How Bad Is Triple Negative Breast Cancer

Can You Be Cured From Triple Negative Breast Cancer

If the cancer has not spread to different areas of the body, surgery is an option for treatment in the early stages. In order to shrink a large tumor, the patient can be treated with chemotherapy until they are eligible for surgery. Treatment success for patients with triple negative breast cancer will vary for each patient because each cancer case is different. Thus, there is no known absolute cure for triple negative breast cancer.

Survival Rates For Triple

Triple-negative breast cancer is considered an aggressive cancer because it grows quickly, is more likely to have spread at the time its found and is more likely to come back after treatment than other types of breast cancer. The outlook is generally not as good as it is for other types of breast cancer.

Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time after they were diagnosed. They cant tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful.

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.

Outlook For People With Stage 3 Breast Cancer

Its natural to want to know your outlook, but statistics dont tell the whole story. Your breast cancer type, overall health, and many more factors beyond your control may affect treatment outcomes.

Establishing open communication with your treatment team can help you best assess where you are in your cancer journey.

Support groups can be a great source of comfort as you navigate your diagnosis through your treatment and beyond. Your doctors office or hospital can offer some suggestions and resources in your area.

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Tnbc Subtyping And Treatment Regimens

In 2011, Lehmann et al. performed gene expression profiling of tumor samples from 587 TNBC patients and divided TNBC into six subtypes: basal-like 1 , basal-like 2 , mesenchymal , mesenchymal stem-like , immunomodulatory , and luminal androgen receptor . They also performed gene profiling and compared existing TNBC breast cancer cell lines, classifying them into six different subtypes, thus providing an accurate cell model for clinical treatment of TNBC .

Table 1 Genomic TNBC subtypes and assignment of TNBC cell lines to subtypes

How To Starve Triple Negative Breast Cancer

Date:

American Society for Biochemistry and Molecular Biology

Summary:

Researchers have developed a strategy that slows the growth of triple negative breast cancer cells by cutting them off from two major food sources.

A team of Brazilian researchers has developed a strategy that slows the growth of triple negative breast cancer cells by cutting them off from two major food sources.

Triple-negative breast cancer, or TNBC, makes up approximately 15% to 20% of all breast cancers and is most common in African American women. These tumors lack estrogen and progesterone receptors and HER2 protein which are present in other breast cancers and permit certain targeted therapies. And because every TNBC tumor has a different genetic makeup, finding new markers that could guide treatment has been a difficult task.

“There is intense interest in finding new medications that can treat this kind of breast cancer,” said Sandra Martha Gomes Dias, a cancer researcher at the Brazilian Biosciences National Laboratory in Campinas, Brazil. “TNBC is considered to be more aggressive and have a poorer prognosis than other types of breast cancer, mainly because there are fewer targeted medicines that treat TNBC.”

To see if alterations in gene expression could explain how these cells survive, the authors of the study exposed TNBC cells to CB-839, defined those that were resistant and those that were sensitive to the drug, and sequenced their RNA, Dias said.

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Annexin V Apoptosis Assay

HCC1806 cells were treated by 0.2 µM triptonide for 20 h. Approximately 2×105 cells were suspended in 1×annexin-binding buffer. After FITC annexin V and PI were added, the mixture was incubated at room temperature for 15 min. Apoptotic cells were detected using the FITC Annexin V/Dead Cell Apoptosis kit according to the manufacturers instruction. Samples were analyzed on the BD LSR Fortessa Flow Cytometer . Cell debris was excluded in SSC-A VS FSC-A plot. Single cell populations were gated from SSC-W VS SSC-H plot. More than 10,000 single cells were recorded from each sample. Data was analyzed using BD FACSDiva V8.02 software.

Staying Positive During Breast Cancer Treatment

Because triple-negative is more common in women with the BRCA1 gene mutation, Dr. Khan sent Wendy for . If positive, she would need a double mastectomy and oophorectomy .

But Wendy tested negative for BRCA1. So, Dr. Khan mapped out a care plan that included , lumpectomy surgery and radiation.

Wendy remembers Dr. Khan telling her they were going to hit the cancer hard with chemotherapy.

Thats when I broke down and cried. I didnt want to lose my hair, admits Wendy. My husband couldnt understand why that would bother me more than the surgery or radiation, but it did.

Wendys husband, Steve, asked Dr. Khan about Wendys odds of beating the cancer. Because the tumor was found early and the cancer cells had not spread to any lymph nodes, Dr. Khan said her chances were good better than 90%.

From that point on, I saw this as a challenge, not a death sentence, says Wendy.

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Can Tnbc Be Prevented

Researchers dont know all the factors that cause triple negative breast cancer. They have identified the BRAC1 gene mutation as one potential cause for triple negative breast cancer. Unfortunately, you cant prevent BRAC1 because you inherit this gene mutation from your parents.

