Manzano A, Hofmarcher T

Improving the care of women with triple-negative breast cancer

Triple-negative breast cancer (TNBC) is a subtype of breast cancer that occurs in about 10–20% of newly diagnosed breast cancer cases but is responsible for 30–40% of all breast cancer deaths.

The survival rate of TNBC is the lowest of all subtypes of breast cancer. e.g., the five-year relative survival rate of TNBC is around 77% compared to 91% in all cases of breast cancer in the United States. TNBC has a negative impact on all aspects of patients’ quality of life, including psychological distress, decline in physical functioning, body image, infertility, job loss, and financial hardship.

TNBC carries a significant economic burden, with substantially greater costs associated with increasing disease severity. Medical costs of treating metastatic patients (stage IV) are around 3–5 times higher than of early-stage patients (stage I–III) in high-income countries. Productivity losses of the economy from sick leave and premature mortality also increase with disease stage.

The low survival rate of TNBC compared to other subtypes of breast cancer indicates a lack of effective treatments. Medical treatment options have historically been limited to chemotherapy and remained unchanged since the 1990s. Recent advances in immunotherapy and BRCA-targeted therapy are currently changing the standard of care by replacing or complementing chemotherapy.

High-income countries in Europe and Northern America face many challenges in all areas of TNBC care – detection, diagnostics, and treatment. Improving the care through better early detection, diagnostics, and treatment can positively affect the survival of patients and their quality of life. This would help to reduce the future disease burden of TNBC.

This report identified a comprehensive set of recommendations to improve TNBC care. These recommendations fall into three broad areas:
• Raise health literacy to facilitate early detection
• Ensure optimal care delivery
• Consider adoption of innovation in clinical practice

IHE Report 2023:2, IHE: Lund, Sweden