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Treating Triple Negative Breast Cancer

Can Triple Negative Breast Cancer Cause Sleep Disturbances

Major Breakthrough In Treating Triple-Negative Breast Cancer

Patients may also find it beneficial to seek counseling to help cope with the loss of their breast, or to help them throughout their treatment. Other issues that may stem from triple-negative breast cancer have to deal with the side effects of chemotherapy treatment. One of the most noted issues is sleep disturbances in addition to fatigue,

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.

Definitions And Molecular Features

It is important to clarify the relationship between triple-negative breast cancer and the basal-like phenotype. Triple-negative is a term based on clinical assays for ER, PR, and HER2, whereas basal-like is a molecular phenotype initially defined using cDNA microarrays. Although most triple-negative breast tumors do cluster within the basal-like subgroup, these terms are not synonymous there is up to 30% discordance between the two groups. In this review we will use the term basal-like when microarray or more comprehensive immunohistochemical profiling methodology was used, and triple-negative when the salient studies relied on clinical assays for definition.

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Local Or Regional Treatments For Stage Iv Breast Cancer

Although systemic drugs are the main treatment for stage IV breast cancer, local and regional treatments such as surgery, radiation therapy, or regional chemotherapy are sometimes used as well. These can help treat breast cancer in a specific part of the body, but they are very unlikely to get rid of all of the cancer. These treatments are more likely to be used to help prevent or treat symptoms or complications from the cancer.

Radiation therapy and/or surgery may also be used in certain situations, such as:

  • When the breast tumor is causing an open wound in the breast
  • To treat a small number of metastases in a certain area, such as the brain
  • To help prevent bone fractures
  • When an area of cancer spread is pressing on the spinal cord
  • To treat a blood vessel blockage in the liver
  • To provide relief of pain or other symptoms

In some cases, regional chemo may be useful as well.

If your doctor recommends such local or regional treatments, it is important that you understand their goalwhether it is to try to cure the cancer or to prevent or treat symptoms.

The Prognosis For Patients With Triple

New promise found in treating triple negative breast cancer

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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Success Among Siteman Triple

In 2016, when Celina Campbell found a quarter-sized lump in her breast, she assumed it was just a swollen area due to a minor injury. However, breast cancer runs in Celinas family and her cousin had just received a TNBC diagnosis. Because of this, she began to suspect the lump could be cancer. After following up with a breast surgeon, it was indeed confirmed that Celina, too, had TNBC.

While triple-negative breast cancer treatment was very emotionally and physically draining, Celina remained determined to overcome her diagnosis. And, after eight sessions of chemotherapy, no more lump could be found. Now, six years later, Celina lives a full life and her cancer is considered fully cured.

Throughout her cancer journey, Celina received the most exceptional care and support from Sitemans breast cancer specialist team. Former Washington University medical oncologist William Popovic, MD, laid out a thorough and personalized treatment plan for Celina, putting her at ease with his warm demeanor and genuine concern. All of the staff dedicated themselves fully to Celinas journey, always working to help her understand her cancer and her treatment. The expertise, commitment and compassion of Washington University breast cancer specialists at Siteman allowed Celina to take charge of her life and to become an incredible inspiration to other TNBC patients.

Predictive Biomarkers In Early Tnbc

BRCA1/2 are tumor suppressor genes that encode proteins involved in the repair of DNA double-strand breaks through the homologous recombination repair pathway. Members of the PARP family of enzymes are central to the repair of DNA single-strand breaks. Fifteen to twenty percent of unselected TNBC have a gBRCA mutation . TNBC patients without gBRCAm have a somatic mutation in the homologous recombination signaling pathway . gBRCAm and BRCAness statuses are associated with an increased sensitivity to chemotherapy and with better outcomes . Cells with gBRCAm are sensitive to PARP inhibition due to the synthetic lethality mechanism, resulting in an incapacity for DNA repair . As gBRCAm is associated with a higher pathological complete response rate and a prognostic impact in patients with TNBC , assessment of the gBRCA status should be considered in the early setting.