But there are steps that help prevent breast cancers, including TNBC:

• Maintain a healthy weight.
• Exercise on a regular basis.
• Know your family medical history.
• Monitor your breast health. Studies show 95% of women whose breast cancer was treated before it could spread were alive four years after diagnosis.
• Talk to your healthcare provider about genetic testing for the BRCA gene if you have a family history of breast cancer, ovarian cancer, pancreatic or prostate cancer. If you have the BRCA gene, there are steps you can take to prevent breast cancer.

Why Receptor Status Matters

Breast cancer is not a single disease, and researchers now have the ability to break down breast cancer into different subtypes based on the receptor status of the tumors. Among the variations between different types of breast cancers are the proteins found on cell surfaces, which are involved tumor growth. These proteins are related to the genetic material of cancer cells.

For example, with estrogen receptor-positive breast cancer, estrogen binds to specific receptors on breast cancer cells, stimulating proliferation. Similarly, HER2 receptors on the surface of breast cancer cells are stimulated by HER2 protein, promoting the growth and spread of breast cancer.

It’s important to note, however, that all breast cellsboth cancerous and noncanceroushave HER2 receptors other their surfaces. The difference is that HER2-positive breast cancer cells have 40 to 100 times more receptors than HER2-negative breast cancer cells or normal breast cells. In positive cases, the abundance of receptors fuels the cancer.

Breast Cancer Discussion Guide

Get our printable guide for your next healthcare provider’s appointment to help you ask the right questions.

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Is Triple Negative Cancer Good Or Bad

Regardless of the stage of the cancer, participation in a clinical trial of new treatments for TNBC is also a good option because TNBC is uncommon and tends to have a poor prognosis compared to other types of breast cancer, and because these studies often allow patients to have access to drugs not available

Dsfcu Complex For Tnbc Therapy

TNBC represents an aggressive subtype, for which radiation and chemotherapy are the only options . Acquired chemoresistance remains the primary cause of therapeutic failure of TNBC . In the clinic, the relapsed TNBC is commonly pan-resistant to various drugs with entirely different resistance mechanisms. Investigation of the resistance mechanisms and development of new drugs to target pan-chemoresistance will potentially improve the therapeutic outcomes of TNBC patients .

The MDA-MB-231PAC10 cell line is made up of a high population of cells expressing stem cell markers that may play a vital role in the pan-resistance. These cells express high ALDH activity and a panel of embryonic stem cellrelated proteins and nuclearization of HIF2a and NF-kBp65. These cells are highly cross-resistant to PAC, cisplatin , docetaxel, and doxorubicin. DSF was reported to abolish CSC characters and completely reverse PAC and CDDP resistance in MDA-MB-231PAC10 cells . In addition, DSF/Cu exposure for 4 h leads to inhibition of both ALDH activity and expression of Sox2 and Nanog in the resistant cells. In combination with DSF/Cu, the cytotoxicity of PAC and CDDP in MDA-MB-231PAC10PAC10 cells was significantly higher than PAC, CDDP, or DSF/Cu single-drug exposure. The cytotoxicity of DSF/Cu plus PAC was synergistic in a wide range of concentrations .

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Adjuvant Therapy For Tnbc In Older Patients

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What Research Trials Are Underway

There are several new and ongoing studies looking at treatments for triple-negative breast cancer.

Dr. Fancher encouraged people with triple-negative breast cancer to look into trials. Research on clinical trials is really important, she told MNT.

If you triple-negative breast cancer, consider a clinical trial. It helps move the research forward. There are lots of trials out there, and many are having good results.

Dr. Nan spoke about the Keynote 522 clinical trial . This trial is looking at the use of pembrolizumab, a type of immunotherapy, in combination with chemotherapy before and after surgery.

The trial focuses on people with stage 2 or 3 breast cancer who are at high risk, and pembrolizumab has shown some promise. In fact, the trial has shown a 65% effectiveness rate, indicating no residual signs of cancer in the tissue. This is up from 51% previously.

The phase 3 ASCENT clinical trial is looking at the use of sacituzumab govitecan, an antibody drug conjugate. In a phase 2 trial, it had shown promise in people who had previously received treatment for metastatic triple-negative breast cancer. The Food and Drug Administration gave the drug accelerated approval in 2020.

A person should talk with a doctor before joining a clinical trial. They may be able to help the person find a relevant study or recommend ones that will work best for them.

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What Should A Person With Stage 4 Breast Cancer Expect From Treatment

Treatment options vary widely depending on where you live, your access to specialists and sub-specialists, and your willingness to try therapies that are still in the experimental phase.

Seek out oncology specialists who specialize in Stage 4 breast cancer. Discuss with your treatment team what clinical trials may be available for your clinical situation.

During this time, be sure to surround yourself with a support system of friends and family.

Is Triple Negative Hereditary

Researchers from the University of Southampton and colleagues from around the world tested DNA samples donated by 1824 women with triple negative breast cancer for mutations in 17 genes that have been linked to breast cancer in a study that was partially funded by Breast Cancer Campaign in order to learn more about the genetics of triple negative breastcancer. This is the broadest analysis on breast cancer gene mutations in triple negative breast cancer that has been conducted to date.

