Stage 3 Breast Cancer
Stage 3 means that the cancer has spread from the breast to lymph nodes close to the breast or to the skin of the breast or to the chest wall.
It is also called locally advanced breast cancer.
The stage of a cancer tells you how big it is and how far it has spread. It helps your doctor decide which treatment you need.
Staging for breast cancer is very complex. Many different factors are considered before doctors can confirm your final stage. For example, they also use a sample of your cancer to test for:
- receptors for the female hormones
- HER2 status
- the grade of your cancer
You may also have a CT scan to check that the cancer has not spread to other parts of your body.
Do speak to your breast doctor or nurse if you have any questions about staging.
Treatment For Stage 4 Breast Cancer
Typically, treatment for stage 4 breast cancer includes a combination of chemotherapy, radiation therapy, and hormone therapy .
Targeted therapy is a treatment that targets the protein that allows cancer cells to grow and this type of therapy may also be an option for people with stage 4 breast cancer.
Sometimes, surgeons will operate to try and remove tumors though this is not usually the first option for treatment.
Doctors, however, may recommend surgery to help with pain relief by treating some of the issues that may develop as a result of having stage 4 breast cancer. These include spinal cord compression, removing single masses caused by metastasis, and fixing any broken bones.
A doctor may also prescribe medication to treat related symptoms such as:
- antidepressants to help mood
- anticonvulsants to manage pain or neurologic conditions
- local anesthetics to manage pain
New treatments and therapies are emerging all the time, and anyone who has breast cancer at any stage can volunteer to try out these new treatments. People considering this should talk to their doctor to see whether any trials are available in their area.
Trials for a new treatment called immunotherapy are currently taking place. Immunotherapy works by raising the bodys natural ability to fight off cancer and has fewer side effects than chemotherapy.
As well as numbers, a zero or an X often follow the letters T, N, and M. According to the AJCC, the meanings are as follows:
Drug And Gene Delivery For Treatment Of Breast Cancer Metastasis
Combinatorial delivery by liposomes of gefitinib and small interfering RNA targeted to EGF receptors for treatment of TNBC
Small interfering RNA represents an attractive tool for inhibition of a specific mRNA and corresponding protein. In our lab, we used siRNA targeted to EGFR receptors in combination with gefitinib for the effective treatment of TNBCs. Both the siRNA and gefitinib were delivered by cationic and neutral liposomes, respectively. The toxicity of this combination for sensitive MCF-7 and triple-negative MDA-MB-231 human breast cancer cells was studied with appropriate controls .
The cellular internalization of siRNA delivered by liposomes. Representative images of human breast cancer cells incubated within 24 h with liposomes containing siRNA . Cell nuclei were stained with nuclear-specific dye . Superimposition of red and green colors gives yellow color
The expression of EGFR mRNA. The relative quantity of EGFR gene expression in MCF-7 and MDA-MB-231 human breast cancer cells was calculated by the 2 method using quantitative PCR. The levels of gene expression were represented as a fold change. Means±SD are shown. a Expression of EGFR in MCF-7 and MDA-MB-231 cells incubated with media . b MDA-MB-231 cells before and after treatment. Cells were incubated within 24 h with liposomal siRNA targeted to EGFR mRNA
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What Is Triple Negative Breast Cancer
Part of your diagnosis includes a biopsy of your cancer. That biopsy is then sent to the lab where it undergoes laboratory analysis to determine the exact type of cancer and its receptors. In the case of breast cancer, there are three main receptors that have been identified.
What are the 3 main receptors for breast cancer?
- Estrogen Receptor Estrogen drives the growth of this cancer so treatment includes blocking estrogen and/or shutting down production of estrogen.
- Progesterone Receptor Similar treatments are used for PR+ as are used for ER+ including hormone therapy such as Tamoxifen and Aromatase Inhibitors.
- HER-2/Neu ReceptorHuman Epidermal Growth Factor was discovered in the mid-1980s. This resulted the development of a targeted drug treatment called Herceptin.
A cancer is called Triple NegativeWhen the pathologists tests determine that the cells from the biopsy are negative for estrogen receptors, negative for progesterone receptors, and negative for HER-2/neu receptors aka triple negative.
Can You Tell Us About How Metastatic Tnbc Is Treated And Are There Any Recent Developments
Dr. Gary: Yes. Once cancer leaves the breast and goes to the lymph nodes and throughout the body, it is considered metastatic and chemotherapy is one of the mainstays of treatment for metastatic TNBC. However, there are new drugs on the horizon and those that have been tested in trials, and we know that drugs like immunotherapy drugs which target these types of cancer cells are really great options. And we’re seeing patients live longer and healthier lives as a result of these advances, but we need more studies, more drugs, more information, and more clinical trials.
