Survival Rates And Prognosis
The outlook for breast cancer is often described in terms of relative survival rates.
Relative survival rates are an estimate of the percentage of people who will survive their cancer for a given period of time after diagnosis. Survival among people with cancer is compared to survival among people of the same age and race who have not been diagnosed with cancer.
Five-year relative survival rates tend to be lower for triple-negative breast cancer than for other forms of breast cancer.
According to the American Cancer Society, the overall 5-year relative survival rate for TNBC is . However, an individuals outlook depends on many factors, including the stage of the cancer and the grade of the tumor.
Your healthcare professional will be able to give you a more precise outlook based on:
- the stage of your TNBC
- your age
From Dna To Metabolites For Tnbc Clustering
New ways of stratifying TNBC patients have arisen thanks to the advent of next-generation sequencing, computing systems, and the exponential increase of available data sources during the following years. Thereby, new data types have been used to classify TNBC into novel subtypes . Different single nucleotide variant patterns have been identified in TNBC tumors and circulating DNA from TNBC patients . Jiang et al. explored these differences in the FUSCC cohort. They discovered that somatic mutations and CNVs events were not homogeneously distributed among TNBC subsets. For instance, FUSCC LAR tumors were enriched in PI3K pathway mutations. High genomic instability was associated with the FUSCC BLIS subtype. Given the mutational differences, this study defined four genetic subtypes: Homologous recombination deficiency , clock-like, APOBEC, and mixed . Interestingly, the HDR subtype showed a greater proportion of germline variants than other mutation subtypes. BRCA1, RAD51D, and BRCA2 were the most frequently mutated genes .
Tnbc Targeted Therapy And Potential Treatment Regimens
Due to the high heterogeneity of TNBC, it is particularly difficult to discover new therapeutic targets and perform targeted therapy. Currently, there are a large number of ongoing clinical trials targeting specific receptors or on targeted therapies of TNBC based on immunohistochemical staining results.
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Treatment For Triple Negative Breast Cancer
The main treatments for triple negative breast cancer are surgery, chemotherapy and radiotherapy. The treatment you need depends on:
- where the cancer is
- the size of the cancer and whether it has spread
- how abnormal the cells look under the microscope
- your general health
You might have surgery to remove:
- an area of the breast
- the whole breast
When you have your surgery, the surgeon usually takes out some of the lymph nodes under your arm. They test these nodes to see if they contain cancer cells. The surgeon might check the lymph nodes closest to the breast using a procedure called sentinel lymph node biopsy. Testing the lymph nodes helps to find the stage of the cancer and decide on further treatment.
After breast conserving surgery you usually have radiotherapy to the rest of the breast tissue.
Sociodemographic And Clinical Characteristics Of Tnbc Patients
We enrolled 152 patients aged 26-85, median age 58 years , just over two-thirds of them menopausal. In routine medical records, family history data were lacking in a high percentage of cases, i.e. 42 for any cancer and 43 for BC. We kept these data in descriptive , but did not interpret them. In patients for whom we had properly collected data, 18/109 had a positive family history of BC. Patients with a positive family history of BC were younger, median age 43 years compared to patients without family BC, median age 57 years. The vast majority of patients had ductal invasive carcinoma with a median tumor size of 2.2 cm, 62 with positive lymph nodes, 124 with grade III tumor, and median Ki67 proliferation index 57 . Just over one-third of patients underwent radical surgery , and almost all of them underwent axillary dissection. Adjuvant chemotherapy was used in 130/148 patients, in 114/128 cases with anthracyclines or a combination of anthracyclines and taxanes. A total of 103/140 patients were treated with adjuvant radiotherapy. None of the patients was treated with the neoadjuvant approach.
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What Is The Treatment For Triple Negative Breast Cancer
Healthcare providers and researchers are making significant progress on TNBC treatments. Recent clinical trials are testing new combinations of drugs and new approaches to existing treatments. Some existing treatments are:
- Chemotherapy: Providers might combine chemotherapy and surgery, with chemotherapy being used to shrink your tumor before surgery or after surgery to kill cancer cells throughout your body.
- Surgery: This could be a lumpectomy to remove an individual lump, or a mastectomy to remove an entire breast. Providers then perform a sentinel node biopsy or axillary node surgery to look for signs your breast cancer has spread to your lymph nodes.
- Radiation therapy: Post-surgery radiation therapy helps reduce the chances your cancer will return or recur.
- Immunotherapy: This treatment stimulates your immune system to produce more cancer-fighting cells or help healthy cells identify and attack cancer cells. Immunotherapy can be added to chemotherapy to before surgery to shrink the tumor. You might also receive immunotherapy for about a year after your surgery and post-surgery radiation therapy.
What Treatments Are Used For Metastatic Cancer
Metastatic cancer may be treated with chemotherapy, biological therapy, targeted therapy, hormonal therapy, radiation therapy, surgery, or a combination of these treatments.
