- 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)
- TNBC is more commonly diagnosed in women younger than 40 years:
- TNBC accounts for approximately 15% of breast cancers diagnosed worldwide:
- 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
- Up to 20% of patients with TNBC harbor a breast cancer susceptibility gene (BRCA) mutation:
- 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
- However, African American women can certainly have ER-positive and / or HER2-positive disease:
- Several population-based studies have found that African American women have a higher risk of TNBC compared with White women:
- 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
- Premenopausal women can frequently have ER-positive and / or HER2-positive disease:
- 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
- While breastfeeding and parity may be associated with lower risks:
- Studies have suggested relationships between other factors such as obesity and a young age of first pregnancy with an increased risk of TNBC:
- Positive BRCA mutation status:
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Rodrigo Arrangoiz MS, MD, FACS, FSSO 