Triple-negative breast cancer: current treatment strategies and factors of negative prognosis

Abstract

Breast cancer is the most common cancer in women and the most common cause of death in working-age women. According to the results of immunohistochemical studies, 10-20% of cases revealed a triple-negative type of breast cancer. This subtype is characterized by significant proliferative activity and growth rate, aggressive clinical course, and early metastasis. This leads to a suspicious prognosis and, accordingly, encourages an increase of surgical treatment radicalism and aggressive systemic treatment. This review briefly analyzes existing treatment strategies for triple-negative breast cancer with a focus on surgical treatment. Surgical treatment is an integral part of complex therapy. Currently, the attention of researchers is focused not only on the radicalism of the operation, ensuring long-term survival, but also on achieving a good cosmetic result that determines the quality of life of patients. In this aspect, organ-preserving and prosthetic methods of operations are promising, the feasibility and effectiveness of which are being discussed. The relevance of choosing the optimal method of operation is evidenced by the lack of generally accepted approaches based on informative markers for the prognosis of the course of the disease. Therefore, the choice of the optimal method of surgical treatment taking into account the individual characteristics of the patient and the tumor, indications for chemotherapy, and radiation therapy remains an unresolved issue and requires further research.

Keywords: ACT – adjuvant chemotherapy; AR – androgen receptors; ART – adjuvant radiation therapy; BC – breast cancer; BMI – body mass index; CT– chemotherapy; ER – estrogen receptors; IHC – immunohistochemical; LN – lymph node; NACT – neoadjuvant chemotherapy; RM – radical mastectomy; TNBC – triple-negative breast cancer; breast cancer; late result; organ-preserving operations; radical mastectomy; surgical treatment; triple-negative type.