Epidemiology and Risk Factors for Triple Negative Breast Cancer (TNBC)

  • Epidemiology:
    • TNBC accounts for approximately 15% of breast cancers diagnosed worldwide:
      • Which amounts to almost 200,000 cases each year
    • Compared with hormone receptor-positive breast cancer:
      • TNBC is more commonly diagnosed in women younger than 40 years:
        • In one study, there was a twofold higher attributable risk of TNBC in women under 40 years compared with women over 50 years (odds ratio [OR] 2.13, 95% CI 1.34-3.39) [5].
      • In addition, TNBC appears to be relatively more common among Black women compared with White women (OR 2.41, 95% CI 1.81-3.21)
  • Risk factors associated with the diagnosis of TNBC include:
    • Positive BRCA mutation status:
      • Up to 20% of patients with TNBC harbor a breast cancer susceptibility gene (BRCA) mutation:
        • Particularly in BRCA1
      • By contrast, less than 6% of all breast cancers are associated with a BRCA mutation
      • Given this finding, any patient with triple-negative disease should be offered a referral to a genetic counselor to discuss BRCA germline testing:
        • Moreover, any patient age 60 years or younger with TNBC should undergo BRCA germline testing
    • Race / ethnicity:
      • Several population-based studies have found that African American women have a higher risk of TNBC compared with White women:
        • However, African American women can certainly have ER-positive and / or HER2-positive disease:
          • Testing their tumors for these markers is essential
    • Premenopausal status:
      • Premenopausal status has been associated with increased incidence of TNBC diagnosis as compared with postmenopausal status
      • As with African American women:
        • Premenopausal women can frequently have ER-positive and / or HER2-positive disease:
          • Testing their tumors for these markers is essential
    • Other factors:
      • Studies have suggested relationships between other factors such as obesity and a young age of first pregnancy with an increased risk of TNBC:
        • While breastfeeding and parity may be associated with lower risks:
          • However, these factors are less well validated and rarely factor into clinical considerations

#Arrangoiz #BreastSurgeon #CancerSurgeon #SurgicalOncologist #Miami #Mexico #BreastCancer #TripleNegativeBreastCancer #MountSinaiMedicalCenter

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