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Breast Cancer Triple Negative Prognosis

What Percentage Of Breast Cancer Is Triple Negative

Risk factors for developing triple-negative breast cancer

Triple-negative breast cancer accounts for about 10-15% of all breast cancers. The term triple-negative breast cancer refers to the fact that the cancer cells dont have estrogen or progesterone receptors and also dont make too much of the protein called HER2. These cancers tend to be more common in women younger than age 40, who are African American, or who have a BRCA1 mutation.

What Is A 5

A relative survival rate compares women with the same type and stage of breast cancer to women in the overall population. For example, if the 5-year relative survival rate for a specific stage of breast cancer is 90%, it means that women who have that cancer are, on average, about 90% as likely as women who dont have that cancer to live for at least 5 years after being diagnosed.

Can Breast Cancer Patients Get A Moon Shot

Through our Breast Cancer Moon Shot, were looking at ways to personalize TNBC treatment more. For newly diagnosed patients whose cancer hasnt metastas ized, we plan to use genomic testing of the tumor. This will allow us to find out who will respond well to treatment and who wont. If we can tell the patients not going to respond to standard chemo, we can switch the patient to a novel treatment protocol before surgery. That way, we can get a better response before the surgery. This will be a game-changer if it works.

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Targeting Tumor Microenvironment For Tnbc Therapy

The development of TNBC has strong association with the physiological state of TME. TNBC has been characterized with unique TME and is different from other subtypes . TME has strong association with induction of angiogenesis, proliferation, apoptosis inhibition, suppression of immune system and resistance to drugs . The exosomes function as promising nanovesicles that directs TME orchestration by communicating cells within TME milieu . The different components of TME particularly the soluble factors, transformed extracellular matrix, immune suppressive cells, re-programmed fibroblasts and epigenetic modifications altogether helps in TNBC progression and metastasis . Hence, TME is regarded as a good therapeutic target. The different TME targets for therapeutic intervention is schematically presented in Figure 5.

FIGURE 5. Different TME targets for therapeutic intervention.

When Should I Go To The Emergency Room

Triple Negative Breast Cancer: Prognosis For Triple Negative Breast Cancer

You might also have unusually strong side effects from your cancer treatment. While your healthcare provider likely gave you medication to help control your side effects, you should go to the emergency room if your side effects continue despite medication.

Many cancer treatments affect your immune system, increasing the chance you will develop infections. Symptoms that might require an emergency room visit during treatment are:

  • Fever of 100.5 and above.
  • Persistent nausea and vomiting.

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What Makes It Triple

Triple-negative refers to the fact that this type of breast cancer is not fueled by certain substances such as hormones or growth proteins in the body.

Estrogen and progesterone receptors are found in some types of breast cancer. Triple-negative breast cancer doesnt show hormone receptors on the cancer cells and most likely wont respond to breast cancer treatments using hormone blockers to slow the growth of cancer cells like many other types of breast cancer.

Another feature important for classifying breast cancer is the presence of the HER2 protein. Healthy cells have some HER2, but about 20% of breast cancer diagnoses have an excess of this protein, signaling the cells to grow and divide rapidly. Cancers that test positive for an excess of HER2 protein may be effectively treated using targeted therapies that disrupt the function and growth of HER2. Triple-negative cancer patients do not have a significant amount of HER2 protein fueling the cancer.

What Is The Estrogen Receptor And How Is It Linked To Breast Cancer

On the surface of cancer cells is a specialized receptor called estrogen, which acts as a hand, consuming hormones from the body and using them as fuel to thrive. TNBC can survive without these receptors because it has a whole new survival mechanism. Estrogen receptor and progesterone receptor are predictive markers for invasive breast cancer, especially within five years of initial diagnosis.

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What Is The Treatment For Triple

Chemotherapy.Chemotherapy is almost always called for, Sun says. Chemo can downstage tumors . While Sun says the chemotherapy for triple-negative breast cancer can be intense, she adds that regimen can be tailored to the individual and adjusted for older or frailer patients.

