Learn about what makes triple-negative breast cancer different from other types of breast cancer.
Update Date: 31.07.2026
Triple-negative breast cancer (TNBC) is a fast-growing type of breast cancer. Like other types of breast cancer, TNBC starts as a growth of cells in the breast. What makes TNBC different from other types is that the cancer cells don't use the hormones estrogen and progesterone to help them grow. The cells also don't make much of a protein called HER2.
TNBC tends to happen at a younger age and is more common in black women. It also happens more often in people who have DNA changes that increase the risk of breast cancer.
This type of breast cancer is called triple negative because the cells test negative for estrogen receptors, progesterone receptors and HER2 protein. Healthcare professionals use the results of these tests to make treatment decisions. Having TNBC limits the treatment options, since the cancer won't respond to estrogen blocker therapy to lower hormone levels or treatments that target the HER2 protein.
Compared with other types of breast cancer, TNBC is more likely to be diagnosed at a later stage. The cancer often has grown large or spread to the lymph nodes by the time it is found. Treatment for TNBC often starts with medicines, such as chemotherapy and immunotherapy. These medicines can shrink the cancer to make it easier to remove with surgery. Other treatments might include radiation therapy and targeted therapy.
Triple-negative breast cancer (TNBC) is not a single condition. TNBC is a broad term for breast cancers that test negative for estrogen receptors, progesterone receptors and HER2. TNBC includes several subtypes. This helps explain why two people with TNBC may have cancers that grow, spread or are affected by treatment differently.
The subtypes include, but are not limited to:
Triple-negative breast cancer (TNBC) may not cause signs or symptoms at first. As it grows, TNBC symptoms are usually the same as most other common breast cancer symptoms. These include:
TNBC is often a fast-growing cancer. It may be more likely to appear between routine mammograms than other breast cancer types. Make an appointment with a healthcare professional if you notice a change in your breasts. Changes to look for may include a lump, an area of puckered or otherwise unusual skin, a thickened region under the skin, and nipple discharge. Don't wait for your next mammogram to see if the change you found is breast cancer. Report any changes in your breasts even if a recent mammogram showed there was no breast cancer. A healthcare professional may recommend additional imaging.
The exact cause of triple-negative breast cancer (TNBC) often isn't known. This type of breast cancer is more likely to happen in people who inherit DNA changes that increase the risk of breast cancer, such as BRCA1 and BRCA2. These DNA changes run in families and raise the risk of breast cancer. Not all people with TNBC have these DNA changes. More research is needed to understand what causes this type of breast cancer.
Factors that may increase the risk of triple-negative breast cancer (TNBC) include:
Complications that can happen with triple-negative breast cancer (TNBC) include:
Sometimes people ask if TNBC can cause ovarian cancer. TNBC itself does not cause ovarian cancer. TNBC and ovarian cancer are linked to changes in BRCA genes.
There's no sure way to prevent triple-negative breast cancer (TNBC). But making changes in your daily life may help lower your risk of breast cancer in general. Try to:
People sometimes wonder if there is a vaccine to protect against TNBC. There currently is no vaccine for TNBC.
Triple-negative breast cancer (TNBC) is usually diagnosed in steps, not with a single test. If symptoms or a screening test such as a mammogram suggest breast cancer, the workup starts with a physical exam with a healthcare professional. Other tests typically include imaging, biopsy, testing cells in the lab and tests for biomarkers.
During a breast exam, a healthcare professional looks at the breasts for anything that's not typical. This might include changes in the skin or to the nipple. Then the health professional feels the breasts for lumps. The health professional also feels along the collarbones and around the armpits for lumps.
A mammogram is an X-ray of the breast tissue. Mammograms are commonly used to screen for breast cancer. If a screening mammogram finds something concerning, you might have another mammogram to look at the area more closely. This more-detailed mammogram is called a diagnostic mammogram. It's often used to look closely at both breasts.
Ultrasound uses sound waves to make pictures of structures inside the body. A breast ultrasound may give your healthcare team more information about a breast lump. For example, an ultrasound might show whether the lump is a solid mass or a fluid-filled cyst. The healthcare team uses this information to decide what tests you might need next.
MRI machines use a magnetic field and radio waves to create pictures of the inside of the body. A breast MRI can make more-detailed pictures of the breast. Sometimes this method is used to look closely for any other areas of cancer in the affected breast. It also might be used to look for cancer in the other breast. Before a breast MRI, you usually receive an injection of dye. The dye helps the tissue show up better in the images.
