Healthcare with Confidence
Triple-Negative Breast Cancer (TNBC)
Personalized treatment plans based on genomic testing are now changing outcomes for women with triple-negative breast cancer, thanks to leading Israeli oncologists.
Triple-negative breast cancer (TNBC) is a rare and aggressive form of breast cancer, more common in younger women, and often more challenging to treat than other types. However, recent advancements in genomic testing and immunotherapy are allowing doctors in Israel to create personalized treatment strategies—tailored to each patient’s unique cancer profile.
⇒ Best Doctors for Breast Cancer – Get a Second Opinion
What Is Triple-Negative Breast Cancer?
Triple-negative breast cancer accounts for approximately 10–25% of all breast cancer cases. The name “triple-negative” refers to the absence of three common receptors found in most other breast cancers:
- Estrogen receptors (ER)
- Progesterone receptors (PR)
- HER2 (Human Epidermal Growth Factor Receptor 2)
Because TNBC cells test negative for all three, the usual hormone therapies and HER2-targeted drugs used in other breast cancer types are not effective.
TNBC tends to grow and spread more quickly than other forms of breast cancer and may have a higher risk of recurrence. However, it is important to remember that TNBC is not one single disease—there are seven known subtypes, each with different behaviors and treatment responses.
Why Genomic Testing Matters
In the past, TNBC treatment followed a “one-size-fits-all” approach, despite differences between patients. Today, Israeli oncologists use genomic profiling to better understand each tumor’s unique genetic features.
This allows doctors to:
- Identify specific mutations such as BRCA1, PTEN, or PIK3CA
- Classify the cancer into a more specific subtype
- Choose targeted treatments and immunotherapy options with greater accuracy
- Reduce unnecessary side effects by avoiding ineffective therapies
Understanding the Biology of TNBC
TNBC tumors are defined by a lack of the three key markers (ER, PR, HER2) based on immunohistochemistry (IHC) and FISH (fluorescence in situ hybridization) tests. These markers typically help guide treatment decisions in breast cancer.
Because TNBC lacks these targets, standard hormone therapy (e.g., tamoxifen, aromatase inhibitors) and HER2-targeted drugs like Herceptin (trastuzumab) do not work. That’s why chemotherapy, immunotherapy, and new molecular-targeted therapies play a central role in treatment.
Interestingly, BRCA1 gene mutations are more common in patients with TNBC, offering additional treatment opportunities such as PARP inhibitors.
Prognosis and Survival in Triple-Negative Breast Cancer
Thanks to early detection, many women with TNBC are diagnosed at a stage where treatment can be very effective. However, TNBC tends to be more aggressive:
- It often appears in younger women
- Tumors are typically larger at diagnosis
- Lymph node involvement is more frequent
- The risk of recurrence is higher, especially in the first 1–3 years
A Canadian study of 1,600 women showed that patients with TNBC were twice as likely to experience recurrence within five years compared to those with other breast cancer types. However, after 5 years, the risk of recurrence becomes similar across all types of breast cancer.
Important: Prognosis varies by individual and depends on tumor size, lymph node involvement, genetic markers, and treatment response.
Treatment for Triple-Negative Breast Cancer in Israel
The standard treatment approach often includes:
- Surgery – either breast-conserving surgery (lumpectomy) or mastectomy
- Radiation therapy – to reduce recurrence risk
- Chemotherapy – especially important since hormone and HER2 therapies are not effective
For patients with tumors larger than 0.5 cm or lymph node involvement, postoperative (adjuvant) chemotherapy is commonly recommended.
Immunotherapy and TNBC
Immunotherapy is a breakthrough in TNBC treatment. It works by enhancing the immune system’s ability to recognize and attack cancer cells.
- Keytruda (pembrolizumab): This immunotherapy drug blocks the PD-1/PD-L1 pathway—used by some tumors to hide from the immune system. Studies show that up to 60% of TNBC patients express PD-L1 and may benefit from this treatment.
- Tecentriq (atezolizumab) combined with nab-paclitaxel (a form of chemotherapy) was the first immunotherapy regimen approved by the FDA for TNBC with PD-L1 expression.
- Trodelvy (sacituzumab govitecan): Approved for metastatic TNBC after at least two prior therapies. It delivers chemotherapy directly to cancer cells using an antibody-drug conjugate.
These treatments offer hope for women with advanced or metastatic TNBC and are now accessible in top cancer centers across Israel.
Genomic Testing: The Future of TNBC Treatment
Genomic analysis is now uncovering new targets for treatment, not just on the tumor’s surface, but within the DNA of cancer cells. For example:
- PTEN and PIK3CA gene mutations are found in about 10% of TNBC cases
- Certain TNBC subtypes may carry mutations in up to 50% of patients
Identifying these mutations allows oncologists to use targeted therapies that interfere with cancer growth on a molecular level.
Second Opinions and Personalized Care in Israel
Israeli oncology centers are known for their advanced approach to breast cancer treatment. Through a second opinion consultation, patients can receive:
- Comprehensive review of pathology and imaging
- Genomic profiling of the tumor
- Personalized treatment plan using the latest therapies
- Remote (online) consultations or in-person visits
- Access to clinical trials and cutting-edge medications
Contact Us
If you or a loved one has been diagnosed with triple-negative breast cancer, our experienced oncology team is here to help. Get in touch for a second opinion, treatment plan, or information about immunotherapy and genomic testing in Israel.
