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Triple Negative Stage 3 Breast Cancer

What Is The Treatment For Triple

How a triple-negative breast cancer survivor became cancer-free

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.

Do People Survive Triple

In general, about 91% of all women with triple-negative breast cancer are still alive 5 years after diagnosis. If the cancer has spread to the lymph nodes near the breast the 5 year relative survival rate is about 65%. If the cancer has spread to distant places, the 5 year relative survival rate is 12%.

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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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 , 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.

Triple Negative Breast Cancer Treatment At Moffitt

Triple Negative and Me: TNBC and its treatments

The Don & Erika Wallace Comprehensive Breast Program at Moffitt Cancer Center offers a full range of advanced treatments for all stages and types of breast cancer, including triple negative. While patients with hormone-receptor-negative cancers do not benefit from hormonal therapy, other treatment options such as surgery, radiation therapy and chemotherapy are often recommended. At Moffitt, each patients treatment plan is developed with input from a tumor board comprised of a multispecialty team of cancer experts. To ensure the best possible patient care, this knowledgeable group meets weekly to review the each patients progress and fine-tune the treatment plan for our patients as necessary.

For more information about triple negative breast cancer stages, call or fill out a new patient registration form. When you reach out to Moffitt, you can expect to be connected with a cancer expert in just one day. Were proud to deliver nationally ranked care in new and transformative ways, and in order to provide patients with the rapid care they deserve, weve disrupted the traditional patient care model. Our one-day turnaround time is faster than that of any other cancer hospital across the country.

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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

Stage 3b Breast Cancer

Stage 3B breast cancer means a tumour of any size that has spread to other tissues near the breast such as skin, muscles, or ribs. At this stage, the tumour may or may not have spread to the lymph nodes. However, the cancer has not spread to other distant parts of the body.

Cancer that has spread to the skin of the breast might be inflammatory breast cancer, a rare form of cancer which can be aggressive and challenging to treat.

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What Is The Recurrence Rate Of Triple

A 2019 study found that roughly 40% of people with stage 1 to stage 3 TNBC will see their cancer return after standard treatment. The remaining 60% will have long-term survival without recurrence.

The outcomes of treatment vary. About 42% of those with this form of cancer will have a rapid relapse after standard treatment. This recurrence typically occurs within the first 23 years following the initial diagnosis.

It is not currently possible to predict who will experience a relapse in their cancer, even if they have had intensive chemotherapy.

On average,

Triple-negative breast cancer can recur in various areas of the body and at local, regional, and distant levels:

  • Local means that the cancer remains in the breast and has not spread.
  • Regional is when the cancer spreads from the breast to lymph nodes and other structures located nearby.
  • Distant refers to cancer that has spread far from the breast to other organs, such as the liver or lungs.

A 2017 study examined the patterns of recurrence among 1,930 people with TNBC. The researchers divided the patients into two age groups: 15% were younger than 40 years at the time of their diagnosis, and 85% were 40 years or older.

The researchers found only a small difference between the two groups in terms of recurrence of the cancer on the local level: 6% of those under 40 versus 5% of those aged 40 or above.

The same study found that the rate of regional recurrence was 2% for both groups.

What Is A 5

Case 3: Metastatic 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 for at least 5 years after being diagnosed.

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Intrinsic Molecular Subtypes In Tnbc

Distinct molecular portraits of breast cancer, originally identified as Luminal, HER2-Enriched, Basal-like , and Normal-like breast cancer, were based unsupervised gene expression analysis. Luminal A and B subtypes express keratins 8/18 and ER-related gene clusters, the BL has overexpression of keratin 5, 17 and epithelial grown factor receptors -related genes, and the HER2-Enriched subtype is characterized by expression of Erb-B2-related genes each of these molecular subtypes can be found within clinical subsets . About 80% of TNBC are BL, and BL tumors cluster biologically far from the other BC subtypes, making intrinsic subtyping less useful for meaningful subclassification than in the other clinical subtypes. More detailed confirmation of BC heterogeneity has come from multiple efforts to examine DNA, RNA, microRNA, and protein expression patterns through cross-platform analyses such as The Cancer Genome Atlas and METABRIC,.

Fig. 1: Intrinsic molecular subtypes of breast cancer.

Within each clinical subtype there are multiple molecular subtypes. ER endocrine receptor TNBC triple negative breast cancer HER2 Human Epidermal Growth Factor Receptor 2.

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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New Medications For Metastatic Breast Cancer

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.