The choice of treatment generally depends on the type of primary cancer the size, location, and the number of metastatic tumors. Also, the patients age and general health and the types of treatment the patient has had in the past.
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What Is Clear About The Still Fuzzy Tnbc Subtyping
Perhaps, the several strategies employed to construct systems that identify clinically useful TNBC subtypes reflect the lack of proper definition of this disease. From the quantitative variables such as gene and protein expression or metabolic and epigenomic profiling to the qualitative traits such as gene mutation, basic and translational researchers have explored a problem that still appears to remain unsolved. We see a common factor, independently of the approach, that clear overlaps exist between the different classification systems . This is encouraging as it points towards the existence of stable entities identified in diverse patient populations. However, the fact that there is still a large variability, added to several subtle similitudes between some of the current subtyping systems , suggests that there is still a long way to go.
What Are The Chances Of Breast Cancer Recurring
Despite huge advancements in breast cancer screening, early detection and treatment, a percentage of breast cancers will recur and spread to distant sites.
Although at the moment, it is almost impossible to say which cancers will recur and at what time period from diagnosis, there are a few factors that are known to increase the risk for recurrence.
These risk factors include:-
- Lymph node involvement and number of lymph nodes affected at the time of diagnosis
- Tumor Size at the time of diagnosis
- A subtype of Breast Cancer and hormonal receptor Status
- The time span from the initial diagnosis to recurrence of breast cancer
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Radiation For Breast Cancer
The fatigue from radiation for breast cancer is underrated. Most days I could not get out of bed from the exhaustion. It is indescribable how radiation fatigue feels it flattened me. I may be a writer but I do not have the words.
My radiation course for node-negative Grade 3 Triple Negative Breast Cancer with clean surgical margins was 60Gy, or 25 whole breast sessions and 5 boost sessions to my tumour bed. I was mapped and tattooed with three dots circling my breast for precise radiation treatment. Some people dont care about the tattoos, but I despise those dots and will have them removed with laser treatment. Everyone is different.
Also, ask your radiation oncologist for all the skin care recipes from saline soaks to specific creams to use. Do the skin care. Rest. Do more skin care. I healed with no skin discolouration. Do the skin care, it can help.
What Is Triple Negative Breast Cancer
A diagnosis of triple negative breast cancer means that the three most common types of receptors known to fuel most breast cancer growthestrogen, progesterone, and the HER-2/neu gene are not present in the cancer tumor. This means that the breast cancer cells have tested negative for hormone epidermal growth factor receptor 2 , estrogen receptors , and progesterone receptors .
Since the tumor cells lack the necessary receptors, common treatments like hormone therapy and drugs that target estrogen, progesterone, and HER-2 are ineffective. Using chemotherapy to treat triple negative breast cancer is still an effective option. In fact, triple negative breast cancer may respond even better to chemotherapy in the earlier stages than many other forms of cancer.
A Note About Statistics
Survival rates are statistics. As such, they tend to tell us how the average person will do with an average triple-negative breast cancer. But people and tumors arent statistics. Some people will do better, and some people will do worse.
Very importantly, statistics are usually several years old. In order to calculate five-year survival rates, a person would have to have been diagnosed at least five years prior, and there is lag time. The treatment of triple-negative breast cancer is changing, and new drugs have been approved.
Do I Need Genetic Counseling And Testing
Your doctor may recommend that you see a genetic counselor. Thats someone who talks to you about any history of cancer in your family to find out if you have a higher risk for getting breast cancer. For example, people of Ashkenazi Jewish heritage have a higher risk of inherited genetic changes that may cause breast cancers, including triple-negative breast cancer. The counselor may recommend that you get a genetic test.
If you have a higher risk of getting breast cancer, your doctor may talk about ways to manage your risk. You may also have a higher risk of getting other cancers such as ovarian cancer, and your family may have a higher risk. Thats something you would talk with the genetic counselor about.
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Build An Emergency Fund
I started keeping a stash of cash on the ready over 20 years ago. Building this fund has served me well and has helped me weather too many storms over the years. I started my emergency fund by making an automatic contribution of $10 to a high-interest savings account every paycheque with my first-ever job. I increased that amount, again making it an automated contribution from my checking account to a high interest savings account, as I got raises and got better at budgeting.
The automation is KEY because it removes the temptation and mental friction from having to make that choice to save and move the money twice a month. By making the saving process automatic I forgot the process was in place and the automation prevented the mental load of doing the thinking work to save. I didnt have to remake the choice every month the banking system did it for me.
Seeing the fund grow can be tempting. But I stopped myself from spending it by thinking how my Future Self would feel if I needed that money to survive. And the answer was always my Future Self would thank my Present Self for saving emergency money. Years of experience with being blindsided by layoffs, recessions, and now cancer have reinforced the habit of keeping an emergency fund on hand. I covered my own butt automatically. Thank you Past Self for saving the butt of my Future Self. Signed, all my Selves.
