Triple receptor negative breast cancer

Dr Henry Knipe and Radswiki et al.

Triple receptor-negative (TRN) breast cancer is a subtype of breast cancer characterized by a relative absence of immunohistochemical staining for the following hormone receptors/protein:

  • estrogen receptor (OR)
  • progesterone receptor (PR)
  • human epidermal growth factor receptor 2 (HER2/neu)

It is more likely to affect younger people and races such as African, Americans, Hispanics, and/or those with a BRCA1 gene mutation.

They have distinctive pathologic features, typically exhibiting a higher histologic grade, elevated mitotic count, central necrosis and fibrosis, pushing margins, scant stromal reaction, stromal lymphocytic response, and ductal or mixed histology with overrepresentation of unusual histologies (metaplastic, medullary, or adenoid cystic carcinoma). It comprises of a heterogeneous group, encompassing at least two subcategories:

  • basal subtype ~60% 
  • less well-defined non basal/multiple marker negative subtype ~40%

TRN cancers were more frequently associated with a mass and were less frequently associated with calcifications than HER2+ / ER+ cancers. Associated ductal carcinoma in situ (DCIS) has also been reported at the much lower rate than HER2+, and ER+ patients. 

Due to the absence of hormone receptors and HER-2, treatments like hormone therapy and other drugs which target estrogen, progesterone and HER-2 are ineffective. However, chemotherapy is considered to be an effective option in such cases with it responding earlier and better as compared to other breast malignancies.

Triple negative breast cancer has the worst prognosis compared to other breast cancer with a more aggressive course and higher rates of recurrence 8

Breast imaging and pathology
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Article information

rID: 15301
System: Breast
Synonyms or Alternate Spellings:
  • Triple receptor negative breast carcinoma
  • Triple receptor negative (TRN) breast cancer
  • Triple receptor negative breast cancer (TNBC)
  • Triple negative breast cancer

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