In those cases where we get complete response, we know we gave you the right medicine and your prognosis is good, Sun says.

Surgery can remove more of the tumor. Surgery for triple-negative breast cancer does not always have to be a mastectomy, Sun says. Effective chemotherapy done first opens up the possibility of less-invasive surgical options that are less of an ordeal for the patient. If the tumor is small enough after chemo, outpatient procedures or a lumpectomy may be possible.

Surgical samples of the cancerous tissues taken from surgery can provide more information on the cancer and how it is behaving so chemotherapy can be tailored accordingly.

Radiation therapy involves the use beams of radiation to destroy cancer cells, using various techniques to prevent damage to healthy surrounding tissue.

Medical treatments are being tested on triple-negative breast tumors in clinical trials.

Immunotherapy and PARP inhibitors are very exciting and theres lots of research going on, including here at Johns Hopkins, Sun says.

Research Into Triple Negative Early Breast Cancer

New Treatment Shows Promise For Triple-Negative Breast Cancer Patients

Research has identified a number of different sub-types of triple negative breast cancer, providing opportunities for new treatments that target these sub-types to be developed.

Targeted treatments are currently being investigated using PARP inhibitors for BRCA related cancers, and PI3K/AKT inhibitors and immunotherapy drugs for other sub-types.

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Symptoms Of Triple Negative Breast Cancer

The symptoms of triple negative breast cancer are similar to other breast cancer types.

Symptoms can include:

  • a new lump or thickening in your breast or armpit
  • a change in size, shape or feel of your breast
  • skin changes in the breast such as puckering, dimpling, a rash or redness of the skin
  • fluid leaking from the nipple in a woman who isnt pregnant or breast feeding
  • changes in the position of nipple

Make an appointment to see your GP if you notice anything different or unusual about the look and feel of your breasts.

Signs And Symptoms To Know

The signs and symptoms of triple-negative breast cancer are the same as with all breast cancers. It may present as a lump, which is more commonly hard, painless and irregular, but can also be soft, round and painful. Other signs include:

  • Breast swelling
  • A nipple that turns inward
  • Skin changes on the breast or nipple, including redness, dryness, thickening or flaking

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Vascular Endothelial Growth Factors

Vascular endothelial growth factors are expressed in 3060% of TNBC . VEGF promotes angiogenesis by stimulating endothelial cell proliferation and migration, inhibiting endothelial cell apoptosis, and supporting newly formed blood vessels . One study found that patients with TNBC had significantly higher rates of intra-tumoral VEGF compared with non-TNBC patients . In this study, patients with TNBC had shorter recurrence-free survival, BC corrected survival, and OS.

Given that angiogenesis is thought to be a key component driving tumor cell proliferation and survival, bevacizumab, a monoclonal antibody that binds VEGF-A, has been studied as a target for the treatment of TNBC . In the neoadjuvant setting, the addition of bevacizumab was found to increase pCR however, no improvement in DFS or OS was seen in the adjuvant setting . The addition of bevacizumab was also evaluated in several phase III studies to first- or second-line chemotherapy treatment in metastatic BC . Each of these studies demonstrated improved PFS with the addition of bevacizumab however, there was no difference in OS.

Can You Predict Cancer Survival

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Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. These statistics can be confusing and may lead you to have more questions. Talk with your doctor about how these numbers may apply to you, as he or she is familiar with your situation.

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History Of Breast Diseases

The initial symptoms of cancer are cancerous lesions in the breast . Regarding the family history of disease, the other risk factors associated with breast cancer are in-situ carcinoma, atypical hyperplasia, proliferative lesions and non-proliferative lesions . Breast cancer risks include a family history of breast cancer and benign lesions .

Causes Of Triple Negative Breast Cancer

The risk factors for triple negative breast cancer are not clear. Some breast cancers depend on hormones to grow. These can be linked with risk factors to do with hormones and having children. But triple negative breast cancer does not seem to share these risk factors.

