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 youre having trouble eating.
- Radiation treatment can leave you feeling exhausted. Plan to rest as much as possible during your treatment.
Symptoms Of Metastatic Breast Cancer
Symptoms depend on where the cancer has metastasized. According to Habibi, common areas include the bones of the spine, the lungs and the liver. The symptoms can be back pain, shortness of breath, cough and fatigue.
Some types, including triple negative breast cancer, can also spread to the brain. The patient can experience headache, convulsions, changes in mood, and difficulty with speech or field of vision, Habibi says.
People who have been treated for breast cancer should be on the lookout for symptoms such as:
- Back or neck pain
Reporting these symptoms is important, says Habibi. Patients are usually the first and best people to notice something is not right, and can ask for guidance from their physicians.
After completion of the active phase of cancer care, and in the absence of specific symptoms, we usually do not recommend routine metastatic workup.
Doing a lot of unnecessary testing can harm the patient, he explains. Small abnormalities in one test can lead to additional test and biopsies, which can be very stressful to the patient, and repeated testing without symptoms has not been shown to improve outcomes.
However, patients should continue with their routine follow-ups as prescribed by their surgeon, medical oncologist and primary care doctor, the latter of whom plays a very important role in the survivorship phase.
Evolving Thoughts On Surgery
When breast cancer is metastatic at the time of diagnosis, surgery has not usually been done, as it was believed that it didn’t improve survival rates. This thought appears to be changing, with evidence that primary surgery in people with stage 4 HER2-positive breast cancer improves overall survival. In addition, when a breast tumor is causing symptoms , palliative mastectomy may significantly reduce symptoms. In a 2018 study, palliative mastectomy was found to improve quality of life for some people.
Preventing Metastatic Breast Cancer
Habibi advises: Having a routine evaluation by your PCP and or cancer specialist would assist in diagnosing any cancer recurrence taking the hormone therapy medications also can decrease the chance of cancer recurrence.
Maintaining a healthy lifestyle, including staying at a healthy weight and avoiding alcohol, can help in reducing the chance of recurrence.
What Is The Survival Outlook For Breast Cancer
According to the National Cancer Institute , the percentage of patients surviving five years after diagnosis is:
- 99 percent for breast cancer that is still local to the breast
- 86 percent for breast cancer that has spread just outside the breast
- 29 percent for breast cancer that has spread to more distant parts of the body
The NCI also lists the five-year survival rate for breast cancer overall as 90.6 percent for women and 83 percent for men.
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The Role Of Caregivers
Caregivers also play a vital role in helping a person with cancer be as comfortable as possible. To help, a caregiver can:
According to the American Society for Clinical Oncology, in 2018, doctors will diagnose invasive breast cancer in an estimated 268,670 people in the United States.
The ACS state that the 5-year relative survival rate for people with metastatic breast cancer is around 22 percent. This means that people with metastatic breast cancer are 22 percent as likely as people without the condition to live at least 5 years following diagnosis.
However, many factors can affect how long a person with metastatic breast cancer lives for, including:
- the type of breast cancer
- the stage of breast cancer
- where the cancer has spread to
- how well the cancer responds to treatment
- any other health issues that the person has
Everyoneâs outlook is different. It is also important to note that survivals rates are just estimates, and that doctors base these figures on data from at least 5 years ago. Continuing advancements in cancer treatments means that survival rates are improving.
Living With Stage : The Breast Cancer No One Understands
Editor’s note: We’re bringing back this piece from October 2014 for Metastatic Breast Cancer Awareness Day and to honor Jody Schoger, featured in the story. Schoger died of metastatic breast cancer in May. Want to learn more about MBC? Look for our tweets at the Northwest Metastatic Breast Cancer Conference this Saturday at Fred Hutch.
A no-nonsense Texan of 60 years, Jody Schoger* has a very no-nonsense way of educating people about her metastatic breast cancer.
âSomeone will say, âWhen are you done with treatment?â and Iâll tell them, âWhen Iâm dead,ââ said Schoger, a writer and cancer advocate who lives near Houston. âSo many people interpret survivorship as going across the board. That everybody survives cancer now. But everybody does not survive cancer.â
An estimated 155,000-plus women in the U.S. currently live with âmets,â or metastatic breast cancer. This type of cancer, also called stage 4 breast cancer, means the cancer has metastasized, or traveled, through the bloodstream to create tumors in the liver, lungs, brain, bones and/or other parts of the body. Between 20 and 30 percent of women with early stage breast cancer go on to develop metastatic disease. While treatable, metastatic breast cancer cannot be cured. The five-year survival rate for stage 4 breast cancer is 22 percent median survival is three years. Annually, the disease takes 40,000 lives.
