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Stage 4 Triple Negative Metastatic Breast Cancer

Facts You Should Know About Triple

Medical Update: Triple-Negative Metastatic Breast Cancer
  • 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.

Stages Of Breast Cancer

The stage of breast cancer is based on the size and location of the tumor, as well as whether the cancer has spread beyond the part of the breast in which it originated. To determine the stage of breast cancer, healthcare professionals use a scale of stage 0 to stage 4.

Stage 0 breast cancers are isolated in one part of the breast, such as a duct or lobule, and show no sign of spreading into other tissue.

Stage 1 is typically localized, although further local growth or spread may cause the cancer to move into stage 2.

In stage 3, the cancer may be larger and has affected the lymph system. Stage 4 cancer has spread beyond the breast and nearby lymph nodes, and into other organs and tissues of the body.

In addition to stages, breast cancers are given grades based on the size, shape, and activity of the cells in the tumor. A higher-grade cancer means a greater percentage of cells look and act abnormal, or they no longer resemble normal, healthy cells.

On a scale of 1 to 3, with 3 being the most serious, TNBC is often labeled grade 3.

American Cancer Society , the symptoms of TNBC can be the same as those for other types of breast cancer. ACS recommends regular screenings such as mammograms to detect breast cancer before symptoms appear, the time when treatment is most effective.

Other signs of breast cancer include:

Any of these signs can be caused by other conditions. But it is always good to have them checked out by your healthcare professional.

Genetic Risks Of Triple

The main demographics for triple-negative breast cancer diagnosis are younger women , African-American and Hispanic women, and people with a BRCA1 mutation. About 15% to 20% of women with a triple-negative breast cancer prognosis have a genetic mutation. That means these women are at risk for other cancers and their family members could be at risk for cancers as well. Our team encourages women to talk with their providers about genetic counseling and testing.

Also Check: What Makes You High Risk For Breast Cancer

Are New Treatments For Metastatic Cancer Being Developed

Yes. Researchers are now studying new ways to kill or stop the growth of primary cancer cells and metastatic cancer cells. One new area of research includes ways to boost the strength of the immune response against tumors.

Regulatory T-cells and RANKL proteins may play a role in breast cancer metastasisRecent breast cancer research suggests that the bodys regulatory T cells, which are an integral part of the immune response system, may play a key role in metastasis.

It is speculated that the T cells produce a protein which seems to accelerate the spread of breast cancer cells to other areas of the body. The inflammatory protein RANKL seems to influence the T-cells ability to spread cancer cells to distant areas of the body.

It is believed that by interfering with RANKLs ability to interact with the T-cells, the early metastasis of breast cancer cells can be significantly inhibited

What Is The Prognosis For Triple

Stage 4

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.

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Treatments For Metastatic Triple

One myth about treating TNBC is that there arent effective treatment options. The truth is that an array of treatments can improve your care. Your treatment options include many medicines and may also include targeted therapies that treat some triple-negative breast cancers with specific features.

How do you choose from the many available chemotherapy options? It is important to talk with your doctors about how you wish to balance the goals of keeping the cancer under control as long as possible and maintaining your ,or overall enjoyment of life.

Another important point about treating metastatic TNBC is that if you had early- disease, you can retry medicines you were treated with before. A certain treatment may have failed to get rid of the primary disease, but that treatment could still control it in the metastatic setting.

Common chemotherapy treatments for metastatic triple-negative disease are:

  • , which kill cancer cells by stopping growth. Three anthracyclines used in metastatic breast cancer are:

Palliative And Supportive Care

Living with advanced TNBC is often difficult, emotionally and physically. Its important to identify and make use of the support that is available, whether it be family, friends, therapists, support groups, financial counselors, social workers or members of the community. Let people know your concerns and what you need from someone, whether it is to watch the kids, provide a ride to your appointment, be another set of ears or a friend who can listen.Its also important to know what services are available to help deal with any physical symptoms that you have. Request a referral to Palliative Care as soon as you get your diagnosis. Palliative Care is there to help with the full range of emotional and physical issues you may encounter throughout the course of your illness.If you are experiencing financial problems, either related to your treatment or to your life, let your health care team know. There are resources that can help with those issues as well.