A biopsy is a procedure to remove a sample of tissue for testing in a lab. To get the sample, a healthcare professional puts a needle through the skin and into the breast tissue. The health professional guides the needle using images created with X-rays, ultrasound or another type of imaging. Once the needle reaches the right place, the health professional uses the needle to draw out tissue from the breast. Often, a marker is placed in the spot where the tissue sample was removed. The small metal marker shows up on imaging tests. The marker helps your healthcare team monitor the area of concern.
The tissue sample from a biopsy goes to a lab for testing. Tests can show whether the cells in the sample are cancerous. Other tests give more details about the cells. Pathologists do the testing. Pathologists are doctors who look for disease in cells, fluids and tissue removed from the body.
Results are often given in a pathology report. The results may show:
The healthcare team uses the results from lab tests to decide on the cancer's stage, understand the prognosis and make a treatment plan.
Treatment for triple-negative breast cancer (TNBC) often involves several steps. Treatments typically include surgery and medicines, such as chemotherapy and immunotherapy. Other treatments might include radiation therapy, targeted therapy and antibody-drug conjugates.
If the cancer in the breast is small enough in stages 1 through 3, treatment may start with a lumpectomy or mastectomy.
Sometimes treatment starts with medicine. Healthcare professionals may use chemotherapy and, sometimes, immunotherapy before surgery. The medicines help shrink the cancer and make it easier to remove. Using medicines first also helps the healthcare team see how well the treatment works. This helps the care team make decisions about what treatments to do after the surgery. Treatment before surgery is called neoadjuvant therapy.
After surgery, treatment depends on what is found. Some people may get more chemotherapy, more immunotherapy or radiation therapy.
Breast cancer surgery typically involves a procedure to remove the breast cancer and a procedure to remove some nearby lymph nodes. Operations used to treat breast cancer include:
Removing all of the breast tissue. A mastectomy is surgery to remove all breast tissue from a breast. The most common mastectomy procedure is total mastectomy, also called simple mastectomy. This procedure removes all of the breast, including the lobules, ducts, fatty tissue and some skin, including the nipple and areola.
Some newer types of mastectomy procedures might not remove the skin or nipple. For instance, a skin-sparing mastectomy leaves some skin. A nipple-sparing mastectomy leaves the nipple and the skin around it, called the areola. These newer operations may not be for everyone.
You may choose to have breast reconstruction after mastectomy surgery. Breast reconstruction is surgery to restore shape to the breast. Options might include reconstruction with a breast implant or reconstruction using your own tissue. Consider asking your healthcare team for a referral to a plastic surgeon before your breast cancer surgery.
Chemotherapy treats cancer with strong medicines that kill cancer cells. It can shrink TNBC to make it easier to remove with surgery. There are many types of chemotherapy medicines that damage the cancer cells in different ways. Most chemotherapy medicines are given through a vein. Some come in pill form.
Immunotherapy for cancer is a treatment with medicine that helps the body's immune system fight cancer cells. Typically, the immune system fights off diseases by attacking germs and other cells that shouldn't be in the body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the immune system cells recognize and kill the cancer cells.
For TNBC, immunotherapy may be used before surgery to shrink the cancer and make it easier to remove. It also may be used after surgery or when surgery isn't an option.
To see if this treatment is likely to help, your healthcare team may test your cancer cells for a protein called programmed cell death ligand 1 (PD-L1). Immunotherapy medicines only work in cells that have this protein.
Radiation therapy treats TNBC with powerful energy beams. The energy can come from X-rays, protons or other sources. During radiation therapy, you lie on a table while a machine moves around you. The machine directs radiation to precise points in your body.
For TNBC, radiation therapy is sometimes used after surgery to kill any cancer cells that might remain.
Targeted therapy for cancer is a treatment that uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die.
One example of targeted therapy is medicines called poly (ADP-ribose) polymerase (PARP) inhibitors. PARP inhibitors target cells with BRCA1 or BRCA2 gene variations. Your healthcare team may do tests to see if these medicines might help fight your cancer.
Many other targeted therapy medicines exist. Some are used only when the cancer comes back or spreads to other parts of the body.
Antibody-drug conjugates are medicines that combine targeted therapy with chemotherapy. These medicines use targeted therapy to target the cancer cells and deliver chemotherapy directly to the cells. Antibody-drug conjugates are typically used alone or with other medicines to treat breast cancer that spreads.
No alternative medicine treatments have been found to cure breast cancer. But complementary and alternative medicine therapies may help you cope with side effects of treatment.
Many people with breast cancer have fatigue during and after treatment. This feeling of being very tired and worn down can continue for years. When combined with care from your healthcare team, complementary and alternative medicine therapies may help relieve fatigue.