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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.
Fantastic Thank You So Much I Hope You Both Enjoy The Rest Of Your Morning
Ricki: You too. Thank you so much for having us have a great day.
Tweet us questions and comments.
About the Reviewer
Dr. Monique Gary
Monique Gary DO, MSc, FACS is a board certified, fellowship-trained breast surgical oncologist, and medical director of the Grand View Health/Penn Cancer Network cancer program in Sellersville, Pennsylvania, where she also serves as director of the breast program.
Dr. Gary holds clinical faculty appointments at Philadelphia College of Osteopathic Medicine, Penn Medicine, and Texas Christian University/UNT Health Sciences in Fort Worth, Texas. As a physician, researcher, advocate, and expert on cancer and healthcare disparities, she is passionate about developing integrative, holistic, and innovative approaches to cancer treatment, prevention, and survivorship both in the Delaware Valley and throughout the world.
Dr. Gary serves on the board of several national oncology advocacy and empowerment organizations, serving as medical director for Touch, the Black Breast Cancer Alliance, and a medical advisor for Tigerlily Foundation. She is also a member of the board of directors for the American Society of Breast Surgeons. Dr. Gary was recognized as a Leading Physician of the World and Top Breast Surgeon in Pennsylvania for 2017, 2018, and 2019, and is a Fellow of the American College of Surgeons, the highest distinction awarded to surgeons in the nation.
About the Author
CEO and Co-Founder of Touch, The Black Breast Cancer Alliance
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Metabolic Interaction Between Tnbc Cells And The Microenvironment
TNBC cells are sustained by adjacent stromal cells such as fibroblasts, macrophages and adipocytes. The interplay between TNBC cells and stromal cells contributes to the altered metabolic phenotypes in these cells, which may promote TNBC malignancy. In this section, we summarize the interplay between TNBC cells and their microenvironment.
How Can Hormones Affect The Growth Of Breast Cancer
Hormones like estrogen and progesterone are chemicals produced by glands in the body. Normally, these hormones help regulate body cycles, like menstruation. However, sometimes these same hormones can cause cancer to grow.
The pathologist will perform tests on the breast cancer cells to determine if they have receptors that feed on estrogen or progesterone, stimulating their growth. If the cancer cells have these receptors, your doctor may recommend hormone therapy drugs, such as blockers or inhibitors. Both types of drugs help to destroy cancer cells by cutting off their supply of hormones.
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Treatment For Triple Negative Breast Cancer
The main treatments for triple negative breast cancer are surgery, chemotherapy and radiotherapy. The treatment you need depends on:
- where the cancer is
You might have surgery to remove:
- an area of the breast
- the whole breast
When you have your surgery, the surgeon usually takes out some of the lymph nodes under your arm. They test these nodes to see if they contain cancer cells. The surgeon might check the lymph nodes closest to the breast using a procedure called sentinel lymph node biopsy. Testing the lymph nodes helps to find the stage of the cancer and decide on further treatment.
After breast conserving surgery you usually have radiotherapy to the rest of the breast tissue.
Stage 3c Lung Cancer: Spread Throughout Chest
Stage 3C lung cancer has spread to all or part of the chest wall or its inner lining, the phrenic nerve, or the membranes of the sac that surrounds the heart.
Cancer has also reached stage 3C when two or more separate tumor nodules in the same lobe of a lung have spread to nearby lymph nodes. In stage 3C, the lung cancer has not spread to distant parts of the body.
Like stage 3A, stages 3B and 3C cancer may have spread to other chest structures. Part or all of the lung may become inflamed or collapse.
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Stage 3 Diagnostic Criteria
While we talk about stage 3 cancers as one monstrous thing, their diagnosis differs drastically based on cancer type. Generally, a stage 3 cancer diagnosis requires one or more of three features:
- Tumor growth beyond a specific size
- Spread to a specific set of nearby lymph nodes
- Extension of the tumor into nearby structures
Once diagnosed, a cancer stage never changes. Even if the doctor re-stages the cancer diagnosis, or it recurs , they keep the initial staging diagnosis.
The doctor will add the new staging diagnosis to the initial stage and differentiate it with letterslike c for clinical, p for pathological , or after treatments .
Some stage 3 cancers are subdivided to give a more precise classification. These sub-stages will differ based on the specific cancerous organ. For example, stage 3 breast cancer has three subcategories:
- The tumor is smaller than 5 centimeters but has spread to 4-9 nodes.
- The tumor is larger than 5 cm and has spread to 1 to 9 nodes.
