There are 4 main types of breast cancer, of which triple negative breast cancer is one. There are significant differences between them, especially in the way they are treated.

For 3 of these types of breast cancer, microscopic ‘receptors' , which are chemicals or proteins on, or in, breast cancer cells that can easily be detected in the laboratory.

Most breast cancers have one or more of these receptors but about 1 in 6 have none or very few receptors. They are therefore ‘negative’ for all three; hence, they are said to be triple negative, sometimes abbreviated to TNBC.

You can find more information to help you understand what TNBC is here.

Not all breast cancers are the same. There are 4 main types, and there are significant differences between them, especially in the way they are treated. 

To diagnose breast cancer, and decide which type of breast cancer it is, a biopsy is undertaken, where a small part of the breast lump is sent to a laboratory for testing. Here the sample is tested for microscopic ‘receptors’, which are chemicals or proteins on, or in, breast cancer cells.

There are 3 types of receptors: estrogen (ER), progesterone (PR) and human epidermal growth factor (HER2). Most breast cancers have one or more of these receptors and are said to be hormone receptor positive (if ER and/or PR is present) or HER2 positive (if HER2 is present at high levels).  

But about 1 in 6 breast cancers either have none, or very few of these receptors. This fourth type is, therefore, ‘negative’ for all 3 receptors and said to be ‘triple negative’, sometimes abbreviated to TNBC.

The best source of information about trials is the Cancer Research UK website. 

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This is comprehensive and up to date, and includes all trials currently recruiting in the UK, not just those funded by Cancer Research UK.

This site can be tricky to navigate, and needs time and patience to see which trials are still open and may be suitable for you. There are separate trials for people with early stage/primary and those with advanced/metastatic breast cancer. Some trials will only be open to people with TNBC, and others to those with HR positive or HER2 positive breast cancer. Other trials may be open to people whether they have TNBC, HR positive or HER2 positive breast cancer. You will also need to meet other eligibility criteria and be sufficiently well.

The best way is to use the search box on the Cancer Research UK homepage to search ‘trials’ and when open, use the next box to search ‘triple negative breast bancer’……you will then see a large number of trials for TNBC from which you can choose.

At the end of the list of trials for TNBC, there is a further list of trials which apply to all types of breast cancers, not just TNBC, for which you may also be eligible. 

If the trial you are interested in is not available at your treatment center, you can ask to be referred to another where it is open.

On the Cancer Research UK site there is also comprehensive advice on what it means to be in a trial and how to be accepted for a trial.

In December 2024, more than 10,000 breast cancer researchers, medical practitioners and drug company representatives met for the annual San Antonio Breast Cancer Symposium.

This is one of the meetings where the world’s leading breast cancer experts present and share their research results, and discuss future plans and treatments. It is at meetings like this that the treatments people with TNBC now receive were first presented. After these meetings important new findings are shared more widely with those who treat people with breast cancer. 

Whilst there were no new breakthroughs concerning TNBC, there were reasons to be optimistic about the future. In particular the already available drugs pembrolizumab and olaparib were shown in ongoing trials to be even more effective than originally thought. There is also interest in new biological treatments and a TNBC vaccine that will be tested in clinical trials. 

Compared with even just a few years ago, there was significantly more attention on TNBC both in terms of laboratory research and clinical trials with new drugs that you may want to ask your medical team about.

Immunotherapy is emerging as an effective way to treat cancers of many kinds, including triple negative breast cancer (TNBC), and there is major ongoing research to develop them further.

Immunotherapy boosts the ability of our body’s immune system to detect and destroy cancers. Cancer cells have ways of hiding from the immune system so they are not attacked in the same way that a bug causing an infection would be. Immunotherapy drugs that are used to treat some people with TNBC make cancer cells visible to the immune system, which consists mainly of white blood cells that can then attack the cancer.

Other types of immunotherapy are being tested in TNBC clinical trials including antibodies, chemotherapy drugs linked to antibodies and vaccines.

Most cancers, including TNBC, are not inherited.

