In 2020, Jonell Deshotel was balancing school, motherhood and the challenges of the COVID-19 pandemic when she noticed a lump on the side of her breast. After years of watching her own mother’s experience with breast cancer, she knew she needed to act quickly.

She went to see her doctor and received news that changed everything for her: Deshotel was diagnosed with triple-negative breast cancer or TNBC.  

“My mom was diagnosed with breast cancer at the age of 36. I remember her saying, ‘I have breast cancer, but I will get through this, and we will get through this together.’ Once I received my own diagnosis, I knew that I wanted to embody that strength with my own daughter.”

• Jonell Deshotel

There are many different types of breast cancer — defined by where it starts in the breast, how much it has grown and how it behaves. One of the more aggressive types is TNBC. 

What is TNBC? 

Breast cancer is the most commonly diagnosed cancer among women in the U.S. But not all breast cancers are the same.

Breast cancer tumors may be tested for three receptors, or proteins, that can influence tumor behavior and may help guide treatment decisions. A TNBC diagnosis is made when the tumor tests negative for all three receptors — estrogen, progesterone and HER2 (Human Epidermal Growth Factor Receptor 2). HER2 is a protein that tells breast cells to grow.

TNBC differs from other types of invasive breast cancer as it tends to grow and spread faster, often with a worse prognosis for patients. It also has a high likelihood of recurrence.  

Who’s at risk of developing TNBC? 

Approximately 1 in 8 women in the U.S. will be diagnosed with breast cancer at some time in their life, and roughly 10-15% of these diagnoses are TNBC.

While TNBC can affect anyone, it’s more common in people who are younger than age 40, Black or have certain gene mutations.

Factors that make someone more likely to be diagnosed with TNBC include:

• Sex: People assigned female at birth are at higher risk for TNBC compared to people assigned male at birth.
• Race/ethnicity: TNBC disproportionately affects Black women compared to white women. Nearly 20% of breast cancers diagnosed in Black women are TNBC.
• Age: TNBC is more common in women younger than 40.
• Genetic mutations: Mutations in certain genes are associated with TNBC.

What are the signs and symptoms of TNBC?

TNBC may have similar signs and symptoms to other common types of breast cancer, though some people with TNBC may have no symptoms at all.

Possible signs and symptoms of breast cancer may include:

• A new breast lump or mass
• Swelling of all or part of a breast
• Skin dimpling
• Breast or nipple pain
• Nipple retraction
• Nipple or breast skin that’s red, dry, flaking or thickened
• Nipple discharge
• Swollen lymph nodes under the arm or near the collarbone

Treatment, support and community after a TNBC diagnosis

Deshotel underwent more than 10 rounds of treatment along with intensive surgery.

Still, she says support made all the difference. “When I was first diagnosed, it was so important for me to do the research to find women who were young, who were of color and that (were) going through the same experiences that I might have been going through,” she said.

That search led her to a community she describes as her village. “I would not be talking to you today without our village. My friends would take me to my chemotherapy treatments, prepare food for me, and stayed by my side,” she said.

Their care and support helped Deshotel through her hardest days. It also shaped how she sees her future as a mother and advocate, because of her family’s multi-generational journey with breast cancer.

Today, she focuses on being healthy to be there for her daughters Payton and Journie Adele, named after her mother and their journeys with breast cancer.

Stories like Deshotel’s remind us why patients are at the heart of our efforts in cancer care. Her journey is a reminder to listen to your body, get checked when something feels wrong and lean on the people around you.

“One of my favorite gifts that I received from my village was my signature umbrella. It’s a symbol of hope, joy, celebration with resilience,” she said. “Together, we are strong.”

Health awareness

Know your risk for bladder cancer — and don’t ignore the signs

Awareness gaps can impact recognition and diagnosis of bladder cancer

May 4, 2026

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When bladder cancer is found early, before it spreads beyond the bladder, patients have more treatment options. That’s why we’re focused on getting to the heart of what people need to hear. Especially those at risk of bladder cancer.

“Too many patients don’t recognize the warning signs for bladder cancer or feel comfortable talking about them. Breaking that silence is just as important as developing new treatments — because awareness is the first step toward helping to save lives.”

• Dr. M. Catherine Pietanza
  Vice president, global clinical development, Merck Research Laboratories
  

Bladder cancer risk is not largely based on family genetics

Some people inherit certain genes from their parents that can increase their risk of bladder cancer. But bladder cancer doesn’t often run in families, and inherited genes are not thought to be a major cause of this disease. Most gene changes linked to bladder cancer develop during a person’s life, rather than having been inherited.

Don’t ignore blood in your urine or changes in your urinary habits — talk to your doctor right away

Bladder cancer can often be found early because it can cause symptoms that lead a person to see a healthcare provider. Blood in your urine is usually the first sign, before pain or other symptoms appear. In most cases, blood in the urine doesn’t mean you have bladder cancer, but it’s important to see your doctor to rule out other causes like a bladder or kidney stone, an infection or kidney disease.

Be aware of your risks for bladder cancer

Knowing and avoiding the risk factors that are within your control may help lower your risk of bladder cancer. Among risk factors for bladder cancer, smoking is highest on the list — causing about half of all bladder cancers. Exposure to other chemicals can also raise risk over time, including industrial chemicals used in making rubber, leather, textiles and paint products, as well as in printing companies. People who work as painters, firefighters, hairdressers and truck drivers can similarly be exposed to certain chemicals and fumes that might increase their risk of bladder cancer.

Some risk factors can’t be controlled, but you may be able to help lower your risk of bladder cancer by not smoking, practicing good work safety practices, limiting exposure to toxins (like arsenic), staying well hydrated and eating plenty of fruits and vegetables.

Know your individual risk factors and talk to your doctor to see if you are at high risk for bladder cancer. If you have risk factors that strongly increase your risk of bladder cancer, and you’ve noticed certain changes in your urine, your doctor may recommend tests to look for bladder cancer.

“Our goal is to reach patients sooner — before the disease advances, before options narrow.”

• Dr. M. Catherine Pietanza

When bladder cancer is found early, there are more treatment options. In later stages of bladder cancer, removing the bladder may need to be part of the treatment plan.

This is where our focus begins: breaking the silence and encouraging people to talk to their doctor right away if they notice any possible symptoms.