What should you know about TNBC and BRCA1?

Triple-negative breast cancer, or TNBC, lacks three commonly measured receptors: oestrogen, progesterone, and HER2. BRCA1 is a gene involved in repairing damaged DNA. A BRCA1 change may be inherited, or it may be present only in tumour cells. These are different findings and require different tests.

A BRCA1 result does not establish why a particular person developed cancer, and it does not predict an individual outcome by itself. BRCA-related cancer risk can involve breast cancer and may also be relevant to ovarian, pancreatic, or prostate cancer in a family. Genetic counselling can help explain what a result may mean for relatives.

Ask whether testing is being done on the tumour, a blood or saliva sample, or both. Tumour testing can help identify treatment-relevant changes, while inherited testing addresses family risk. A genetic counsellor can discuss consent, possible results, privacy, and how relatives might receive information.

Your breast cancer team may discuss surgery, medicines, imaging, and follow-up according to stage, pathology, previous treatment, and test results. Breast MRI may be considered in selected risk-assessment plans. Risk-reducing options, including removal of an ovary, are personal decisions that require discussion of benefits, effects on fertility, hormones, and timing.

Contact your cancer team promptly for a new or worsening breast or wound change, fever, uncontrolled pain, shortness of breath, or a reaction after treatment. Seek urgent help for severe breathing difficulty, chest pain, fainting, sudden weakness, or heavy bleeding. A BRCA result itself is not an emergency, but receiving it can feel difficult; ask for support while decisions are being made.

Ask whether the BRCA1 finding is inherited or limited to the tumour, what the laboratory classified it as, and whether genetic counselling is available. Ask how the result affects treatment choices, screening for other cancers, relatives' options, reproductive planning, and the timing of any risk-reducing surgery.