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What is Triple-Negative Breast Cancer?

Triple-negative breast cancer is a type of breast cancer that does not have any of the receptors that are usually present within the breast tissue and breast cancer cells. These include the estrogen (ER) and progesterone (PR) receptors and a protein known as HER2 (human epidermal growth factor receptor 2).

TNBC KV breast-cancer-inner-1

In Malaysia, breast cancer was the most commonly diagnosed cancer among women of all ethnic groups between 2012-20161. The incidence of triple-negative breast cancer ranged from 12.4-17.6% of total breast cancer cases in the country24,25.

Characteristics of Triple-Negative Breast Cancer3,26


More aggressive in behavior


Likely to have spread at the time it is found


Harder to treat


More likely to recur (come back) after treatment


Tends to have a worse outlook

Signs and Symptoms27

The signs and symptoms of triple-negative breast cancer are similar to other types of breast cancer and can include:


A lump or mass in your breast or armpit


Swelling in all or part of your breast


Skin changes in your breast (dimpling, rash, redness)


Breast or nipple pain


Nipple that turns inwards or has a discharge


Swollen lymph nodes

Risk Factors and Prevention

Who is most at risk of triple-negative breast cancer?



How to help prevent triple-negative breast cancer29?
  • prevent-breast-1 Maintain a healthy weight
  • Avoid-alcohol Avoid alcohol and smoking
  • prevent-breast-5 Monitor your breast health by doing breast self-examination
  • prevent-breast-4 Exercise regularly
  • prevent-breast-2 Be aware of your family’s medical history of cancer
  • prevent-breast-3 Speak to your doctor about testing if you have family members who are carriers of the BRCA gene or other hereditary gene mutations that increases the risk for breast cancer

Screening and Diagnosis

How do you screen for breast cancer30,31?
  • screeningdiagnosis-4

    Breast self exam: Changes in the look and feel of your breast such as lumps, pain, and size should be reported to your doctor.

  • screeningdiagnosis-3

    Clinical breast exam: A doctor or a nurse examines the breast by using their hands to feel for lumps or other changes.

  • screeningdiagnosis-2

    Breast magnetic resonance imaging (MRI): A breast MRI uses magnets and radio waves to take pictures of the breast.

  • Breast-ultrasound-for-women-below

    Breast ultrasound for women below 40 at higher risk for breast cancer: An ultrasound helps doctors look at some breast changes, such as lumps (especially those that can be felt) or changes in women with dense breast tissue.

  • screeningdiagnosis-1

    Screening mammogram for women above 40: An x-ray of the breast is taken to detect breast cancer early.

Who needs to be screened for breast cancer32?


Screening for breast cancer is done in people without any signs or symptoms of the disease to facilitate early detection and ensure the best chance of survival.

In Malaysia, the Clinical Practice Guidelines for the Management of Breast Cancer recommends screening based on a women’s risk for developing breast cancer.

  • screened-breast-1

    General population

    • Women 50-74 years: Screening mammography once every two years.
  • screened-breast-2

    Moderate risk

    • Women 40-49 years: Screening mammography annually.
    • Women 50-59 years: Screening mammography annually or once every two years.
    • Women 60 years onwards: Screening mammography once every two years.
  • screened-breast-3

    High risk without gene mutation

    • Women 30-39 years: Consider screening mammography.
    • Women 40-59 years: Screening mammography annually.
    • Women 60 years onwards: Screening mammography once every two years.
  • screened-breast-4

    BRCA1 gene mutation

    • Women 30-49 years: MRI annually.
    • Women 40-69 years: Mammography annually
    • Women 70 years onwards: Mammography once every two years.
How is triple-negative breast cancer diagnosed?
  • breast-cancer-surgery-1

    Diagnostic mammogram

    • Used if there are breast symptoms or if screening mammogram detects something unusual33.
    • Additional images may be taken for diagnostic mammograms.
  • breast-cancer-surgery-2

    Breast ultrasound34

    • Looks at breast changes that cannot be seen on mammograms.
    • For those who have dense breast tissue, such as women below 40 years old.
    • Takes a better look at unusual mammogram findings23.
    • Able to tell apart fluid-filled masses i.e. cysts and solid masses which may require further testing to rule out cancer.
  • breast-cancer-surgery-3


    • Conducted when mammograms, other imaging tests, or a physical exam shows a breast change that may be cancerous35.
    • Small pieces of the suspicious area at the breast are taken to be examined at the laboratory to determine if they contain cancer cells.

Once a breast cancer diagnosis has been made, the cancer cells will be checked for certain proteins to determine the cancer type. If the cells do not have estrogen or progesterone receptors, and do not make any or too much of the HER2 protein, the cancer is classified as triple-negative breast cancer3.