If you are interested in ways to reduce fatigue, talk with your healthcare team about:
Some breast cancer survivors say their diagnosis felt overwhelming at first. It can be stressful to feel overwhelmed at the same time that you need to make important decisions about your treatment. In time, you may find ways to cope with your feelings. Until you find what works for you, it might help to:
If you'd like to know more about your TNBC, ask your healthcare team for the details of your cancer. Write down the type, stage and hormone receptor status. Ask for reliable sources of information where you can learn more about your treatment options.
Knowing more about your cancer and your options may help you feel more confident when making treatment decisions. Still, some people don't want to know the details of their cancer. If this is how you feel, let your care team know that too.
You may find it helpful and encouraging to talk with others who have been diagnosed with breast cancer. For support groups, contact the American Cancer Society or ask your healthcare team about local or online groups. Find support online through Mayo Clinic Connect, a community where you can connect with others for support, practical information and answers to everyday questions.
Find a person who has experience helping people with serious illnesses. Ask your healthcare team to suggest a counselor, clergy member or medical social worker you can talk with.
Your friends and family can provide a crucial support network for you during your cancer treatment.
As you begin telling people about your breast cancer diagnosis, you'll likely get many offers for help. Think ahead about things you may want help with. Examples include listening when you want to talk, helping you with preparing meals, cleaning your home or caring for your pets.
Make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you or are not going away. If an exam or imaging test shows you might have breast cancer, your healthcare team will likely refer you to a specialist.
Specialists who care for people with breast cancer include:
Your time with your healthcare professional is limited. Prepare a list of questions so that you can make the most of your time together. List your questions from most important to least important in case time runs out. For breast cancer, some basic questions to ask include:
Other questions to ask may include:
More questions to ask:
In addition to the questions that you've prepared, don't hesitate to ask other questions you think of during your appointment.
Be prepared to answer some questions about your symptoms and your health, such as:
Once your healthcare team diagnoses triple-negative breast cancer (TNBC), you may have other tests to figure out the extent of the cancer. This is called the cancer's stage. Your healthcare team uses your cancer's stage to understand your prognosis.
Complete information about the cancer's stage may not be available until after you have breast cancer surgery.
Tests and procedures used to stage breast cancer may include:
Not everyone needs all these tests. Your healthcare team picks the tests for you based on your situation.
First, healthcare professionals typically confirm if the cancer is triple negative by testing for the HER2 protein and the estrogen and progesterone receptors. Then they check to see how big the cancer is, its location and the distance it traveled from where it first started.
The process of breast cancer staging can take place at different times after diagnosis and around treatment. Your stage may change as your care team gets more information about your cancer.
Healthcare professionals use different types of stages at different times.
Because there are several types of stages that consider different factors, the stages of breast cancer can be confusing and complicated. Ask your healthcare team to explain your stage and what it means for your treatment.
Anatomic staging is the simplest form of breast cancer staging. To decide on the anatomic stage, the healthcare team uses the size of the cancer and whether it has spread. Using this type of staging, the stages go from 0 to 4.
The anatomic stage may be the first stage your healthcare team talks about after your diagnosis.
Triple-negative breast cancer (TNBC) survival rates come from studying many people with this cancer. The rates describe how many people are living five years after diagnosis.
People diagnosed with cancer often want to know the survival rates. The numbers may be helpful to some people because they offer a general sense of what to expect and help put the diagnosis in perspective. Or they may not be helpful. Sometimes the statistics can be confusing, discouraging or overwhelming.
Survival statistics can provide general information about the seriousness of the situation, but they can't predict what will happen to an individual. These statistics include thousands of people with TNBC, including people of different ages, with different health conditions and with different treatment histories.
Keep in mind that your healthcare team uses much more detailed information when talking with you about your individual prognosis and treatment options.
The National Cancer Institute (NCI) tracks cancer survival rates in the United States based on how far the cancer has spread. Many people expect survival rates by stage, such as stages 1 to 4. But the NCI uses summary staging to report survival rates. It gives rates for cancers that are localized, regional or distant.
Advances in research continue to improve survival rates. The people included in these numbers were diagnosed more than five years ago, so they may not have had access to the latest treatments.
Your own chances for survival depend greatly on the details of your cancer.
Cancer prognosis describes how likely it is that a cancer can be treated successfully. Healthcare professionals estimate prognosis using information about the cancer and your overall health. To better understand your personal prognosis, talk with your healthcare team. Your care team can explain the factors that affect your situation.
Factors that may affect prognosis for TNBC include:
Your healthcare team can explain how these factors apply to your specific situation and discuss treatments that may offer the best possible outcome.
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