Most women with triple negative breast cancer have no strong history of breast cancer in their family . But some women with triple negative breast cancer have an altered BRCA1 gene. This will have been inherited from a parent.

An altered BRCA 1 gene can cause breast cancer to run in families. Most breast cancers caused by BRCA1 are triple negative.

If you have triple negative breast cancer, you may be offered genetic testing. This is even if you do not have a family history of breast cancer. Your cancer doctor or breast care nurse can explain more about this to you.

The tests are the same as for any type of breast cancer. You usually have a:

  • Mammogram

    A mammogram is an x-ray of the breast.

  • Ultrasound scan

    An ultrasound scan uses sound waves to produce a picture of the breast tissue and the lymph nodes in the armpit.

  • Breast biopsy

    When you have a breast biopsy, your cancer doctor or breast care nurse takes small samples of cells or tissue from your breast. The samples are looked at under a microscope to check for cancer cells. They also do other tests to find out if the cells have receptors for hormones, or for HER2.

See also

The staging and grading is the same as for other types of breast cancer.

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New Treatments Needed For Advanced Triple

Triple-negative breast cancer tends to be more aggressive, harder to treat, and more likely to recur than other forms of the disease, such as hormone receptorpositive or HER2-positive breast cancers.

Conventional chemotherapy drugs have not been effective against triple-negative breast cancer, and new treatment options are needed, said Jung-Min Lee, M.D., of the Womens Malignancies Branch in NCIs Center for Cancer Research.

In the KEYNOTE-355 trial, 847 patients with advanced triple-negative breast cancer were randomly assigned to receive chemotherapy plus placebo or chemotherapy plus pembrolizumab.

The study assessed the amount of time before the disease worsened and overall survival in all patients, in those with PD-L1 combined positive scores of 1 or more, and in those with combined positive scores of 10 or more. The trial was funded by Merck, the manufacturer of pembrolizumab.

The PD-L1 combined positive score is essentially a measure of the extent to which cells in a tumor produce PD-L1, the immune checkpoint protein that pembrolizumab targets. By blocking immune checkpoints, pembrolizumab and other immune checkpoint inhibitors unleash the immune system against cancer cells.

The incidence of treatment-related side effects, including serious side effects, was similar between the two groups of patients in the study.

What You Need To Know

Triple Negative Breast Cancer
  • Triple-negative breast cancer accounts for about 10% to 20% of all breast cancer cases.
  • Every cancer diagnosis is unique, but in general, triple-negative breast cancer is a more aggressive type of tumor with a faster growth rate, higher risk of metastasis and recurrence risk. Therefore, it often requires chemotherapy as part of the treatment.
  • Surgery is also an important part of treatment, but if a tumor is small and localized, mastectomy may not be necessary. Chemotherapy can shrink triple-negative breast tumors, and patients can become candidates for less-extensive surgery.
  • Triple-negative cancers are more common in patients with hereditary genetic mutations, and genetic counseling and testing should be considered.

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What Happens If Breast Cancer Spreads To The Brain

The brain is a common site for breast cancer to metastasize, or spread, to. Brain metastasis can lead to symptoms like headache, weakness in your limbs, and seizures. Imaging with a head MRI is the main way that doctors diagnose brain metastases. Treatment approaches may be local, systemic, or a combination of both.

Poor Survival In Triple Negative Breast Cancer

ABSTRACT

Material and methods.Results.

REFERENCES

  • INEGI. Available at: http://www.inegi.org.mx/saladeprensa/aproposito/ 2015/mama0.pdf.

  • Kumar P, Aggarwal R. An overview of triple-negative breast cancer. Arch Gynecol Obstet 2016 293: 247-69.

  • Burnett JP, Korkaya H, Ouzounova MD, Jiang H, Conley SJ, Newman BW, et al. Trastuzumab resistance induces EMT to transform HER2 PTEN to a triple negative breast cancer that requires unique treatment options. Sci Rep 2015 5: 15821.

  • Kaminska M, Ciszewski T, Lopacka-Szatan K, Miotla P, Staroslawska E. Breast cancer risk factors. Prz Menopauzalny 2015 14: 196-202.

