Breast cancer is a major threat to women’s health. Triple-negative breast cancer (TNBC) has attracted much attention because of its special biological characteristics and high recurrence rate and mortality. TNBC is a subtype of breast cancer that is negative for estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expression. It has the characteristics of strong heterogeneity and high invasiveness, and is not sensitive to endocrine therapy. Chemotherapy is the basis of its standardized treatment. Globally, the incidence and mortality of breast cancer are high, and the incidence and mortality of breast cancer in Chinese women are on the rise. The morbidity of TNBC is related to family heredity, genetic changes and other factors, and early screening is essential to improve the prognosis. The diagnostic mode of TNBC has gradually developed from morphology combined with immunohistochemistry to morphology + immunohistochemistry + molecular biology. Pathological diagnosis is still the gold standard, and combined with genomics and other technologies, molecular typing can be more accurately determined to guide individualized treatment. Surgical treatment is the first choice for TNBC. The model of neoadjuvant therapy combined with surgery is widely accepted. Neoadjuvant chemotherapy can reduce the stage of tumors, increase the possibility of breast-conserving surgery, and evaluate the sensitivity of tumors to treatment. For the treatment of axillary lymph nodes, it is necessary to decide whether to carry out clearance or radiotherapy according to the specific situation. Postoperative adjuvant therapy is helpful to reduce local recurrence, in which radiotherapy plays an important role. Systemic treatment is an important part of TNBC treatment. Systemic chemotherapy is still the main method, taxanes are commonly used, and whether to combine anthracycline and platinum is controversial. Targeted therapy has made new breakthroughs with the progress of molecular biology research. For example, PARP inhibitors can be used to treat patients with BRCA1/2 mutations, and antibody drug conjugates such as goxatuzumab have also shown good efficacy. Immunotherapy in combination with chemotherapy also has clinical implications for TNBC, and although the role of immunosuppressants remains controversial, patients with TNBC may benefit from higher levels of immunogenicity. Local treatment is helpful to relieve symptoms and improve the quality of life, but it is not effective in improving the survival time of advanced patients. Although TNBC therapy has made some progress, it still faces many challenges. After diagnosis, patients should actively cooperate with doctors, choose appropriate treatment plans according to their own conditions, and maintain an optimistic attitude and healthy lifestyle to improve the therapeutic effect and quality of life.
References
: [1] Sun Yafei, Xu Tu, Chen Chaobo. Progress in the treatment of triple-negative breast cancer [J]. Chinese Journal of Modern General Surgery, 2024, 27 (09): 714-719.
Breast cancer
