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Prognosis Triple Negative Breast Cancer

What Is The Relative Survival Rate Of Breast Cancer

Risk factors for developing triple-negative breast cancer

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

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 Table 1, 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.

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.

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Risk Factors For Triple Negative Breast Cancer

A risk factor is a characteristic that increases an individuals chance of getting a certain condition. For example, cigarette smoking is a risk factor for lung cancer. While anyone can receive a diagnosis of triple negative breast cancer, it is more likely to affect the following individuals:

  • Those who are younger than age 40
  • Those who have the BRCA1 mutation
  • Those of African-American or Hispanic descent

Having one or more of these risk factors does not mean developing triple negative breast cancer is for certain, just as not having any of these risk factors doesnt prevent an individual from being diagnosed with this condition.

Treating Triple Negative Breast Cancer

(PDF) Triple

Triple negative breast cancer can be treated with a combination of

Research has shown chemotherapy generally has a larger benefit for triple negative breast cancer compared to oestrogen receptor positive breast cancer. Chemotherapy for triple negative breast cancer is often given before surgery. The drugs used are likely to include carboplatin or cisplatin.

Some breast cancer treatments, such as hormone therapy and HER2 targeted therapies are of no benefit to people with triple negative breast cancer.

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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

What Factors Contribute To The Risk Of Breast Cancer Recurrence

Whilst it is never completely certain that breast cancer has been cured, there are many treatments available that reduce the risk of recurrence. There are a number of risk factors that can contribute to a breast cancer recurrence.

Your age at first diagnosis Younger women, particularly those who had their first diagnosis under the age of 35, have a greater risk of recurrence. This is because those diagnosed at a young age are more likely to have aggressive features in their breast cancer. Additionally women diagnosed with breast cancer before menopause have a greater risk of recurrence.

Tumour size Women who have a larger breast tumour have a greater risk of recurrence.

Lifestyle factors Lifestyle factors can influence the risk of recurrence. Excess weight is associated with a higher risk of postmenopausal breast cancer and is also associated with a higher risk of breast cancer recurrence and death. Smoking has also been shown to increase the risk of recurrence. Women who exercise regularly appear to have a lower rate of breast cancer recurrence.

Lymph node involvement If cancer is found in lymph nodes at the time of the original breast cancer diagnosis, there is an increased risk of breast cancer recurrence. This is the strongest prognostic factor, and the more nodes involved, the higher the risk of recurrence.

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Clinical And Relapse Features

BC is the most common tumor and the main cause of cancer-related mortality worldwide TNBC is about 1520% among all. Epidemiology, distribution and mortality from TNBC varies within populations based on race or country of origin. In the prospective population-based study in North Carolina, the Carolina Breast Cancer Study , designed to oversample Black and premenopausal women with newly diagnosed BC, it was observed that patients with TNBC were far more likely to be Black, younger than those with other subtypes, had tumors diagnosed at higher stage, and those tumors were mostly high-grade. This racial and age distribution was confirmed and extended in CBCS3, in which intrinsic subtyping revealed that a young Black woman was more than twice as likely to have a BL tumor as an older white woman.

The aggressive biological and clinical behavior of TNBC translates into more frequent and earlier relapses than other subtypes of BC. It is well established that the risk of early distant recurrence within five years of diagnosis is nearly three-fold higher for TNBC compared with non-TNBC. Conversely, the risk of late relapse after 5 years is less than 3%. The most common sites of relapses are lung, lymph nodes and brain . Optimizing treatment for patients with brain metastases remains an unmet need.

Signaling Pathway Of Cspg4 Protein

New Treatment Shows Promise For Triple-Negative Breast Cancer Patients

The CSPG4 protein is expressed as a cell surface proteoglycan by basal breast carcinoma cells. Therapeutically, CSPG4 inhibition allows for efficient management of breast cancer . Monoclonal antibodies can block the CSPG4 protein, which hinders survival signaling pathways in tumor cells. In addition, controlling the overexpression of CSPG4 by targeting it therapeutically is seen in different TNBC cells .

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Is Triple Negative Breast Cancer The Worst Kind

Triple negative breast cancer is an aggressive cancer that grows quickly, making it more likely to have spread by the time it is diagnosed and to come back after treatment. Therefore, the outlook is generally not as good when compared to other types of breast cancer. To find active triple negative breast cancer clinical trials in your area, you can use Power to search by condition, treatment, or location. Anonymous Online Contributor

What Is The Survival Rate By Stage For Triple Negative Breast Cancer

Survival rates are a way to discuss the prognosis and outlook of a cancer diagnosis. The number most frequently mentioned is 5-year survival. Many patients live much longer, and some die earlier from causes other than breast cancer. With constant change and improvement in therapies, these numbers also change. Current 5-year survival statistics are based on patients who were diagnosed at least 5 years ago and may have received different therapies than are available today.