As PD-L1 is a dynamic marker and differences exist in the types of assay used and in PD-L1 assessment, additional predictive biomarkers are under investigation. A high tumor mutational burden is associated with a higher neoantigen burden and increased T-cell infiltration. Recently, it was shown that hypermutated breast cancers, like tumors with a mismatch repair deficiency, seem to benefit from PD-1 inhibitor therapy independently of the underlying mutational process . Further investigation is needed.

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Neoadjuvant Ct Versus Adjuvant Ct

Compared with adjuvant CT, neoadjuvant CT led to no significant improvement in OS or DFS in patients with TNBC. However, when PCR was achieved after NACT, the OS and DFS were significantly improved. The OS was lower when there were residual lesions after neoadjuvant therapy .12

Compared with patients with non TNBC, patients with TNBC had higher PCR rates after NACT , and DFS and OS were significantly improved in patients with PCR. The PCR rate in patients with TNBC with high Ki-67 expression was higher than that in patients with low Ki-67 expression .13

Can Tnbc Be Prevented

Research now showing different treatment options for triple negative breast cancers

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.

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What Is The First Step In A Breast Biopsy

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.

Causes Of Triple Negative Breast Cancer

The risk factors for triple negative breast cancer are not clear. Some breast cancers depend on hormones to grow. These can be linked with risk factors to do with hormones and having children. But triple negative breast cancer does not seem to share these risk factors.

Most women with triple negative breast cancer have no strong history of breast cancer in their family . But some women with triple negative breast cancer have an altered BRCA1 gene. This will have been inherited from a parent.

An altered BRCA 1 gene can cause breast cancer to run in families. Most breast cancers caused by BRCA1 are triple negative.

If you have triple negative breast cancer, you may be offered genetic testing. This is even if you do not have a family history of breast cancer. Your cancer doctor or breast care nurse can explain more about this to you.

The tests are the same as for any type of breast cancer. You usually have a:

  • Mammogram

    A mammogram is an x-ray of the breast.

  • Ultrasound scan

    An ultrasound scan uses sound waves to produce a picture of the breast tissue and the lymph nodes in the armpit.

  • Breast biopsy

    When you have a breast biopsy, your cancer doctor or breast care nurse takes small samples of cells or tissue from your breast. The samples are looked at under a microscope to check for cancer cells. They also do other tests to find out if the cells have receptors for hormones, or for HER2.

See also

The staging and grading is the same as for other types of breast cancer.

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Can Stress Cause Triple

Social stress connected to triple-negative breast cancer via fat cells. Local chemical signals released by fat cells in the mammary gland appear to provide a crucial link between exposure to unrelenting social stressors early in life and to the subsequent development of breast cancer, according to new research.

Trials For Advanced Triple Negative Breast Cancer

SABCS2020: Chemo

Trials are comparing different types of chemotherapy to see which are better at treating advanced disease. For example, researchers are waiting for the results of the Triple Negative Trial to find out whether it is better to use carboplatin or docetaxel.

Research is looking at using targeted cancer drugs alongside other treatments. For example, a trial is using a drug called atezolizumab in combination with chemotherapy. Some trials are testing a drug called pembrolizumab. Researchers think that these targeted drugs on their own might help to control the growth of the cancer.

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What Is Triple Negative Breast Cancer

Triple negative breast cancer is:

  • Estrogen receptor-negative
  • Progesterone receptor-negative

Most triple negative tumors are basal-like . Basal-like tumors have cells that look similar to those of the outer cells surrounding the mammary ducts.

Triple negative/basal-like tumors are a molecular subtype of breast cancer.

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? i3Health is hosting an upcoming webinar Metastatic Triple-Negative Breast Cancer: Applying Treatment Advances to Personalized Care. Learn more here.

