KUALA LUMPUR — Women below the age of 40 need more awareness about triple-negative breast cancer (TNBC), as the more aggressive disease disproportionately affects females in this age group, an oncologist said.
Dr Hafizah Zaharah Ahmad, consultant oncologist at Sunway Medical Centre Velocity (SMCV) told Bernama in an interview that young women must understand the risk factors.
“Being young young is no guarantee against breast cancer. TNBC is often diagnosed in women under 40.
“Additionally, sudden changes during pregnancy may be misinterpreted as pregnancy side effects, but any abnormal or suspicious changes in the breast should still be evaluated by a doctor,” she told the national news agency.
As such, early detection, such as observing any changes in the body and immediately consulting a surgeon if a lump in the breast grows, is important, said the oncologist, who treats between two to four new cases, including follow-up cases of TNBC cancer patients, every month.
Citing figures, she said that in Malaysia, approximately 10% to 15% of all breast cancer cases involve TNBC.
Compared to regular breast cancer, TNBC is an aggressive form of cancer that grows rapidly, is more likely to have spread by the time it is detected, and has a higher risk of recurrence after treatment, she explained.
It is called triple-negative because it lacks the three common receptors typically associated with most breast cancers.
These three receptors, said Hafizah, are the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2).
The absence of the three receptors makes TNBC different from regular breast cancers in terms of biological characteristics and response to treatment.
“Triple-negative breast cancer lacks all three types of receptors, meaning it is estrogen receptor-negative (ER-), progesterone receptor-negative (PR-), and HER2 receptor-negative (HER2-).
“The absence of these receptors makes it more challenging to treat, as drugs targeting hormones (such as tamoxifen or aromatase inhibitors) or therapies targeting HER2 (like Herceptin) are ineffective against TNBC,” she explained.
“Triple-negative breast cancer is also more prone to metastasize, spreading to other parts of the body, especially to areas like the brain and lungs,” she said.
She also noted that TNBC is more common among younger women, especially those with BRCA1 (breast cancer gene 1) genetic mutations.
Because of limited treatment options, chemotherapy is one of the few standard treatment options available for TNBC, Hafizah said.
However, the oncologist noted that triple-negative breast cancer can respond to chemotherapy, along with newer treatments such as immunotherapy.
Other typical treatments for TNBC include surgery, radiation therapy and targeted therapy.
Recognising symptoms
To recognise the signs and symptoms of TNBC, Hafizah advised paying attention to several key indicators, including a hard lump that remains stationary when touched.
“This is the most common sign and may be felt in the breast or under the armpit. A change in the size or shape of one of the breasts is among the signs of breast cancer. Other signs include abnormal discharge from the nipple or an inverted nipple.
“The skin of the breast may appear dimpled, wrinkled, or take on the texture of an orange peel (known as peau d’orange). It may also become reddish or show signs of inflammation, even without pain,” she added.
She added that while early-stage breast cancer is usually painless, some women with TNBC may experience discomfort or pain in the breast or armpit area.
Pay attention to any lumps, changes in shape, skin colour, or unusual nipple retraction. Although TNBC can develop quickly, regular examinations allow for early detection. Never ignore symptoms, as young women often dismiss signs like hard lumps or breast changes, assuming breast cancer only affects older women,” she said.
TNBC remains an active area of research, with scientists working to find more effective treatments and better understand why it disproportionately affects younger women.
Regardless of age, all women should stay vigilant and pay attention for signs, besides maintaining a healthy lifestyle, Hafizah added.
Meanwhile, Lim Kim Foong, president of the Breast Cancer Welfare Association Malaysia (BCWA), said people mostly know about breast cancer in general but are unaware that there are different subtypes of breast cancer, such as TNBC.
“Information and awareness about triple-negative breast cancer needs to be increased continuously so that more people are aware. This is important because each patient’s journey and treatment are different, (even when it comes to side effects),” she told Bernama.
Lim, who was diagnosed with stage three TNBC at the age of 39, recounted being in deep sadness and denial over her illness, particularly because she had no family history of breast cancer.
After a seven-month treatment course of lumpectomy, chemotherapy, and radiotherapy, she has been in remission for four years.
Women who have bene diagnosed must remember they are not alone in their struggle, she said.
“There are many many patient support groups, such as BCWA, that provide emotional support, counselling, rehabilitation activities, and accurate information to help guide patients on their cancer journey. Don’t stay in sorrow.” – October 9, 2024
