This is one of those $64,000 questions that we don't know the answer to. It is interesting that if one looks at women in Nigeria, a high percentage of women there have triple-negative breast cancers. So this may indeed be more than just environment; there may be an important genetic component although we have not identified what that is at present. Indeed, the only genetic factor we have identified so far for triple-negative breast cancers (and only in a small percentage) is the BRCA1 mutation.
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