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Triple-negative Breast Cancer In The Elderly Prognosis And Treatment

What Is The Treatment For Triple

New Treatment Shows Promise For Triple-Negative Breast Cancer Patients

Chemotherapy.Chemotherapy is almost always called for, Sun says. Chemo can downstage tumors . While Sun says the chemotherapy for triple-negative breast cancer can be intense, she adds that regimen can be tailored to the individual and adjusted for older or frailer patients.

In those cases where we get complete response, we know we gave you the right medicine and your prognosis is good, Sun says.

Surgery can remove more of the tumor. Surgery for triple-negative breast cancer does not always have to be a mastectomy, Sun says. Effective chemotherapy done first opens up the possibility of less-invasive surgical options that are less of an ordeal for the patient. If the tumor is small enough after chemo, outpatient procedures or a lumpectomy may be possible.

Surgical samples of the cancerous tissues taken from surgery can provide more information on the cancer and how it is behaving so chemotherapy can be tailored accordingly.

Radiation therapy involves the use beams of radiation to destroy cancer cells, using various techniques to prevent damage to healthy surrounding tissue.

Medical treatments are being tested on triple-negative breast tumors in clinical trials.

Immunotherapy and PARP inhibitors are very exciting and theres lots of research going on, including here at Johns Hopkins, Sun says.

Compliance With Ethical Standards

The authors declare no conflicts of interest.

The study has been conducted in accordance with the Declaration of Helsinki. The Sahlgrenska University Hospital Ethical Review Board, Gothenburg, Sweden approved the study . The need for informed consent was waived under the approval of the Ethical Review Board due to the retrospective design.

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.

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What Is The Risk For Triple

The disease can affect anyone, but is more likely to show up in those who are:

  • Younger than age 50 .
  • Black or Latinx.
  • Living with a genetic condition called BRCA mutation that increases the risk for breast cancer and other forms of cancer. Most cancers diagnosed in people with the BRCA1 mutation are triple negative.

Basal Cell Breast Cancer

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Basal cell breast cancer is a type of breast cancer with a clear pattern of changes in proteins in the cells.

Cancer doctors recognise basal cell breast cancer when they examine the cancer cells under a microscope. It is often linked with triple negative breast cancer.

Basal cell breast cancers are usually triple negative. And most triple negative breast cancers are basal cell cancers. They are similar types of breast cancer, but not exactly the same.

See also

The symptoms of triple negative breast cancer are the same as for other breast cancer types.

See also

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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.

Risk Factors For Triple

Doctors aren’t sure what makes you more likely to get triple-negative breast cancer. Not many women do — it only affects up to 20% of those who have breast cancer. You’re most at risk for triple-negative breast cancer if you:

  • Are African-American or Latina
  • Have what your doctor will call a BRCA mutation , especially the gene BRCA1

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Univariate And Multivariate Cox Analyses Of The Prognostic Factors For Css

In terms of 3-, 5-, and 7- year CSS, univariate Cox analysis showed that age , worse differentiation grade , larger tumor size , positive N stage , and radical surgical extension were the potential risk factor in impairing the long-term CSS. By contrast, Asian/Pacific Islander and American Indian/Alaska Native race and receiving radiation therapy were favorable prognostic factors for CSS . As for chemotherapy, there was a slight trend to become statistically significant .

Table 3 Univariate and multivariate Cox regression analyses of predictive variables correlated with CSS in elderly primary operable TNBC patients .

In stepwise multivariate Cox analysis, seven variables including age , Asian/Pacific Islander and American Indian/Alaska Native race , differentiation grade , larger tumor size , positive N stage , receiving chemotherapy , and radiation therapy were the independent prognostic factors for CSS .

How Is Triple

Predicting disease recurrence in patients with early triple-negative breast cancer using circula…

Once a breast cancer diagnosis has been made using imaging tests and a biopsy, the cancer cells will be checked for certain proteins. If the cells do not have estrogen or progesterone receptors , and also do not make any or too much of the HER2 protein, the cancer is considered to be triple-negative breast cancer.

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What Is A 5

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 for at least 5 years after being diagnosed.

Can Tnbc Be Prevented

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 Are Breast Cancer Subtypes And Why Do They Matter

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.

New Medications For Metastatic Breast Cancer

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Immunotherapy drugs called checkpoint inhibitors have led to a significant improvement in survival rates for lung cancer and melanoma.

In 2019, Tecentriq became the first immunotherapy drug to be approved for triple-negative breast cancer that is metastatic or locally advanced but unresectable . However, in August 2021, Tecentriq’s manufacturer voluntarily withdrew that indication in the United States.

However, also in 2021, the Food and Drug Administration approved Keytruda for high-risk, early-stage, triple-negative breast cancer. It is used in combination with chemotherapy as a neoadjuvant treatment , and then continued as a single agent as adjuvant treatment .

PARP inhibitors are another class of medication that may alter survival rates in the future, particularly among women who have hereditary breast cancer .

For bone metastases, bone-modifying drugs may be effective in both treating metastases and possibly reducing the development of further metastases in bone.

Finally, for people who have only a single or a few metastases , treating these metastases locally may be an option. While studies are young, treating oligometastases may improve survival or even lead to long-term survival for a minority of people.

