Breast Cancer Triple Negative

Breast Cancer Triple Negative

• Overview
• Staging
• Staging Illustrations
• Treatment
• Genetic Testing
• Clinical Trials
• Supportive Care
• Survivors
• Resources
• Back to Breast Cancer

Download Your Complete Guide Today! DOWNLOAD NOW

Triple Negative Breast Cancer

Staging & Grading

Staging enables your doctor to develop the best treatment plan for your diagnosis. Along with considering the results of your physical exam, imaging studies and laboratory tests, your doctor will classify and stage the breast cancer according to the tumor, node and metastasis (TNM) system developed by the American Joint Committee on Cancer (AJCC).

In this system, the tumor (T) is categorized according to its size and location; the node (N) category describes whether cancer cells are found in lymph nodes; and the metastasis (M) category indicates whether the cancer has metastasized, or spread, to other parts of the body, such as the bones, brain, liver or lungs (see Table 1). The stage is described by Roman numerals from 0 to IV and the letters A, B or C, if applicable (see Table 2).

Breast cancer is also classified into subtypes based on molecular or genetic changes. Identifying the subtype is important because treatments and monitoring milestones, such as the length of time without progression and response to therapy, will vary by subtype. As a result, AJCC recommends molecular testing along with staging to identify the most effective therapy. Tumors can be tested for proteins produced either by the cancer cells themselves or other cells in response to cancer as well as for genetic mutations (see Genetic Testing). Results of multi-gene panels, such as MammaPrint, Oncotype DX 21-gene recurrence score, PAM 50 (Prosigna), and the Breast Cancer Index may be considered to guide treatment planning.

The tables included here share information based on the size and spread of disease. Your final stage will be determined after your doctor considers other factors, such as tumor marker expression and tumor grade. The most well-known tumor markers to guide breast cancer treatment are estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor-2 (HER2) status. As noted above, TNBC is negative for these three markers. The grade is assigned by a pathologist, a doctor who is specially trained to identify diseases by studying cells and tissues under a microscope. Based on the microscopic features of tumor cell growth rate and aggressiveness, the grade helps determine how fast a cancer is likely to grow and spread. Grades range from 1 to 3, and TNBC is often diagnosed as Grade 3, meaning it tends to grow quickly and may spread quickly.