Some cancers are, however, caused by abnormal or mutated genes that can be inherited. Two such genes, known as BRCA1 and BRCA2, can cause cancers and in particular breast cancer. The mutated BRCA genes can be passed on to the next generations, both through the female and male family lines. Such inherited breast cancers are often, but not always, TNBC.

For this reason many people diagnosed with TNBC are offered a genetic, sometimes called genomic, blood test. The NHS has guidelines as to in whom BRCA testing is most helpful, such as those with TNBC, people diagnosed at a younger age and where there is a history of breast (or other) cancers in the family. This is something you may want to discuss with your medical team. The NHS employs counsellors to explain what are the implications and options for people with the BRCA gene mutation, ask your Breast Cancer Specialist Nurse. For more information and support contact the British Society for Genetic Medicine.

When someone is diagnosed with TNBC, and they have a BRCA mutation, there are a number of things to think about

• There are new drugs called PARP inhibitors that are taken by mouth; one, called olaparib, can reduce the risk of cancer coming back in some people with BRCA mutations that are available through the NHS. These drugs can also be used to treat some people with BRCA mutations whose cancer has come back and spread 

• There is an increased risk of people with BRCA mutations developing another breast cancer or a different cancer, in particular ovarian cancer, so there would be discussion of if and how to reduce this risk.

• There is a chance that relatives may also carry the BRCA mutation and be at increased risk of developing cancer so there would be discussions about whether they should be tested and whether they may need other tests such as extra screening

The NHS employs counsellors to explain what are the implications and options for people with the BRCA gene mutation, ask your Breast Cancer Specialist Nurse.

For more information and support contact the British Society for Genetic Medicine.

Breast cancer is much rarer in men than women, representing about 1% of cases and TNBC is even rarer in men.

This would seem to be confirmed by statistics provided by the Government for the year 2021 when men represented only 0.1% of cases. This data was provided by the National Disease Registration Service in response to a question in the Houses of Parliament tabled by an MP at the request of the Charity.

Breast Cancer in men is treated in the same way as for women.

There is a charity dedicated to male breast cancer called moobs.

Triple negative breast cancer is more common in women with Afro Caribbean roots, with most of the evidence coming from the USA. 

Whereas around 15% of all breast cancer cases are triple negative, in the USA about 20% or more of black women with breast cancer have TNBC.

It also seems that TNBC in black women is more often seen in those who are younger, are more likely to carry the BRCA gene mutation; TNBC appears more likely to recur or come back, possibly because of later diagnosis.

For more information see Black Women Rising and a USA charity Touch BBCA.

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Inflammatory breast cancer accounts for less than 5% (1 in 20) of all breast cancers. It is different from other breast cancers as inflammatory breast cancer does not appear as a solid lump or tumour in the breast, but as ‘inflammation’ of the breast and skin.

Inflammatory breast cancer is in many ways like other breast cancers, although triple negative breast cancer (TNBC) is more likely to be inflammatory than other types of breast cancer such as hormone receptor positive.

The key challenge with inflammatory breast cancer is that diagnosis can be difficult with the main sign being changes to the skin over the breast becoming swollen, red or inflamed; this is often likened to the texture of orange peel. These changes are caused by the cancer cells blocking the lymph vessels in the skin but can look like infection such as mastitis. The breast itself feels generally more firm or solid, rather than there being an actual “lump”. Inflammatory breast cancer can be  fast growing and can spread quickly. As with other breast cancers, the diagnosis is confirmed with a biopsy.

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For further information and support, visit the Inflammatory Breast Cancer Network.

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The treatment of inflammatory TNBC is similar to other types of TNBC but there can be differences for those diagnosed with early inflammatory TNBC.

Because it affects the whole breast, surgery is more difficult and people may be offered neo-adjuvant chemotherapy first, followed by surgery; this is more likely to be a mastectomy, and to be followed by radiotherapy. After surgery and radiotherapy people may be offered further, adjuvant chemotherapy. 

If inflammatory TNBC spreads to other parts of the body it is treated in the same way as other TNBCs.