  • Lara-Medina F, Pérez-Sánchez V, Saavedra-Pérez D, Blake-Cerda M, Arce C, Motola-Kuba D, et al. Triple-negative breast cancer in Hispanic patients: high prevalence, poor prognosis, and association with menopausal status, body mass index, and parity. Cancer 2011 117: 3658-69.

  • Qiu J, Xue X, Hu C, Xu H, Kou D, Li R, et al. Comparison of clinicopathological features and prognosis in triple-negative and non-triple negative breast cancer. J Cancer 2016 7: 167-73.

  • Lehmann BD, Bauer JA, Chen X, Sanders ME, Chakravarthy AB, Shyr Y, et al. Identification of human triple-negative breast cancer subtypes and preclinical models for selectio

  • Trivers KF, Lund MJ, Porter PL, Liff JM, Flagg EW, Coates RJ, et al. The epidemiology of triple-negative breast cancer, including race. Cancer Causes Control 2009 20: 1071-82.

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    What Is The Survival Rate For Tnbc

    For cancers with regional spread to nearby structures or lymph nodes, the 5-year survival rate is 65 percent for TNBC compared with 86 percent for all breast cancers. A persons survival rate depends on many factors, including the stage and grade of the cancer as well as your response to treatment. As with all cancers, its imperative

    Does Fructose Cause Breast Cancer

    Histologic heterogeneity of triple negative breast cancer: A National ...

    Fructose has also been shown to induce changes in triple negative breast cancer cells that may increase their aggressiveness, suggesting that patients should avoid concentrated sources such as agave nectar and processed foods sweetened with fructose, including beverages. Exposure to bisphenol A has also been shown to increase proliferation of triple negative breast cancer cells.

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    What Is The Immunotherapy For Breast Cancer

    The immunotherapy drugs called checkpoint inhibitors have led to a significant improvement in survival rates for lung cancer and melanoma. In March of 2019 the first immunotherapy drug, Tecentriq was approved for triple-negative breast cancer that is metastatic . As noted above, there are at least a few people who have had excellent responses in clinical trials prior to approval.

    Can You Take A Supplement For Triple Negative Breast Cancer

    There is no supplement or combination of supplements that has been proven to reliably reduce the risk of triple negative breast cancer recurrence in women. When a beneficial micronutrient is administered at low doses by consuming food, it is likely to have subtle chemopreventive effects, whereas when the same micronutrient is administered at a high dose in a supplement, it is more likely to have pharmacological effects, with mostly unknown results. It is best to obtain beneficial compounds by consuming food, if possible. Supplements should be used if medically necessary or to make up for deficiencies that are difficult to correct through diet.

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    What Is The Recurrence Rate Of Triple

    A 2019 study found that roughly 40% of people with stage 1 to stage 3 TNBC will see their cancer return after standard treatment. The remaining 60% will have long-term survival without recurrence.

    The outcomes of treatment vary. About 42% of those with this form of cancer will have a rapid relapse after standard treatment. This recurrence typically occurs within the first 23 years following the initial diagnosis.

    It is not currently possible to predict who will experience a relapse in their cancer, even if they have had intensive chemotherapy.

    On average,

    Triple-negative breast cancer can recur in various areas of the body and at local, regional, and distant levels:

    • Local means that the cancer remains in the breast and has not spread.
    • Regional is when the cancer spreads from the breast to lymph nodes and other structures located nearby.
    • Distant refers to cancer that has spread far from the breast to other organs, such as the liver or lungs.

    A 2017 study examined the patterns of recurrence among 1,930 people with TNBC. The researchers divided the patients into two age groups: 15% were younger than 40 years at the time of their diagnosis, and 85% were 40 years or older.

    The researchers found only a small difference between the two groups in terms of recurrence of the cancer on the local level: 6% of those under 40 versus 5% of those aged 40 or above.

    The same study found that the rate of regional recurrence was 2% for both groups.

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