center for Biotechnology Information. “Depression and family support in breast cancer patients.” 13 Sep. 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5602463/. Accessed May 25, 2021.

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