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.
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.
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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Can You Predict Cancer Survival
Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. These statistics can be confusing and may lead you to have more questions. Talk with your doctor about how these numbers may apply to you, as he or she is familiar with your situation.
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.
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Research Into Triple Negative Early Breast Cancer
Research has identified a number of different sub-types of triple negative breast cancer, providing opportunities for new treatments that target these sub-types to be developed.
Targeted treatments are currently being investigated using PARP inhibitors for BRCA related cancers, and PI3K/AKT inhibitors and immunotherapy drugs for other sub-types.
Patient And Treatment Characteristics
One hundred ten of the 992 patients were triple negative. The median age was 50 and 50 in the TNBC and non-TNBC groups, respectively. The median follow-up was 73.57 months . Also, 47.4% of our patients were postmenopausal. The characteristics of the patients and the treatments are summarized in Table1 and Table 2. The most common histology in the TNBC group was invasive ductal carcinoma . The medullary carcinoma subtype was observed more frequently than non-TNBC group. The TNBC group had more grade 2-3 tumors , a higher ki-67 value , more metastasis presence and more exitus than the non-TNBC group. Also, local recurrence was higher in the TNBC group, although it was not statistically significant. When the patients with metastases were evaluated, visceral and bone metastases were not different between the groups, while brain metastases were observed to be more common in the TNBC group .
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What Does Triple Negative Mean In Terms Of Breast Cancer
Normal breast cells have receptors that respond to hormones such as estrogen and progesterone, which allows them to grow and regress in response to the hormone level. Hormone receptors may or may not be present in breast cancer. About two-thirds of breast cancers are positive and contain these receptors like normal breast cells do. These are less aggressive cancers that are less likely to need chemo and are often treated with hormone therapy and surgery. Radiation may or may not be needed.
HER2/neu , is a protein molecule that has a role in cell proliferation in normal cells. In some breast cancers, this protein is overly produced or positive. For HER2-positive tumors, there a specific medication that targets this protein.
Triple-negative breast cancers are not positive for estrogen receptors, progesterone receptors or HER2 protein. Since these targets are absent in triple-negative breast cancer, chemotherapy is needed, Sun says. Triple-negative breast cancer is often very sensitive to chemotherapy, which, despite the side effects, is an effective treatment that can save lives. Because this is an aggressive cancer, treatment is aggressive also. But there are several ways we can address it.
Immunosuppressive Immune Cells In The Tnbc Tumor Microenvironment
The tumor microenvironment involves the surrounding blood vessels, fibroblasts, immune cells, signaling molecules and the extracellular matrix around the tumor . Tumor Infiltrating Lymphocytes produce endogenous antitumor immune response for inhibiting tumor progression and improving free survival rate of TNBC patients . Tumor associated macrophages are important for immunosuppressive role by secreting inhibitory cytokines, regulatory T cells infiltration promotion, and reactive oxygen species reduction . Cancer-Associated Fibroblasts lower anti-tumor immunity, favor tumor cell proliferation and invasion and reshape the extracellular matrix . Tumor associated neutrophils aid in lysing tumor cells and induce antitumor function .
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When To See A Healthcare Provider
If you notice a lump or any physical changes to your breast or nipple, its important to make an appointment with your healthcare provider to get it checked out. In addition, keep an eye on your breasts with self-examination.
The American Cancer Society recommends that females ages 45 to 54 get a mammogram every year, and females ages 40 to 44 should have the option to get a mammogram if they want to. Females 55 years or older can switch to a mammogram every two years or stick with a yearly exam if they prefer.
What Are Causes And Risk Factors For Triple
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:
- changes in the nipple, including inversion of the nipple and nipple discharge.
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Trials For Advanced Triple Negative Breast Cancer
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.
A Note About Statistics
Survival rates are statistics. As such, they tend to tell us how the average person will do with an average triple-negative breast cancer. But people and tumors arent statistics. Some people will do better, and some people will do worse.
Very importantly, statistics are usually several years old. In order to calculate five-year survival rates, a person would have to have been diagnosed at least five years prior, and there is lag time. The treatment of triple-negative breast cancer is changing, and new drugs have been approved.