What Is The Staging Of Triple

Triple Negative Breast Cancer

Staging is the process of determining the extent of the cancer and its spread in the body. Together with the type of cancer, staging helps determine the appropriate therapy and predict the chances for survival.

To determine if the cancer has spread, medical professionals may use several different imaging techniques, including X-ray, CT scans, bone scans, and PET scans. Staging depends upon the size of a tumor and the extent to which it spread to lymph nodes or distant sites and organs in the body. Examination of lymph nodes removed at surgery and the results of ER, PR, and HER2 tests performed on the tumor tissue also help determine the stage of a tumor. Stage I is the lowest stage, while stage IV is the highest stage and refers to tumors that have metastasized, or spread to areas distant from the breast.

Most doctors specifically adjust breast cancer treatments to the type of cancer and the staging group.

Surgery

Many women with breast cancer will require surgery. Broadly, the surgical therapies for breast cancer consist of breast-conserving surgery and mastectomy .

Radiation therapy

Radiation therapy destroys cancer cells with high-energy rays. Doctors commonly administer radiation therapy to patients after breast cancer surgery, most commonly after lumpectomy.

Chemotherapy

Types of chemotherapy include the following:

Other therapies for triple-negative breast cancer

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Survival Rate For Patients With Triple

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.

Stage 3a Breast Cancer

If you are diagnosed with Stage 3A breast cancer, it means that one of the following applies to you:

Either:

The tumour is less than 5 cm and breast cancer cells have been found in:

  • 4-9 lymph nodes in the armpit. or
  • 1 or more lymph nodes under the breastbone

The tumour is larger than 5 cm and breast cancer cells have spread to 1-9 lymph nodes.

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Where Do These Numbers Come From

The American Cancer Society relies on information from the Surveillance, Epidemiology, and End Results Program database, maintained by the National Cancer Institute , to provide survival statistics for different types of cancer.

The SEER database tracks 5-year relative survival rates for breast cancer in the United States, based on how far the cancer has spread. The SEER database, however, does not group cancers by AJCC TNM stages . Instead, it groups cancers into localized, regional, and distant stages:

  • Localized: There is no sign that the cancer has spread outside of the breast.
  • Regional: The cancer has spread outside the breast to nearby structures or lymph nodes.
  • Distant: The cancer has spread to distant parts of the body such as the lungs, liver, or bones.

Diagnosing Triple Negative Breast Cancer

Survival outcomes from the CALGB 40603 study in triple-negative breast cancer

In many women the cancer is found during breast screening. But symptoms such as a breast lump can be a sign of breast cancer. So it is important to get any symptoms checked by your doctor.

If you have symptoms and see your GP they refer you to a specialist breast clinic. At the breast clinic the doctor or breast care nurse takes your medical history and examines your breasts. They also feel for any swollen lymph nodes under your arms and at the base of your neck.

You have some of the following tests:

  • a biopsy your doctor or nurse take a small sample of cells or tissue from your breast to look at under a microscope

Depending on your age and whether other family members have had breast cancer, your doctor might refer you for gene testing. This is to find out if there is a fault in the BRCA cancer gene.

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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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Morbidity Financial And Social Burdens Of Therapy

Chemotherapy is often feared by patients due to the side effects associated with treatment however, the costs for administering therapy have also become a major burden for both the United States healthcare system as well as the patients it serves. Financial toxicity is not frequently disclosed, and can be materially and psychologically debilitating for patients. Financial hardships induced by the cost of cancer care worsen patient psychological stress and financial insolvency has been identified as a risk factor for early mortality in cancer patients.,

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Triple Negative Breast Cancer Grade 3

I have just been told on 2nd November that i have invasive ductal cancer grade 3 triple negative. It has been a crazy 2 weeks with apointments doctors tests . I start my chemotherapy today at 11am i am so scared. I am going to try the cold cap and also been told that sucking ice cubes while have chemo help to stop getting sores in the mouth , so i will try it . Hope all of you going through this will be ok . Lots of love to you all xx

ZeldaC,

My advice is do your best to push that fear out. Fear is due to the unknown so by end of day today you will know what to expect. Take the nausea meds on time and it should help. Also if you are getting Adriomycin, take some hard candy to suck on…it will help with the metal taste.

If you don’t have a port, get one. It will be less stress on your veins. You will get through this!! Think of it a a long journey where you will be rewarded in the end with a cancer free body. Stay strong and positive…watch funny movies and laugh as much as you can! You got this!!!!

Many blessings.

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