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What Are Symptoms Of Triple Negative Breast Cancer

TNBC symptoms are the same as other common breast cancers. And many breast cancer symptoms are similar to other less serious conditions. That means having certain symptom doesnt mean you have breast cancer. Possible breast cancer symptoms include:

  • A new lump or mass.
  • Swelling in all or part of a breast.
  • Nipple retraction, when your nipple turns inward.
  • Nipple or breast skin thats dry, flaking, thickened or red.
  • Nipple discharge that is not breast milk.
  • Swollen lymph nodes. This symptom happens when breast cancer spreads to the lymph nodes under your arm or near your collarbone.

What Are Breast Cancer Subtypes And Why Do They Matter

Yuan Yuan, M.D., Ph.D., on Triple Negative Breast Cancer Treatments | #ASCO21

Your breast cancer subtype is one factor healthcare providers take into account when theyre deciding how to treat your cancer. Thats because not all cancer treatments are successful with all breast cancer subtypes.

Providers look at your cancer cells to identify subtypes. Specifically, they look for molecules on your cells surfaces. These molecules, called receptors, are built to order so only certain substances can climb on and start affecting what your cells do.

Breast cancer cells receptors are open to estrogen and progesterone. Understanding if your breast cancer cells have receptors and if theyre housing hormones helps providers determine how your breast cancer might spread and what treatment might be most effective.

The other type of breast cancer that has another receptor is called her-2 neu. This receptor makes the cells more active, but allows healthcare providers to treat the cancer with specific medicines that target her-2 proteins. If your breast cancer doesnt have her-2 neu and hormone receptors, its called triple negative.

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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.

What Is A Triple

What Is Triple-Negative Breast Cancer? Triple-negative breast cancer is a kind of breast cancer that does not have any of the receptors that are commonly found in breast cancer. Think of cancer cells as a house. The front door may have three kinds of locks, called receptors One is for the female hormone estrogen.

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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.

Role Of Platinum Agents

Effect of Clinical and Treatment Factors on Survival Outcomes of Triple ...

TNBC is often associated with a deficiency in BRCA-driven DNA repair mechanisms, leading to a higher sensibility to interstrand cross-linking agents damaging the DNA, such as platinum agents .

Contrary to data obtained in the metastatic setting, the carboplatin effect was independent of gBRCA status. Patients with gBRCAm had in general a higher pCR rate compared to wild type ones, but the increase in pCR with the addition of carboplatin was more prominent in the wild type cohort . One explanation of the different results could be the single versus combination therapy or the treatment setting.

Results of meta-analyses are consistent . Even though only a few small studies assessed the role of cisplatin , it seems to be as effective as carboplatin in increasing the pCR rate, but with a different safety profile . A head-to-head study of 4 cycles of weekly carboplatin or cisplatin and paclitaxel showed similar pCR rates and outcomes for the 2 compounds. No significant differences were seen in terms of AE .

Many new trials have incorporated carboplatin as part of the standard regimen. Its use is recommended irrespectively of the BRCA status.

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New Treatments Needed For Advanced Triple

Triple-negative breast cancer tends to be more aggressive, harder to treat, and more likely to recur than other forms of the disease, such as hormone receptorpositive or HER2-positive breast cancers.

Conventional chemotherapy drugs have not been effective against triple-negative breast cancer, and new treatment options are needed, said Jung-Min Lee, M.D., of the Womens Malignancies Branch in NCIs Center for Cancer Research.

In the KEYNOTE-355 trial, 847 patients with advanced triple-negative breast cancer were randomly assigned to receive chemotherapy plus placebo or chemotherapy plus pembrolizumab.

The study assessed the amount of time before the disease worsened and overall survival in all patients, in those with PD-L1 combined positive scores of 1 or more, and in those with combined positive scores of 10 or more. The trial was funded by Merck, the manufacturer of pembrolizumab.

The PD-L1 combined positive score is essentially a measure of the extent to which cells in a tumor produce PD-L1, the immune checkpoint protein that pembrolizumab targets. By blocking immune checkpoints, pembrolizumab and other immune checkpoint inhibitors unleash the immune system against cancer cells.

The incidence of treatment-related side effects, including serious side effects, was similar between the two groups of patients in the study.


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