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“Everybody is nervous about triple-negative breast cancer,” says Dr. Marleen Meyers, a medical oncologist at NYU Perlmutter Cancer Center. “Of all the breast cancers, it’s considered the most aggressive and the most difficult to treat.”

RELATED: Triple-Negative Breast Cancer More Deadly Among Black Women

Triple-negative breast cancer means that your cancer is not being fueled by any of the three main types of receptors: estrogen, progesterone, or the HER2 protein. Because of this, the cancer won’t respond to certain targeted therapies, including hormone therapy or HER2-targeted agents like Herceptin.

Chemotherapy is typically the treatment, and there are several options.

“Any triple‑negative cancer that’s over half a centimeter or involves the lymph nodes needs chemotherapy,” explains medical oncologist Dr. Julie Nangia.

Treatment typically involves two classes of chemotherapy, taxanes and anthracyclines, often given before surgery to shrink the tumor.

For years, chemotherapy was the backbone of treatment. But now, following the FDA’s approval of datopotamab deruxtecan (Datroway), patients who are not candidates for surgery or immunotherapy have a new option.

The approval is based on the TROPION‑Breast02 Phase 3 clinical trial, which showed Datroway extended survival by about five months compared with standard chemotherapy.

Datroway is an antibody‑drug conjugate, which is a targeted therapy that delivers chemotherapy directly to cancer cells.

WATCH: A Treatment Option for Triple-Negative Breast Cancer Patients

“This is a huge win for our metastatic triple‑negative breast cancer patients,” says Dr. Matt Kurian of St. Elizabeth’s Yung Family Cancer Center.

Dr. Sarah Premji of the Sarah Cannon Research Institute adds, “We’re seeing longer time before the cancer worsens, longer overall survival, and better patient‑reported outcomes. That’s a win.”

Parks admits the coming year “is going to be difficult,” with nonstop tests, appointments, and “mental rollercoasters.” But she says she feels confident in her treatment plan and is at peace knowing she will come out the other side.

Newer Triple-Negative Breast Cancer Treatments

People with metastatic triple-negative breast cancer now have a new first-line treatment option with Sacituzumab Govitecan (Trodelvy), either alone or combined with Keytruda, depending on their cancer.

Two phase 3 studies, ASCENT-03 and ASCENT-04/KEYNOTE-D19, have helped doctors understand whether a drug called Trodelvy should be used earlier in treatment for certain patients with advanced triple-negative breast cancer.

ASCENT-03 studied Trodelvy compared with chemotherapy in patients with previously untreated, locally advanced inoperable or metastatic triple-negative breast cancer who were not candidates for PD-1/PD-L1 immunotherapy. ASCENT-04/KEYNOTE-D19 studied Trodelvy plus pembrolizumab, an immunotherapy drug also known as Keytruda, compared with chemotherapy plus pembrolizumab in patients whose tumors expressed PD-L1.

Dr. Sara Tolaney, a breast medical oncologist at Dana-Farber Cancer Institute, told SurvivorNet that the newer data strengthen the case for using this type of treatment earlier.

“I think the data that we’re seeing really continued to confirm that Trodelvy should be a first-line standard of care option for our patients with metastatic triple-negative breast cancer,” Dr. Tolaney said.

Datopotamab Deruxtecan (Datroway)

Datroway’s approval is for patients with a type of breast cancer known as triple-negative breast cancer who are not good candidates for surgery (unresectable) or immunotherapy, a treatment that uses the body’s reengineered immune cells to fight the cancer.

“My hope is that this will allow more options for patients and replace our traditional chemotherapies that did not work as effectively in the past,” Dr. Kurian said.

During clinical trials, Datroway extended survival by about 5 months compared with standard chemotherapy.

“This is a meaningful step forward,” Dr. Premji said.

Genetic Testing to Gauge Triple-Negative Breast Cancer Risk

A research team at Mayo Clinic has identified a group of genes linked to an increased risk of developing triple-negative breast cancer (TNBC)—a discovery that could pave the way for improved screening and earlier detection of this aggressive disease.

“Everybody is nervous about triple-negative breast cancer,” says Dr. Marleen Meyers, a medical oncologist at NYU Perlmutter Cancer Center. “Of all the breast cancers, it’s considered the most aggressive and the most difficult to treat.”

WATCH: Genetic Tests for Triple-Negative Breast Cancer Risk

In the 2018 study involving more than 10,000 people diagnosed with TNBC, researchers found that mutations in five genes—BARD1, BRCA1, BRCA2, PALB2, and RAD51D—were associated with a significantly higher risk of developing the disease. Among Caucasian participants, these mutations also correlated with a greater than 20% lifetime risk for breast cancer overall. Similar patterns were observed in African-American participants.

While this genetic insight is promising, experts caution that only about 10% of breast cancers are hereditary. “Most women who undergo genetic testing won’t test positive for these mutations,” explains Dr. Ophira Ginsburg, Director of the High-Risk Cancer Program at NYU Langone’s Perlmutter Cancer Center.

WATCH: Breast Cancer: Molecular Testing Terms To Know

That’s why genetic testing is typically recommended for women with a strong family history—especially those with relatives who’ve had breast or ovarian cancer, rare cancers, or cancers linked to Lynch Syndrome, a hereditary condition that increases cancer risk. Early identification in these high-risk groups can be critical for prevention and timely treatment.

Breast Cancer Symptoms & Self-Exams

Women are encouraged to do regular self-exams to become familiar with how their breasts feel normally, so when something unusual, like a lump, does form, it can be easily detected. A self-exam includes pressing your fingertips along your breast in a circular motion.

For some women, that means going to their doctor and walking through what a self-breast exam looks like, so they know what normal breast tissue feels like, so if they do feel something abnormal, whether it’s a lump or discharge from the nipple, they know what to ask and what to look for.

Below are common symptoms to look out for:

• New lump in the breast or underarm (armpit)
• Any change in the size or shape of the breast
• Swelling of all or part of the breast
• Skin dimpling or peeling
• Breast or nipple pain
• Nipple turning inward
• Redness or scaliness of the breast or nipple skin
• Nipple discharge (not associated with breastfeeding

When to Screen for Breast Cancer

The medical community has a broad consensus that women should have annual mammograms between the ages of 45 and 54. However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) is saying that women should now start getting mammograms every other year at the age of 40, suggesting that this lowered age for breast cancer screening could save 19% more lives.

The American Cancer Society recommends getting a mammogram every other year for women 55 and older. However, women in this age group who want added reassurance can still get annual mammograms.

WATCH: When you’re getting a mammogram, ask about dense breasts.

Women with a strong family history of breast cancer, a genetic mutation known to increase the risk of breast cancer, such as a BRCA gene mutation, or a medical history, including chest radiation therapy before the age of 30, are considered at higher risk for breast cancer.

Experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk of developing breast cancer, you should begin screening earlier.

Questions For Your Doctor

• What stage is my cancer, and how does that affect my treatment plan?
• What are the recommended chemotherapy options for triple-negative breast cancer, and what side effects should I expect?
• Are there any clinical trials or emerging treatments I should consider?
• How will treatment affect my fertility, physical activity, or ability to work?
• What follow-up care and monitoring will I need after treatment ends?

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