Chemotherapy for Triple-Negative Breast Cancer

Triple-negative breast cancer (TNBC) does not have estrogen receptors (ER), progesterone receptors (PR) or human epidermal growth factor receptor 2 (HER2), which are commonly found in other types of breast cancer. Because TNBC lacks these receptors, it does not respond to certain breast cancer treatments, such as hormonal therapies and medications that specifically target HER2.

In many cases, TNBC can be effectively treated with surgery, radiation therapy and/or chemotherapy. Scientists continue to evaluate targeted treatment options for this aggressive breast cancer.

What does chemotherapy for triple-negative breast cancer involve?

Chemotherapy for TNBC involves the use of powerful medications, which enter the bloodstream and circulate throughout the body to target and destroy rapidly dividing cells, including cancer cells. Chemo may be administered before surgery to shrink a tumor and make it easier to remove. Alternatively, the drugs can be given after surgery to eliminate any remaining microscopic cancer cells and help prevent a recurrence.

Chemo can also be used as a systemic treatment to ease symptoms and control the progression of a large tumor that cannot be surgically removed. Given the aggressive nature of triple-negative breast cancer and its lack of hormone receptors and HER2 protein, chemotherapy is often the primary systemic treatment.

What happens during chemotherapy for triple-negative breast cancer?

In general, chemotherapy for TBNC includes:

• Treatment planning – An oncologist will develop a personalized chemotherapy regimen based on the stage of the tumor and the patient’s overall health.
• Treatment administration – Chemotherapy is given in cycles, often over several months. Each treatment session is followed by one or more days of rest to allow the patient’s body time to recover. The drugs may be infused into a vein through an intravenous (IV) drip, injected with a needle into a vein or muscle, taken by mouth in pill or capsule form or swallowed in liquid form.
• Monitoring – The healthcare team will continually monitor the patient with periodic blood tests and imaging scans to assess the effects of the chemo and adjust the treatment regimen as necessary.
• Side effect management – Chemotherapy can cause temporary side effects, such as fatigue, hair loss, gastrointestinal distress and mouth sores. Supportive care and medications may be provided to improve comfort as needed.
• Post-treatment care – After completing chemotherapy, the patient will receive follow-up care to periodically check for signs of cancer recurrence and manage any long-term side effects.

What are the risks and possible complications of chemotherapy for triple-negative breast cancer?

Chemotherapy for TNBC involves several risks and possible complications, including:

• Fatigue – Persistent tiredness may affect daily activities.
• Gastrointestinal distress – Chemo-related nausea, vomiting, diarrhea or constipation can often be managed with medications.
• Hair loss – Chemo medications can affect healthy cells that naturally divide rapidly, such as those in the hair follicles, which can cause temporary loss of hair from the scalp and other parts of the body.
• Increased risk of infection – Low white blood cell counts can increase susceptibility to infection.
• Anemia – Low red blood cell counts can cause weakness and shortness of breath.
• Bruising and bleeding – Low platelet counts can lead to easy bruising and bleeding.
• Mouth sores – Painful sores may develop in the mouth and throat, which can make eating and drinking difficult.

These risks and complications can vary from person to person, and not all patients will experience every side effect. Close monitoring and supportive care from the healthcare team are essential to manage and mitigate these risks during and after chemotherapy for triple-negative breast cancer.

What to expect during recovery from chemotherapy for triple-negative breast cancer

During recovery from chemotherapy for TNBC, the patient can expect a gradual return to normal energy levels. Any fatigue, nausea or other side effects should slowly diminish over several weeks to months. Maintaining a healthy diet, staying well hydrated and engaging in light physical activity can aid in the recovery process. The patient should discuss any persistent or concerning symptoms with their physician to ensure appropriate care and support.

How effective is chemotherapy for triple-negative breast cancer?

Chemotherapy is generally effective for treating TNBC, which does not respond to hormone therapy or HER2-targeted treatments. However, its effectiveness can vary depending on several factors, including the stage of the tumor, the specific chemotherapy regimen used and the patient's overall health. For early-stage triple-negative breast cancer, chemo is often administered both before and after surgery to help ensure the best possible outcome and quality of life.

Benefit from world-class care at Moffitt Cancer Center

The multispecialty team in Moffitt’s renowned Don & Erika Wallace Comprehensive Breast Program takes an individualized approach to breast cancer treatment. After evaluating multiple factors, we can develop a customized chemotherapy treatment regimen for TNBC, including the most appropriate drug or drug combination, dose and delivery schedule. Our breast cancer oncologists are also reproductive specialists who can take appropriate measures to protect your fertility.

If you have questions about chemotherapy for triple-negative breast cancer, you can request an appointment with a specialist at Moffitt by calling 1-888-663-3488 or submitting a new patient registration form online. We do not require referrals.