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What Questions Should I Ask My Doctor

You will have lots of questions about your cancer, starting with your diagnosis. Here are some basic questions you might ask:

  • What is triple negative breast cancer?
  • How do you know my cancer is triple negative breast cancer?
  • Why did I get this cancer?
  • Do I need genetic testing?
  • Has my breast cancer spread, and if so, how far has it spread?
  • What is the stage of my cancer?
  • What is my prognosis or expected outcome?
  • What treatments do you recommend?
  • Why do you recommend those treatments?
  • What are those treatment side effects?
  • Will I need surgery? If so, what surgery do you recommend and why?
  • Im interested in participating in clinical trials. Are you able to help me find one?
  • Do you know if there are any local support groups?

A note from Cleveland Clinic

Triple negative breast cancer is one of the more challenging breast cancers to treat. You might be discouraged by what you have read about triple negative breast cancer. But there are a number of very effective treatments for triple negative breast cancer, including immunotherapy, chemotherapy, surgery and radiation. And every day researchers learn more about this rare cancer. Their knowledge is your power. If youre concerned you arent getting the straight story about your cancer, ask your healthcare provider to walk you through your diagnosis and treatment options.

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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What Is Triple Negative Breast Cancer

Triple negative breast cancer is a rare cancer that affects about 13 in 100,000 women each year. It represents about 15 % of all invasive breast cancers. Triple negative breast cancer is one of three types of breast cancer. It is called as triple negative because it doesnt have three markers associated with other types of breast cancer, which is important for prognosis and treatment. Its one of the more challenging breast cancers to treat. But researchers are making steady progress toward more effective treatments. Overall, 77% of women who have triple negative breast cancer are alive five years after diagnosis.

Is There Hope For Triple

How Is Triple-Negative Breast Cancer Treated?

According to experts, triple-negative can be a very treatable and potentially curable type of breast cancer, especially with recent research advances. Treatment of triple-negative breast cancer involves both local therapies, such as surgery and radiation, and can also include systemic therapies, like chemotherapy.

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Demographics And Clinical Characteristics Of The Study Population

Overall, 4,696 eligible patients were enrolled in our study, including 2,122 patients belonged to chemotherapy group and 2,574 patients belonged to no-chemotherapy group. The median follow-up time was 27 months. The baseline characteristics of the chemotherapy group and no-chemotherapy group were summarized in Table . There were significant differences in characteristics between two groups, including age, marital status, grade, AJCC stage, tumor status, nodal status and radiation status. The patients treated with chemotherapy presented a higher proportion of younger age , married status , and grade III . A lower proportion of patients in chemotherapy group presented AJCC stage I, T1 stage and N0 stage . In addition, the chemotherapy group were inclined to accept radiotherapy than no-chemotherapy group . Other characteristics, including race and surgery approach, were similarly distributed between two groups.

Table 1 Baseline characteristics of patients with chemotherapy and no-chemotherapy

Prognostic Factors And Models For Elderly Primary Operable Triple

  • 1Department of Breast Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
  • 2Department of Pathology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China
  • 3Department of Breast and Thyroid Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China

Background: Triple-negative breast cancer is an aggressive subtype of breast cancer. In the elderly primary operable TNBC, individualized treatment modalities for this population are pivotal and important, but limited studies are explored.

Methods: The clinicopathological features of elderly primary operable TNBC patients were retrospectively selected from the Surveillance, Epidemiology, and End Results database between January 2010 and December 2015. KaplanMeier curves were used to show the survival patterns in the different subgroups. Multivariate Cox analysis was used to identify independent risk factors in the 3-, 5-, and 7- year overall survival and cancer-specific survival in this subpopulation. The predictive model was further developed and validated for clinical use.

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Clinicopathological Characteristics Of Elderly Primary Operable Tnbc Patients

In total, from the SEER database between 2010 and 2015 years, 4,761 elderly primary operable TNBC patients were enrolled in this study with a mean age of 76.85 years at diagnosis and a median follow-up time of 56 months . White race played a majority population in the present study , whereas Asian or Pacific Islander and American Indian/Alaska Native only accounted for 3.4% of the whole population . Based on the TNM stage classification, nearly half of the study population in the present study was at the IA stage . The patients were subsequently randomized divided into training and validating cohorts for further Cox analysis and nomogram construction as well validation. The specific demographic and clinical characteristics of the elderly primary operable TNBC patients are shown in Table 1.

Table 1 Clinicopathological characteristics of elderly primary operable TNBC patients in training and validation cohorts.

How Fast Can Triple

Correlation between RTEHBP and RTE90. There was a positive correlation ...

Studies suggest about 75% of recurrences happen within 3 years of diagnosis, and most occur within 5 years. A 2018 Brazilian study found that in people with triple-negative breast cancer, cancers that had spread to the lymph nodes, were at later stages, or both were associated with higher recurrence rates.

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Statistics Dont Account For Late Recurrences

When comparing triple-negative breast cancer to positive tumors, its important to keep in mind late recurrences. Most statistics are presented as five-year survival rate, and in this setting, triple-negative breast cancer can look more ominous. But looking at longer periods of time, say 20 years following diagnosis, this may be different.

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.

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