Some types of breast cancer have hormone receptors in their tissue. Triple-negative breast cancer (TNBC) does not have three of these receptors. Stage 4 TNBC means the cancer is advanced and has spread beyond the breasts and nearby lymph nodes.
Read on to learn more about stage 4 TNBC, including the symptoms, diagnosis, treatments, and support resources.
Stage 4 means the breast cancer has spread outside of the breast and surrounding lymph nodes. Doctors may also refer to this as “metastatic” or “distant” breast cancer.
The term “triple negative” means the tumors themselves
- estrogen (ER) receptors
- progesterone (PR) receptors
- human epidermal growth factor (HER2) receptors
Stage 4 breast cancer is not curable. Additionally, TNBC
The 5-year relative survival rate for people with a diagnosis of distant TNBC between 2011 and 2017 was 12%. This number comes from the Surveillance, Epidemiology, and End Results (SEER) database.
However, it is worth noting that this data comes from people who received a diagnosis and treatment at least 4–5 years ago, so the current outlook may be better due to advances in research. Survival rates also do not take into account other factors, such as age and overall health.
Treatment may extend a person’s life and reduce symptoms. Stage 4 cancers
The symptoms of stage 4 TNBC are similar to other types of breast cancer and may include:
- a lump in or around the breasts
- swelling of the breasts
- swollen lymph nodes under the arm
- discharge from the nipple
- dimpling of the skin on the breast, which may resemble the texture of the skin on an orange, or other unusual skin changes
- redness, in people with lighter skin
- an inverted nipple
To diagnose breast cancer, doctors
To diagnose the subtype of breast cancer, doctors
To diagnose the stage of cancer, doctors will look at various factors,
TNBC does not have as many treatment options as other types of breast cancer. This is due to the lack of hormone receptors on the tumors, which makes treatments such as hormone therapy ineffective.
Instead, treatment for stage 4 TNBC
- chemotherapy, with drugs such as anthracyclines, capecitabine, taxanes, gemcitabine, or eribulin
- platinum chemotherapy drugs, such as cisplatin or carboplatin
- targeted therapy with PARP inhibitors, such as olaparib or talazoparib
- immunotherapy, with drugs such as pembrolizumab, in combination with chemotherapy
- sacituzumab govitecan, an antibody-drug conjugate, for people who have already received two other types of drug treatments
In some cases, surgery and radiation therapy may also be options to remove or destroy cancer cells. However, at stage 4, the goal of these treatments is typically to alleviate symptoms or reduce the risk of certain complications. It is unlikely to remove all of the cancer.
People may want to talk with a healthcare professional about taking part in clinical trials to try new treatments.
When receiving a diagnosis and undergoing treatment, people may want to ask:
- How much experience do you have in treating TNBC?
- What is the goal of treatment?
- Could it be helpful to get a second opinion?
- Do I need further testing?
- What are the treatment options?
- Which treatments do you recommend, and why?
- When can treatment start?
- What are the side effects of treatment? How will it affect day-to-day life?
- Do you have advice for diet, exercise, and managing mental health during treatment?
- Which symptoms should I report to a doctor?
- Will treatment affect my fertility?
- Can I take part in any clinical trials?
- What is the outlook? What are the options if the cancer returns?
People may find it helpful to write down any questions they want to ask, as well as noting down key points during any consultations. Taking another person along to appointments may also help people remember any important information.
Receiving a diagnosis of stage 4 TNBC may feel overwhelming. People may find it helpful to seek support from those around them, support groups, or mental health professionals.
Some support organizations include:
- Triple Negative Breast Cancer Foundation, which provides information, a helpline, online forums, and virtual meet-ups to connect people going through similar experiences
- Cancer Care, which offers resources, community programs, and counseling for people with TNBC
- TNBC Support Group, which offers free, online, 15-week support groups for people with TNBC who are receiving treatment
National Cancer Institute, which provides a list of breast cancer support services
If a person requires financial help for the costs of stage 4 TNBC cancer, the following resources may provide useful information and support:
- Cancer Care, which offers financial and copay assistance programs to help with care-related costs
- Facing Our Risk of Cancer Empowered (FORCE), which provides a resource list for financial assistance
- Patient Advocate Foundation, which offers a range of disease funds to provide grants to eligible people who require financial assistance
- Young Survival Coalition, which has a resource list for young people with breast cancer
TNBC is a type of breast cancer that tests negative for three hormone receptors that can occur in other types of cancer. Stage 4 means that cancer has spread outside of the breast and surrounding lymph nodes to other areas of the body.
The outlook for those with stage 4 TNBC can depend on many factors, including how the cancer responds to treatment, as well as people’s age and overall health.
Treatments for stage 4 TNBC may include chemotherapy, immunotherapy, and targeted therapy. In some cases, people may also have radiation therapy and surgery. The goal of these treatments is typically to extend a person’s life or reduce their symptoms.