Below are the statistics from the National Cancer Institute’s SEER database for the survival of all patients with breast cancer, by tumor stage:

5-Year Survival Rate by Stage

Stage
IV 22%

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What Types Of Breast Cancer Have The Highest Recurrence Rates

A study published in the Journal of Clinical Oncology found the risk of recurrence for all breast cancers was highest in the first five years from the initial cancer diagnosis at 10.4%. This was highest between the first and second years after the initial diagnosis. During the first five years after the initial diagnosis, patients with oestrogen receptor positive breast cancer had lower rates of recurrence compared with those with ER negative disease. However, beyond five years, patients with ER positive disease had higher rates of recurrence.

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Triple Negative Breast Cancer Treatment

Triple Negative Breast Cancer: Prognosis For Triple Negative Breast Cancer

When formulating a treatment plan, oncologists will take the triple negative diagnosis into significant consideration. The reason is that traditional hormone-based therapies like tamoxifen and Herceptin, which are often helpful for treating hormone-receptive breast cancers, do not affect triple negative breast cancer. Typically, triple negative breast cancer is treated with one or more of the following methods:

  • Surgery A lumpectomy or mastectomy procedure can be used to remove as much of a tumor as possible.
  • Radiation therapy Targeted, high-energy rays are used to destroy breast cancer cells.
  • Chemotherapy Drugs are administered to destroy rapidly dividing cancer cells.
  • Neoadjuvant therapy Chemotherapy or radiation therapy is administered before or after surgery.

Some patients wonder whether triple negative breast cancer should be treated more aggressively than other types of breast cancer. This is not necessarily the case. In fact, some researchers believe that triple negative breast cancer responds more favorably to chemotherapy than hormone-receptive cancers.

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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.

Chemotherapy For Early Tnbc

Early TNBC is treated with chemotherapy. People with TNBC tend to get more treatment benefit from chemotherapy than people with hormone receptor-positive breast cancers do .

Some people get chemotherapy before breast surgery. This is called neoadjuvant chemotherapy.

For people with TNBC who have cancer remaining in their breast after neoadjuvant chemotherapy, treatment with the chemotherapy drug capecitabine may lower the risk of recurrence and improve survival .

Learn more about chemotherapy.

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What Is The Prognosis For Triple Negative Breast Cancer

Triple negative breast cancer can be more aggressive and difficult to treat. Also, the cancer is more likely to spread and recur. The stage of breast cancer and the grade of the tumor will influence your prognosis. Research is being done currently to create drug therapies that are specific for triple negative breast cancer.

Interested in learning more? Watch the free webinar, Facing TNBC: Self-Advocacy & Decision Making.

Material on this page courtesy of Johns Hopkins Medicine

Medically Reviewed on April 15, 2020

Survival Rate For Patients With Triple

Triple Negative Breast Cancer

Triple-negative breast cancer is considered aggressive, or fast-growing, but it is treatable. Survival depends on factors such as how advanced the cancer was at diagnosis, your overall health, and your response to treatment.

When assessing survival, researchers use a 5-year marker to make predictions about if cancer will reoccur.

According to the American Cancer Society, if any type of breast cancer is found to be stage 1, the 5-year survival rate is nearly 100%. Stage 2 breast cancer survival is about 93%, stage 3 is 72%, and metastasized or grade 4 breast cancer has about a 22% chance of survival. Keep in mind most triple-negative breast cancers are stage 3 when found.

Its important to note that the survival rates may be higher than this data suggests because new treatments are becoming available through clinical research.

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Exposure To Chemicals And Drugs

Females who have been exposed to dreadful carcinogenic chemicals are at higher risk of breast cancer and epigenetic alterations and mutations. Exposure and duration of exposure contribute to an increased risk of breast cancer mutagenesis . Exposure of mammary glands to polychlorinated biphenyl and dichlorodiphenyltrichloroethane chemicals increases the risk of breast cancer . Furthermore, continuous exposure to organic solvents, insecticides, and oil mist increases the risk of breast cancer . Antibiotics, statins, antidepressants, and antihypertensive drugs can increase the risk of breast cancer. Similarly, NSAIDs that contain aspirin and ibuprofen are considered major risk factors for breast cancer .

