Table of ContentsView AllTable of ContentsRecurrence RatesSymptoms of RecurrencePrevention MeasuresNext in Triple-Negative Breast Cancer GuideWhat You Need to Know About Triple-Negative Breast Cancer with Chemo Resistance
Table of ContentsView All
View All
Table of Contents
Recurrence Rates
Symptoms of Recurrence
Prevention Measures
Next in Triple-Negative Breast Cancer Guide
Triple-negative breast cancer recurrence after a mastectomy is one of the most aggressive types of cancer. It’s harder to treat than other types of breast cancer because it lacks the three most common proteins—estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2/neu)—that targeted medications act upon to reduce tumor growth.
Even when initial treatment leads to remission, the chance of triple-negative breast cancer (TNBC) recurrence remains higher than in other breast cancers. Recurrence rates after standard conventional therapy (surgery, chemotherapy, and radiation therapy) are around 25%.
FatCamera / Getty Images
Recurrence Rates in Triple-Negative Breast Cancer Patients
Chemotherapy is also given for TNBC. It may be given before surgery (neoadjuvant chemotherapy), after surgery, or both.
TNBCcan recurin the same area where the original cancer was found or an adjacent area, often along the surgical scar, where a lumpectomy or mastectomy was performed.
Research suggests that TNBC appears to have many root causes. Recurrence may vary depending on the patient, type of initial cancer, type of treatment, and other unique biological behaviors.
Without Mastectomy
Some studies have found that the type of surgery is not a significant factor in recurrence. For example, a study of lumpectomy found no more local recurrence of cancer in TNBC than in other subtypes.
With such studies in hand, healthcare providers will consider the individual case and decide whether it can be treated with breast-conserving surgery or lumpectomy. Radiation and systemic treatments like chemotherapy are also used.
After Mastectomy
Mastectomy, and sometimes lymph node dissection, is often recommended for people with TNBC due to its aggressive nature.
By the time TNBC is found, many people have large tumor size, lymphovascular invasion (tumor cells in the blood vessels or lymph vessels), and lymph node lesions. This indicates that cancer has begun to spread outside of the breast cavity.
An analysis of 390 cases found that the risk of local TNBC recurrence was higher in people under 50. It was also higher in those with lymphovascular infiltration, those with a higher degree of lymph node involvement (presence of cancer in three or more lymph nodes), and those withstage 3 disease(advanced but without spread to other organs).
In addition, the risk was highest in those with two or more of these factors. The five-year frequency of regional recurrence in the presence of one factor was 4.2% compared to 25.2% for two factors and 81% in the presence of three or more factors.
The stage at diagnosis is a key factor in the recurrence rate for triple-negative breast cancer. The stage denotes how far cancer has spread at the time of diagnosis.
The high recurrence rate generally reported for TNBC reflects that this cancer is often discovered when it is more advanced. The numbers are better for cancer found in the early stages.
Unfortunately, reporting local or locoregional recurrence numbers does not reflect that the vast majority of recurrence isdistant metastasis. A New Zealand study of people with TNBC but without distant metastasis at diagnosis reported that 74% of first recurrences were distant metastases (often to the lung or multiple sites).
A study of people treated with stages 2 or 3 triple-negative breast cancer treated with preoperative chemotherapy and breast-conserving surgery showed:
These numbers continue to change based on the development of new therapies and treatment strategies. By definition, five-year statistics cannot show the effects of treatments introduced in less than five years.
Symptoms associated with recurrence vary depending on their location in the body. Local recurrence symptoms mimic the symptoms people living with TNBC originally experienced before treatment. Local symptoms include:
More distant recurrence symptoms usually manifest as a combination of generalized and organ-specific symptoms. Metastatic symptoms include:
Taking a low dose of Xeloda (capecitabine)—a chemotherapy drug—for one year after surgery to remove early-stage triple-negative breast cancer plus standard postsurgical chemotherapy may reduce your risk of TNBC recurrence. In a study, the five-year recurrence rate after this treatment was 17.2%, compared with 27% in those who did not receive this maintenance treatment.
Lifestyle modifications also decrease your general risk. These include:
Summary
Few breast cancers are more aggressive and harder to treat than triple-negative breast cancer (TNBC). Even after initial success with conventional treatment such as mastectomy, recurrence rates remain high. Breast-conserving surgery (lumpectomy) may be an option as recurrence rates are similar to those of mastectomy.
The treatment chosen will depend on the size of the tumor, stage, and other factors. Early-stage TNBC has a lower rate of recurrence than advanced stages.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Steward L, Conant L, Gao F, Margenthaler JA.Predictive factors and patterns of recurrence in patients with triple negative breast cancer.Ann Surg Oncol. 2014;21(7):2165-71. doi:10.1245/s10434-014-3546-4
Shuang-Long Cai, Jing-Jing Liu, Ying-Xue Liu, Shao-Hong Yu, Xu Liu, Xiu-Quan Lin, Hong-Dan Chen.Characteristics of recurrence, predictors for relapse and prognosis of rapid relapse triple-negative breast cancer.Front Oncol.2023; 13: 1119611. Published online 2023 Feb 16. doi: 10.3389/fonc.2023.1119611
Kim S, Park HS, Kim JY, Ryu J, Park S, Kim SI.Comparisons of oncologic outcomes between triple-negative breast cancer (TNBC) and non-TNBC among patients treated with breast-conserving therapy.Yonsei Med J. 2016;57(5):1192-8. doi:10.3349/ymj.2016.57.5.1192
Baranova A, Krasnoselskyi M, Starikov V, et al.Triple-negative breast cancer: current treatment strategies and factors of negative prognosis.J Med Life. 2022;15(2):153-161. doi:10.25122/jml-2021-0108
Zumsteg ZS, Morrow M, Arnold B, Zheng J, Zhang Z, Robson M, Traina T, McCormick B, Powell S, Ho AY.Breast-conserving therapy achieves locoregional outcomes comparable to mastectomy in women with T1-2N0 triple-negative breast cancer.Ann Surg Oncol. 2013;20(11):3469-76. doi:10.1245/s10434-013-3011-9
James M, Dixit A, Robinson B, Frampton C, Davey V.Outcomes for patients with non-metastatic triple-negative breast cancer in New Zealand.Clin Oncol (R Coll Radiol). 2019;31(1):17-24. doi:10.1016/j.clon.2018.09.006
Vijay Trisal, MD. City of Hope.What is cancer recurrence?
Wang X, Wang SS, Huang H, et al.Effect of capecitabine maintenance therapy using lower dosage and higher frequency vs observation on disease-free survival among patients with early-stage triple-negative breast cancer who had received standard treatment: the SYSUCC-001 randomized clinical trial.JAMA. 2021;325(1):50-58. doi:10.1001/jama.2020.23370
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