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De Novo Metastatic Breast Cancer And Recurrent Breast Cancer

It is important to understand the two types of Stage IV Breast Cancer and the differences between them:-

  • De Novo metastatic breast cancer: This term refers to women who are Stage IV at the initial diagnosis of breast cancer. That is, cancer has already spread to other parts of the body. De novo metastatic breast cancer accounts for only around 6% of cases at diagnosis in the US.
  • Recurrent Breast Cancer: More often, breast cancer returns or spreads after the initial diagnosis and treatment of breast cancer. This recurrence can happen months, or even years, after the first presentation and treatment.
  • What You Need To Know

    Stage 4 Triple Negative Breast Cancer Survivor, Meet Denise (4/20/21 The Beat Broadcast)
    • 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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    Diagnosis Of Stage 4 Breast Cancer

    If you are diagnosed with breast cancer, you may have further tests to determine the extent that the cancer has spread throughout the body. This is called staging. It helps you and your doctors decide on the best treatment options for you.

    In addition the numbered staging system, the TNM staging system is also commonly used for breast cancer staging.

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    Can Stage 4 Breast Cancer Go Into Remission

    Stage 4 breast cancer can go into remission, meaning that it isnt detected in imaging or other tests. Pathological complete remission indicates a lack of cancer cells in tissues removed after surgery or biopsy.

    But its rare to take tissue samples while treating stage 4 breast cancer. This could mean that although treatment has been effective, it hasnt completely destroyed the cancer.

    Advances in stage 4 breast cancer treatments are helping to increase the length of remission.

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    Treatment Of Early Tnbc

    Early TNBC is aggressive, but it can be treated effectively. Its usually treated with some combination of surgery, radiation therapy, chemotherapy and immunotherapy.

    TNBC isnt treated with hormone therapy or HER2-targeted therapy because its ER-negative and HER2-negative.

    Learn about emerging areas in drug therapies for early breast cancer.

    What Are Causes And Risk Factors For Triple

    Metastatic TNBC

    Although there are known risk factors for the development of any kind of breast cancer, doctors do not understand the exact cause of breast cancer.

    • Normal cells become cancer cells due to changes or mutations in the DNA.
    • While people inherit some DNA changes, others acquire these DNA changes during a person’s life.

    The following are causes and risk factors for any type of breast cancer, including triple-negative breast cancer:

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    Who Is Most Likely To Have Tnbc

    Triple negative breast cancer appears more frequently in women age 40 and younger than in older women. Black and Latina women are more likely to develop TNBC than white women. Women who have the gene change BRCA1 are more likely to develop TNBC than other women. When the BRCA1 gene mutates, it stops preventing cancer and appears to make your bodys cells more vulnerable to cancer.

    How Is Tnbc Diagnosed

    Imaging tests are usually the first tests done:

    • Mammography, the most common screening tool for breast cancer, uses X-rays to take images of the breast and can uncover tumors that may be too small to feel.
    • MRI uses a magnet, radio waves and a computer to make detailed images of the breast with a much greater resolution than a mammogram offers.

    The next step is a biopsy to remove a sample of suspicious cells from the breast to analyze them. Techniques include:

    The appropriate type of biopsy for you depends on factors such as the size and location of the tumor. You may also have a biopsy of your underarm lymph nodes at the same time to see if any cancer is there.

    Breast cancer treatment: The care you need is one call away

    Your multidisciplinary team will work with you to develop a personalized plan to treat your breast cancer in a way that fits your individual needs and goals.

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    Mechanisms Of Breast Cancer Metastasis

    No one really knows what factors will make a certain patient more or less susceptible to breast cancer metastasis.