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Selection Criteria And Data Extraction

Study eligibility was established using the PICO approach52. Studies were eligible for inclusion if the population included patients diagnosed with TNBC, BMI at diagnosis was included as exposure, the outcome was disease-free survival and/or overall survival , and the study design was longitudinal, investigating the association of overweight with clinical outcome in TNBC patients. We imposed no restrictions on publication year, geographical setting, or length of follow-up. We did not consider case-control studies, studies reporting other effect sizes than hazard ratios, and studies where data on BMI were retrieved > 6 months after TNBC diagnosis. Only English language papers in peer-reviewed journals were considered, and gray literature, e.g., conference abstracts and dissertations, were not included. Two authors independently screened titles and abstracts using the Covidence systematic review software . After excluding studies based on titles and abstracts, the remaining full text references were reviewed. Disagreements were discussed with a third author until a negotiated conclusion was reached. Data were extracted by one author and coded according to a priori specified characteristics, including study name, patient characteristics, treatment characteristics, exposure , outcome data , and risk of bias, and validated by a second author .

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How Is Triple Negative Breast Cancer Diagnosed

The first step might be a mammogram to evaluate a suspicious mass or lump in your breast. Based on what they learn, healthcare providers might perform a biopsy to remove breast tissue. Then they examine the tissues cells to determine the cancer subtype. Identifying the cancer subtype is part of the staging process, which is when providers decide how to treat your cancer.

Sometimes providers use the following tests before treatment to check on your tumors size and whether it has spread, or after treatment to monitor response to treatment:

Overweight And Obesity Definitions By Bmi

Merck

Overweight was determined using the World Health Organization BMI definition of overweight, i.e., when a patient has a BMI of 25kg/m2 or above the patient is considered overweight, and if the patient has a BMI of less than 25kg/m2 the patient is considered normal-weight3. WHOs BMI definition of overweight differs depending on geographic location e.g., in Asian populations, the BMI definition for overweight is defined as a BMI of 24kg/m2 or more according to WHOs Asian-Pacific classification for overweight41. WHO further defines subgroups of overweight where patients with a BMI between 25 and 30kg/m2 are considered overweight and patients with a BMI of 30kg/m2 or above are considered obese. In the present study, all patients with a BMI defined as overweight or obese according to WHO are considered overweight and referred to as overweight from this point forward.

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Am I Still At Risk Of Breast Cancer Recurrence If I Have Had A Mastectomy

Yes. You are still at risk of breast cancer recurrence if you have had a bilateral mastectomy . Undergoing a bilateral mastectomy drastically reduces your chances of local or contralateral breast cancer recurrence as almost all of the breast tissue has been removed. However, there is still a chance that residual breast tissue or cancer cells could recur on the chest wall.

If you have had a single mastectomy , you are still at risk of developing cancer in the breast that remains.

It must be noted that having a mastectomy or bi-lateral mastectomy does not reduce your risk of developing cancer in other parts of your body .

What Are Risk Factors For Breast Cancer Recurrence

Anyone with a breast cancer diagnosis can have a recurrence. Your risk of cancer recurrence depends on several factors:

  • Age: Women who develop breast cancer before age 35 are more likely to get breast cancer again.
  • Cancer stage: Cancer stage at the time of diagnosis correlates with the risk of the cancer being able to recur. Several factors determine cancer stage: tumor size, cancer grade and cancer spread to lymph nodes or other parts of the body. Cancer grade indicates how unusual cancer cells look in comparison to healthy cells.
  • Cancer type: Aggressive cancers like inflammatory breast cancer and triple-negative breast cancer are harder to treat. Theyre more likely to come back and spread.

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Facts You Should Know About Triple

  • Triple-negative breast cancer is an uncommon kind of breast cancer in which the cancer cells test negative for three common markers, the estrogen receptor , progesterone receptor , and a protein involved in cell growth known as HER2.
  • The triple-negative status of a cancer means that anti-hormonal therapies and therapies targeted against the HER2 protein are not effective.
  • About 10%-20% of all breast cancers are triple-negative.
  • Doctors usually treat triple-negative breast cancers with surgery, chemotherapy, and in many cases, radiation therapy.
  • Triple-negative cancers have a more aggressive course than other breast cancers and are more likely to recur over the first few years after diagnosis. After 5 years, the likelihood of recurrence decreases.
  • A majority of cases of breast cancer in women with a BRCA-1 mutation are triple-negative.

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