3B: The tumor is any size but has invaded the chest wall or breast skin and is swollen, inflamed, or has ulcers. It may have also invaded up to 9 nearby nodes
3C: The tumor can be any size but has spread to either: 10 or more lymph nodes, nodes near the collar bones, or lymph nodes near the underarm and the breast bone
Breast Cancer Stage: What Do They Mean
Stages are numbers used to describe how far a cancer has advanced and where it has spread in the body. Cancer that has not spread beyond your breast is considered local.
Regional cancer has spread into the breast skin, chest structures, and lymph nodes. When cancer spreads to other parts of the body, it is considered distant since it exists far away from just the breasts.
Your prognosis, or your long-term outcome, relies heavily on what stage your cancer is. Cancer stages are often further broken down into subcategories to provide more specific information.
Staging previously relied only on whether it is invasive or noninvasive, the tumors size, which lymph nodes contained cancer, and where and how far the cancer had spread.
Breast cancer stages now also take into account the tumors grade and the cancers estrogen receptor, progesterone receptor, and HER2 status.
Estrogen receptor, progesterone receptor, and HER2 status all have to do with the specific hormones and/or proteins involved in your cancer. The tumor grade describes what the cancer cells look like.
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The Best Diet For Triple Negative Breast Cancer
Image Source: Freedigitalphotos.net / Rakratchada Torsap
The Best Diet For Triple Negative Breast Cancer
As a follow-up to last weeks article The Best Diet For Hormone Receptor Positive Breast Cancers, this one is all about the best food for someone who has or is healing from triple negative breast cancer.
Doctors often tell us that triple negative breast cancer is harder to overcome because the usual hormonal therapies dont work for this form of breast cancer. Dont let that worry you though there are plenty of things you can eat and supplements you can take which will greatly help your return to wellness.
What Does Triple Negative Breast Cancer Mean?
If the term triple negative is unfamiliar to you, it refers to the fact that this type of breast cancer has no hormone receptors on the surface of the cells, meaning it is not fueled by hormones. It is estrogen receptor negative , progesterone receptor negative , and it does not overexpress HER2, three of the things your pathologist will be looking for when a tumor has been removed and is examined to see what therapies should be recommended. It is often referred to as TNBC.
Does Food Actually Make A Difference?
Yes it does. A recent small study done on 354 women with TNBC found that dietary modulations and/or micronutrient supplementations may prevent or reverse TNBC phenotype, so tumors can be treated with less toxic therapeutic strategies, particularly in genetically susceptible women. 1
Heres the list:
What If I Want To Follow A Low Methionine Diet
I certainly understand if you as a cancer patient or survivor do not want to wait for a clinical trial to finish and the results to be published. I know many of you want to be actively fighting against your cancer and doing everything you can.
So, I want to provide you with some additional information about methionine and a low methionine diet. Since studies have shown a low methionine diet is safe and we know plant-based diets are safe and healthy, following a low methionine diet could be just what you need to help you feel that you are doing more to help reduce your cancer and its spread. By actively participating in your care in this way, it can help to give you back some control and reduce some of your fear.
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How To Starve Triple Negative Breast Cancer
- American Society for Biochemistry and Molecular Biology
- Researchers have developed a strategy that slows the growth of triple negative breast cancer cells by cutting them off from two major food sources.
A team of Brazilian researchers has developed a strategy that slows the growth of triple negative breast cancer cells by cutting them off from two major food sources.
Triple-negative breast cancer, or TNBC, makes up approximately 15% to 20% of all breast cancers and is most common in African American women. These tumors lack estrogen and progesterone receptors and HER2 protein which are present in other breast cancers and permit certain targeted therapies. And because every TNBC tumor has a different genetic makeup, finding new markers that could guide treatment has been a difficult task.
“There is intense interest in finding new medications that can treat this kind of breast cancer,” said Sandra Martha Gomes Dias, a cancer researcher at the Brazilian Biosciences National Laboratory in Campinas, Brazil. “TNBC is considered to be more aggressive and have a poorer prognosis than other types of breast cancer, mainly because there are fewer targeted medicines that treat TNBC.”
To see if alterations in gene expression could explain how these cells survive, the authors of the study exposed TNBC cells to CB-839, defined those that were resistant and those that were sensitive to the drug, and sequenced their RNA, Dias said.
What Do These Mean For Me
This is important research, but there is no single approach that would help anyone diagnosed with breast cancer. Actually, everyone is different, and the details of our diagnosis play an important role in shaping the best diet to get through cancer.
Furthermore, different treatments work in different ways, making it very difficult for any one single approach to work for everyone.
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Brca1 Inherited Gene Mutations And Tnbc
Most breast cancers related to a BRCA1 inherited gene mutation are both triple negative and basal-like .
TNBC may also be related to a BRCA2 inherited gene mutation .
The National Comprehensive Cancer Network recommends people diagnosed with TNBC at age 60 or younger get genetic testing .
Learn more about genetic testing.
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.
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