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Aggressive And Advanced Metastatic Breast Cancer
Habibi says the most extreme situations involve patients who are diagnosed with a very fast, aggressive breast cancer that has already spread to multiple organs and begins to overwhelm the body. For those patients, palliative care is important, concentrating on local control, pain management and avoiding bleeding and infection.
Prognostic And Predictive Factors
Breast cancer is commonly treated by various combinations of surgery, radiationtherapy, chemotherapy, and hormone therapy. Prognosis and selection of therapymay be influenced by the following clinical and pathology features :
- Menopausal status of the patient.
- Stage of thedisease.
- Grade of the primary tumor.
- Estrogen receptor and progesterone receptor status of the tumor.
- Human epidermal growth factor type 2 receptor overexpression and/or amplification.
- Histologic type. Breastcancer is classified into a variety of histologic types, some of which haveprognostic importance. Favorable histologic types includemucinous, medullary, and tubular carcinomas.
The use of molecular profiling in breast cancer includes the following:
- ER and PR status testing.
- HER2/neu receptor status testing.
- Gene profile testing by microarray assay or reverse transcription-polymerase chain reaction .
On the basis of ER, PR, and HER2/neu results, breast cancer is classified as one of the following types:
- Hormone receptor positive.
- HER2/neu positive.
- Triple negative .
ER, PR, and HER2 status are important in determining prognosis and in predicting response to endocrine and HER2-directed therapy. The American Society of Clinical Oncology/College of American Pathologists consensus panel has published guidelines to help standardize the performance, interpretation, and reporting of assays used to assess the ER-PR status by immunohistochemistry and HER2 status by immunohistochemistry and in situ hybridization.
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Stage Groups For Breast Cancer
Doctors assign the stage of the cancer by combining the T, N, and M classifications , the tumor grade, and the results of ER/PR and HER2 testing. This information is used to help determine your prognosis . The simpler approach to explaining the stage of breast cancer is to use the T, N, and M classifications alone. This is the approach used below to describe the different stages.
Most patients are anxious to learn the exact stage of the cancer. If you have surgery as the first treatment for your cancer, your doctor will generally confirm the stage of the cancer when the testing after surgery is finalized, usually about 5 to 7 days after surgery. When systemic treatment is given before surgery, which is typically with medications and is called neoadjuvant therapy, the stage of the cancer is primarily determined clinically. Doctors may refer to stage I to stage IIA cancer as “early stage” and stage IIB to stage III as “locally advanced.” Stage 0: Stage zero describes disease that is only in the ducts of the breast tissue and has not spread to the surrounding tissue of the breast. It is also called non-invasive or in situ cancer . Stage IA: The tumor is small, invasive, and has not spread to the lymph nodes . Stage IB: Cancer has spread to the lymph nodes and the cancer in the lymph node is larger than 0.2 mm but less than 2 mm in size. There is either no evidence of a tumor in the breast or the tumor in the breast is 20 mm or smaller .
Stage IIA: Any 1 of these conditions:
What Is Metastatic Breast Cancer
Metastatic breast cancer is the most advanced stage of breast cancer. Breast cancer develops when abnormal cells in the breast start to divide uncontrollably. A tumor is a mass or collection of these abnormal cells.
Metastasis refers to cancer cells that have spread to a new area of the body. In metastatic breast cancer, cells may spread to the:
Healthcare providers name cancer based on its primary origin. That means breast cancer that spreads to other body parts is still considered breast cancer. The cancer cells are still breast cancer cells. Your care team will use breast cancer therapies, even if the cancer cells are in other areas.
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How Grade Affects Treatment Options
Your treatment team will consider the grade of your cancer when deciding which treatment to offer you.
If you have grade 3 breast cancer, youre more likely to be offered chemotherapy. This is to help destroy any cancer cells that may have spread as a result of the cancer being faster growing.
Chemotherapy is less likely for grade 1 and grade 2 cancers.
The grade of your cancer alone will not determine what treatment youre offered. Your treatment team will consider the grade alongside all other information about your cancer when deciding on the best treatment options for you.
Find out more about breast cancer and prognosis.
The Tnm Staging System
The breast cancer staging system, called the TNM system, is overseen by the American Joint Committee on Cancer . The AJCC is a group of cancer experts who oversee how cancer is classified and communicated. This is to ensure that all doctors and treatment facilities are describing cancer in a uniform way so that the treatment results of all people can be compared and understood.
In the past, stage number was calculated based on just three clinical characteristics, T, N, and M.
The T category describes the original tumor:
HER2 status: are the cancer cells making too much of the HER2 protein?