What Has Been The Standard Protocol For Treating Triple
The standard protocol to treat early-stage triple-negative breast cancer confined to the breast and axillary lymph nodes is chemotherapy and surgery. Often chemotherapy is administered before surgery. At present there are no further treatment options for early-stage triple-negative breast cancer beyond close follow-up care with regular physical exams and mammograms.
There are, however, innovative approaches currently under study, including the addition of targeted therapy to this chemotherapy backbone.
For advanced triple-negative breast cancer, the current standard approach is to treat with various chemotherapy regimens. The most recent breakthrough in the treatment of such tumors is the success story of PARP inhibitors. Short for poly polymerase, PARP is an enzyme that is required for cells to repair the DNA damage induced by any form of injury . Unfortunately, the cancer cells also use this enzyme to correct the damage induced by chemotherapy, making that treatment less effective. Now researchers have shown that by including a drug that inhibits the PARP enzyme along with chemotherapy, they can cause more damage to triple-negative breast cancers than when chemotherapy is delivered alone.
Several clinical trials are currently under way at various centers, using different PARP inhibitors with different chemotherapy in triple-negative and genetically inherited breast cancers.
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Please Describe The Defining Characteristics Of Triple
Triple-negative breast cancers account for about 15 percent of all breast cancers and are defined as breast cancers that are estrogen receptor and progesterone receptornegative, meaning that these cancers do not depend on estrogen for their growth. In addition, the HER2/neu gene is not amplified in these cancers.
I Have Triple Negative Breast Cancer What Can I Do To Help Myself
You already took the first step when you decided to help yourself. Many times cancer makes people feel as if theyve lost control of their lives. Committing to self-care is one way to overcome that feeling. Here are some things you can do during and after your treatment:
- Triple negative breast cancer is a rare and often misunderstood illness. Many people dont realize this cancer cant be treated the same as other breast cancers. As a result, you might feel isolated and alone with your cancer. If that happens, your healthcare provider can direct you to TNBC support groups and programs where you can talk to people who understand your experience.
- Youll probably need or want help while youre going through treatment. Your friends and family likely are anxious to do what they can. Let them know how they can help you.
- If you will need cancer surgery, ask your healthcare provider what to expect immediately after surgery and any follow-up treatment. Knowing what to expect will help you focus on what you can control rather than what you cant control.
- Cancer is stressful. You might find activities such as meditation, relaxation exercises or deep breathing exercises help to ease your stress.
- Chemotherapy treatments might affect your appetite. Try to eat a healthy diet, and talk to a nutritionist if you’re having trouble eating.
- Radiation treatment can leave you feeling exhausted. Plan to rest as much as possible during your treatment.
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A Note From Dr Halls Regarding The Statistics For Metastatic Recurrence In Breast Cancer
The statistic of 20% to 30% for metastatic breast cancer that recurs remain controversial amongst medical experts. The figure of 30% metastatic breast cancer recurrence rate first appears in a 2005medical study, but no statistical data or sources are cited.
The MBCN take the 18-year relative survival rate from the SEERS data between the years of 1990 to 1994 as 71%. The argument is, that this takes us close to the 30% recurrence rate statistic. However, there are many other factors at play and treatment has advanced so much that recurrence rates may have even halved since then.
It is safe to say that much more data and research into metastatic recurrence rates would be of huge value towards a long-term cancer cure.
Indeed, it has also been suggested that research into the rare group of women who survive many years with metastasis may be of equal importance to understanding recurrence and patterns of breast cancer.
Cancer Stem Cells And Autophagy
As mentioned, numerous biochemical pathways in TNBC are relevant to cancer stem cells , thus, efforts are ruining into mAbs, dendritic cells and pluripotent cells cancer vaccines as well as adoptive immunotherapy .
TNBC cancer stem cells feature enhanced proliferative capacity, refractory treatment which leads to recurrence and metastasis . Several biomarkers have been designed to detect CSCs. However, most biomarkers are also shared by normal stem cells, and therefore these biomarkers become to unspecific molecules leading to side effects. Chemo-resistance is present in TNBC stem cells, and they are the generals that lead the battle in tumor micro-environments riddled with hypoxia . Hypoxia is responsible for increasing chemo-resistance of autophagic TNBC stem cells. Blocking the autophagic cascade network can increase chemo-response .
Autophagy is required for cancer stem cells and autophagy processes helps in the maintenance of cellular homeostasis and, therefore, represents a survival pathway in cells. Unfortunately, cancer cells can regulate the autophagy pathway to develop resistance to chemotherapy. Therefore, molecular inhibition of the malignant autophagic pathway could reverse resistance to chemotherapy . More research needs to be done regarding abnormal stem cells autophagy mechanism, since it may harbor the key to get a definitive cure not only against TNBC but against many types of cancer.
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