    There is growing awareness that part of that susceptibility is due to host factors. The host factors are the characteristics of the non-malignant cells and the general biological environment surrounding the malignant breast tumor.

    Sometimes the host factors are referred to as the pre-metastatic niche and it is thought that bone-marrow-derived progenitor cells may directly influence the dissemination of malignant cells to distant areas.

    Non-neoplastichost cells within the tumor may also play a key role in the regulation of breast cancer metastasis.

    Stage 4 Breast Cancer

    Stage IV WHAT’S NEXT? TRIPLE NEGATIVE METASTATIC BREAST CANCER

    Advanced breast cancer refers to cancer that has spread beyond the breast to other parts of the body. This process of spreading from the original location to a new location is known as metastasis.

    The most common places of breast cancer spread include the bones, liver, lung, and brain. However, breast cancer may also spread to other organs.

    The majority of women who are diagnosed with metastatic breast cancer have been diagnosed with an earlier stage of breast cancer before. In this instance, the original cancer in the breast is called the primary cancer. However, for some women, a diagnosis of metastatic breast cancer may be their first diagnosis of cancer .

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    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

    Stage 4 Triple Negative Breast Cancer

    Hi all my wife has just been diagnosed with stage 4 TNBC which has unfortunately spread to her lungs. on a posotive note we have caught it early so only one small tumor in her lungs. I am so confused reading online and speaking to some doctors they say her long term chances are not very good. i have not told her yet the truth all she knows is that this is going to be removed and hopefully we wont hear of this dreaded disease again.Does anyone have any long term positive stories of survival with TNBC stage 4 ? Or is it all basically doom and gloom? Also any advice on how and if i should break the news to her if is better for now to show positivity?

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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 Treatments Are Used For Metastatic Cancer

    What is the life expectancy of someone with stage 4 metastatic breast ...

    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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    Advanced Cancer That Progresses During Treatment

    Treatment for advanced breast cancer can often shrink the cancer or slow its growth , but after a time, it tends to stop working. Further treatment options at this point depend on several factors, including previous treatments, where the cancer is located, a woman’s menopause status, general health, desire to continue getting treatment, and whether the hormone receptor status and HER2 status have changed on the cancer cells.

    How Life Expectancy And Relapse Differ From Positive Tumors

    Questions about the survival rate and recurrence rate are very common when someone is diagnosed with triple-negative breast cancer. While prognosis is, on average, poorer than with hormone receptor or human epidermal growth factor receptor 2 positive tumors, triple-negative breast cancer is a very diverse disease.

    On a positive note, and unlike hormone-positive tumors that commonly recur late , late recurrence is less common with triple-negative tumors. The recent approval of immunotherapy only for triple-negative disease is also optimistic.

    This article looks at factors that may affect survival or recurrence of triple-negative breast cancer, as well as the statistical rates of both. It also discusses life expectancy with stage 4 and recent case reports of some longtime survivors.

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    This Is Just One Of Many Examples Of Patients Who Need To Take Charge Of Their Own Disease I Would Gladly Have Worked With The Patients Doctor And Offered To Provide Doses And Schedules That We Had So Successfully Applied In This Setting

    I provided the patient with several of our published studies that I had written over the years establishing the benefit of what we were recommending. That having been said, saving this patients life is the most important mission, and we will proceed with our treatment, regardless of what her physicians say or do.

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    Recurrence Of Metastatic Breast Cancer

    First Chemo-Infustion For Stage 4 Triple Negative Breast Cancer Pt. 2

    Metastatic breast cancer is considered a chronic disease, so it doesnt go away and recur.

    But in recent years, people under age 50 have seen a particularly strong decline in death rates due to breast cancer, according to the Centers for Disease Control and Prevention .

    These declines are due in part to improved screening and treatment for the disease.

    There are a few general facts that are helpful to know about breast cancer outlook:

    • Breast cancer is the most common cancer diagnosis in the United States, according to the

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