Oncotype DX score, if the cancer is estrogen-receptor-positive, HER2-negative, and there is no cancer in the lymph nodes
Adding information about tumor grade, hormone-receptor status, HER2 status, and possibly Oncotype DX test results has made determining the stage of a breast cancer more complex, but also more accurate.
In general, according to experts, the new staging system classifies triple-negative breast cancer at a higher stage and classifies most hormone receptor-positive breast cancer at a lower stage.
You also may see or hear certain words used to describe the stage of the breast cancer:
Distant: The cancer is found in other parts of the body as well.
The updated AJCC breast cancer staging guidelines have made determining the stage of a cancer a more complicated but accurate process. So, the characteristics of each stage below are somewhat generalized.
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How Is Dcis Diagnosed
DCIS is usually diagnosed by a stereotactic core needle biopsy. This is a biopsy of the breastthat is guided by mammography.
Same Day Results
At the Johns Hopkins Breast Center, we are sensitive to the anxiety a possible diagnosis of breast cancer creates for our patients. If the radiologist who read your mammogram suspects you have DCIS, he or she will arrange for you to have a stereotactic biopsy. The biopsy can sometimes be done the same day, but is always done within a week. On the day of your breast biopsy, you will be given the probability that the biopsy is a breast cancer. Firm confirmation will follow within 24 hours.
How Can I Take Care Of Myself While Living With Metastatic Breast Cancer
Living with metastatic breast cancer can be challenging. Your care team can help provide physical and emotional support. Talk to them about how you can:
- Eat the most nutritious diet for your needs.
- Exercise regularly.
- Get emotional support, including finding support groups.
- Reach out for help from friends, family and loved ones.
- Find mental health services.
- Find complementary therapies.
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Pearls And Other Issues
Breast cancer patients are advised to be followed up for life to detect early recurrence and spread. Yearly or biannual follow-up mammography is recommended for the treated and the other breast. The patient must be informed that they must visit a breast clinic if they have any suspicious manifestations. Currently, there is no role for repeated measurements of tumor markers or doing follow-up imaging other than mammography.
Treatment For Metastatic Breast Cancer
There are a number of different approaches to treating metastatic breast cancer. Every cancer is unique and treatment can be tailored to your specific circumstances.
Doctors usually treat metastatic breast cancer in any part of the body with systemic medications, which treat cancer throughout the entire body. Chemotherapy, hormonal therapy, targeted therapies, and immunotherapy are all systemic medications. Local treatments that target a specific part of the body, such as surgery or radiation, are sometimes recommended.
Most treatment decisions depend on where in the body the cancer has spread, the cancers characteristics , and any cancer treatments youve had in the past.
If youre being treated for metastatic breast cancer, you may want to talk to your doctor about whether participating in a clinical trial makes sense for you. Its important to know that researchers conducting clinical trials carefully consider your specific situation before approving you as a study participant. By participating in a clinical trial, you can help researchers find better breast cancer treatments that may help extend lives in the future. But you also may benefit from the treatment the researchers are studying.
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Tnm Staging And Stage 2 Classification
In addition to using the numerical stage classifications, healthcare professionals also describe tumors using the tumor, node, metastasis staging system that the American Joint Committee on Cancer issued.
In this system, T describes tumor size, N describes the presence of cancer cells in the lymph nodes, and M describes whether or not the cancer has spread to other areas of the body.
The classifications for tumor size are:
- TX: Healthcare professionals cannot measure primary tumor size.
- T0: Healthcare professionals cannot find a tumor.
- T1: The tumor is smaller than 2 centimeters .
- T2: The tumor measures 25 cm.
- T2: The tumor is larger than 5 cm.
- T4: The tumor has spread beyond the breast tissue and lymph nodes or is inflammatory.
The classifications for lymph node involvement are:
- NX: Healthcare professionals cannot assess the lymph nodes.
- N0: The cancer has not spread to the surrounding nodes.
- N1, N2, N3: These indicate the number of nodes involved.
The classifications for metastasis are:
- M0: There is no sign that the cancer has spread .
- M1: The cancer has spread to another area of the body.
- MX: The cancer spread is not measurable.
The Prognosis For Patients With Triple
Prognosis refers to the likely outcome of treatment for patients with triple-negative breast cancer. Unlike other types of breast cancer that have a well-proven set of treatments, triple-negative breast cancer is still in the process of being researched for a more standardized treatment plan. Because of this, several treatments may be needed to find one that is effective. Studies have shown that triple-negative breast cancer is more likely to have metastasized , have a higher grade, and are more likely to recur after treatment.
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