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What Is The Staging Of Triple
Staging is the process of determining the extent of 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 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.
- The American Cancer Society defines 4 stages of breast cancer.
- 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
What Is The Relative Survival Rate Of 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
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Diagnosing 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.
Training Strategy And Evaluation Criteria
Similar to several related research studies,,, we used the negative partial log likelihood as the loss function to train our model. For the \ patient, we can denote the predicted output risk score as \ and label as , \), where \ is the follow-up event time and \ is the censoring status. For patients whose death is not observed, \, and for patients subjected to disease specific death, \. Event times can be considered as an ordered set of observations where \ for \ number of patients. For any arbitrary patient i whose follow-up time is \, a risk set \\) can be defined as the set of patients whose follow-up times are greater than or equal to \. Given that a unique event occurs at time t, the probability of death for patient i can be calculated according to \. Conditioned upon occurrence of all deaths, the joint probability of all events becomes the partial likelihood L.
We can maximise \\) and equivalently minimize the negative log partial likelihood over the deep learning model parameters. Therefore, the loss function for our model is defined by
It can be seen that \\) considers only the relative ordering of events when calculating the loss.
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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.
What Is The Survival Rate By Stage For Triple Negative Breast Cancer
Survival rates are a way to discuss the prognosis and outlook of a cancer diagnosis. The number most frequently mentioned is 5-year survival. Many patients live much longer, and some die earlier from causes other than breast cancer. With constant change and improvement in therapies, these numbers also change. Current 5-year survival statistics are based on patients who were diagnosed at least 5 years ago and may have received different therapies than are available today.
Below are the statistics from the National Cancer Institute’s SEER database for the survival of all patients with breast cancer, by tumor stage:
| Stage | |
|---|---|
| IV | 22% |
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When Should I Go To The Emergency Room
You might also have unusually strong side effects from your cancer treatment. While your healthcare provider likely gave you medication to help control your side effects, you should go to the emergency room if your side effects continue despite medication.
Many cancer treatments affect your immune system, increasing the chance you will develop infections. Symptoms that might require an emergency room visit during treatment are:
- Fever of 100.5 and above.
- Persistent nausea and vomiting.
Existing And Investigational Treatment Paradigm
From a chemotherapeutic perspective, TNBC is very sensitive, and treatments require extreme care. Common treatment involves the use of alkylating agents , anthracycline , anti-metabolite fluorouracil, and anti-microtubule agent . For early diagnosis of TNBC, neoadjuvant chemotherapy and subsequent surgery are applied. No standard chemotherapy has been described for the treatment of relapsed TNBC. Treating advanced TNBC includes the following drugs: gemcitabine and capecitabine , eribulin , and platinum . The conventional treatment options for TNBC are listed in Table 1.
TABLE 1. Conventional treatment option for TNBC.
TABLE 2. Different types of nano medicines under experimental and clinical testing for TNBC theranostics .
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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.
What Is Triple Negative Early Breast Cancer
Triple negative breast cancer is a type of breast cancer that does not have any of the three receptors commonly found on breast cancer cells the oestrogen, progesterone and HER2 receptors. Around 15% of early breast cancers are triple negative.
Triple negative breast cancer generally responds well to chemotherapy. Five years after diagnosis, people with triple negative breast cancer are no more likely to experience a recurrence of their breast cancer than people with other types of breast cancer. In the longer term , a recurrence is less likely with triple negative breast cancer.
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What Tests And Exams Diagnose Triple
The diagnosis of triple-negative breast cancer requires a sampling of tissue from the breast, known as a breast biopsy.
- Medical professionals may perform the biopsy using imaging techniques, such as mammography or others, for guidance.
- If the biopsy shows cancer, they may perform other tests on the biopsy sample to determine the precise type of cancer.
- In particular, they commonly perform tests for expression of the estrogen receptor , progesterone receptor , and HER2 protein as a first step. If these tests are all negative, they classify cancer as triple-negative breast cancer.