The findings, which were published revealed that 14.5 percent of the triple negative patients had genetic abnormalities that were passed down via their families. The mutations were detected in 14 of the 17 genes under investigation, with the BRCA1 and BRCA2 genes exhibiting the highest frequency of alterations. A genetic mutation also increased the likelihood of being detected at a younger age, with the average age at diagnosis being 45 years old, compared to 52 for women who did not have mutations.

In addition, many of the women who had a genetic mutation did not have a family history of breast or ovarian cancer. This was especially true for women who had a mutation in a gene other than the BRCA genes.

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Issues With Current Treatments

According to Dr. Crystal Fancher, the lack of receptors to target mean that some treatments for other forms of breast cancer are not effective for triple-negative breast cancer.

Dr. Fancher is a surgical breast oncologist at the Margie Petersen Breast Center at Providence Saint Johns Health Center and an assistant professor of surgery at Saint Johns Cancer Institute, both in Santa Monica, CA.

Unlike other breast cancers that have hormone receptors, like HER2, triple-negative is harder to treat, she told MNT.

Dr. Jacoub explained that peoples outcomes tend to improve when they use chemotherapy in combination with other treatments. A course of treatment now typically includes immunotherapeutics, which we use before and after surgery as well as during a recurrence, he added.

Platinum chemotherapy, or chemotherapy using platinum-based drugs, is common in the treatment of triple-negative breast cancer due to its effectiveness. However, research has shown that severe side effects can limit its use.

One found around 40 specific side effects, including a decrease in bone marrow production, problems with kidney function, headaches, and other negative effects on the nervous system. There are some treatments available to address these side effects.

Dr. Nan estimated that about 40% of people can use a combination of immunotherapy and chemotherapy.

Exosome And Tnbc Metastasis

In recent years, there is a rising interest in exosome-related research. Exosomes are extracellular, membrane-bound vesicles that intercede intercellular communication by the transportation of regulatory molecules among cells under pathological and physiological conditions . It has been indicated that exosomes secreted by tumor cells would aid in the development of drug resistance and metastasis . An interesting finding reported by Ozawa and colleagues revealed that exosomes derived from chemoresistant TNBC cells can promote proliferation and bestow chemoresistance to non-malignant breast epithelial cells . Another intriguing report suggested that drug efflux pumps are overexpressed in exosomes of paclitaxel resistant CAL51 cells . Kavanagh and colleagues demonstrated that the therapy-induced senescent cells release a higher amount of extracellular vesicles in the microenvironment compared to control cells. The EVs of TIS cells contain proteins involved in ATP depletion, cell growth, apoptosis, and senescence-associated secretory phenotype factors. Other than that, those chemoresistant TIS TNBC cells also have an increased expression of ABCC1 . Similarly, it has been indicated that ABCB1 confers resistance to docetaxel through EV transportation in breast and prostate cancer cells.

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Rt2 Profiler Pcr Array

HCC1806 cells were treated with triptonide for 10 h. Total RNA was extracted and quantified by NanoDrop 2000 Spectrophotometer . First-strand cDNA was synthesized using the QuantTect Reverse Transcription Kit. The expression of the 84 genes was analyzed using the CT method of quantification with RT2 Profiler PCR Array kit .

Determining Your Her2 Status

A breast biopsy is used to determine HER2 status. The biopsy can be sent for laboratory testing with an immunohistochemistry test. The fluorescence in situ hybridization test looks for the HER2 gene in breast cancer cells.

The results of an immunohistochemistry test show different levels of HER2 positivity. For example, a tumor may be reported as 0, 1+, 2+, or 3+. Tumors with a higher number may be referred to as having an overexpression of HER2.

According to the American Cancer Society, immunohistochemistry test results should be considered as follows:

The impact of being HER2-positive on breast cancer survival is, of course, a top concern. Unfortunately, statistics can be misleading without considering other aspects of your diagnosis, including cancer stage at diagnosis and whether the tumor is also estrogen and/or progesterone receptor-positive.

With this in mind, you may also be tested for progesterone and estrogen receptors. Triple-negative breast cancers are negative for HER2, estrogen, and progesterone, while triple-positive breast cancers are positive for all three.

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What Is The Prognosis For Triple

A good treatment result depends on several factors. Chemotherapy is what can really make a difference in the outcome. The size of the invasive part of the tumor, and the number of involved lymph nodes can also greatly influence your prognosis, Sun says, but adds that if the cancer has spread , the prognosis is less certain.

There is hope, even with this serious diagnosis, and staying optimistic is essential. It can be stressful and scary to go through chemo, but positive thinking can make a difference. You have to believe that its doing you good, and for most people, it does.

Breast Cancer Treatment at Johns Hopkins

The breast cancer program at Johns Hopkins is made up of a diverse group of nationally-recognized specialists in breast cancer research and treatment.