Patient Receives Anticancer Vaccine After Beating Stage 2 Triple Negative Breast Cancer
Karyn Staton is originally from North Haven, Connecticut, and later lived in Madison, Mississippi. She has resided in Northern Virginia for 12 years, where she is a substitute teacher and a full time Mom. Her husband of 24 years, Syd, is a U.S. Secret Service Agent in Washington, D.C. They have two children, Emily , and Matthew .
Karyn was enjoying an active, healthy life, when she randomly discovered a suspicious lump one cold, snowy morning in February 2015. The following days consisted of a whirlwind of doctors, scans, biopsies, worried conversations between family and friends, and culminated with the shocking confirmation that she had Stage 2 Triple Negative Breast Cancer. After radiation therapy, chemotherapy and surgery, Karyn traveled to UMGCCC to participate in a novel clinical trial. Here’s her story:
I was diagnosed with Stage 2 Triple Negative Breast Cancer on February 24, 2015. Triple negative breast cancer accounts for approximately 20 percent of breast cancers and refers to the subtype of breast cancer that is negative for the estrogen, progesterone and HER2 genes/receptors. This subtype of breast cancer is more difficult to treat, and the only treatment options currently include chemotherapy in addition to surgery and radiation.
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.
Treatment Options For Triple
Typically, triple-negative breast cancer patients will receive a combination of surgery, radiation therapy, and chemotherapy.
Research shows that survival rates are higher when chemotherapy is used to shrink the tumor before surgery. Doing chemotherapy before surgery usually means fewer cancer cells in the body at the time time of surgery. This makes it less likely for cancer cells to spread to other areas of the body during the surgery.
Another option to treat triple-negative breast cancer is using drugs that inhibit the poly ADP-ribose polymerase enzyme. Particularly in patients that also test positive for BRCA mutation, PARP inhibitors make it harder for the cancer cells to survive.
Finally, a combination of immunotherapy and chemotherapy may treat advanced triple-negative breast cancer that tested positive for the PD-L1 protein. Immunotherapy helps the patients immune system work harder to fight the cancer cells, in this case also fighting the PD-L1 protein.
If you or someone you know has been diagnosed with triple-negative breast cancer, request an appointment to meet with one of our breast cancer specialists located in the Denver area, Colorado Springs, Boulder, and other areas throughout the Colorado Front Range. We are also happy to quickly schedule a second opinion to help you with making the cancer treatment decision youre confident in.
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What Is The Survival Rate 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 a 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 Instituteâs SEER database for survival of all patients with breast cancer, by tumor stage:
| Stage |
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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.
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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.
Clinical Characteristics Epidemiology And Risk Factors
Triple-negative breast tumors have been characterized by several aggressive clinicopathologic features including onset at a younger age, higher mean tumor size, higher-grade tumors, and, in some cases, a higher rate of node positivity. A histologic study of basal-like tumors, of which all were ER/HER2negative, illustrated marked increases in mitotic count, geographic necrosis, pushing borders of invasion, and stromal lymphocytic response. The majority of triple-negative breast carcinomas are ductal in origin however, several other aggressive phenotypes appear to be overrepresented, including meta-plastic, atypical or typical medullary, and adenoid cystic.
In parallel with our understanding of the molecular basis of triple-negative breast cancer, our awareness of the epidemiology and risk factors associated with this disease process has matured, specifically related to age and race. Among approximately 500 women evaluated in the Carolina Breast Cancer Study, those with basal-like tumors were more likely to be African-American and premenopausal . These investigators observed a particularly high prevalence of basal-like tumors among premenopausal, African-American women compared to postmenopausal African-American women and nonAfrican-American women of any age . These findings are consistent with several large-scale, population-based studies indicating that triple-negative breast cancers are more likely to occur among premenopausal women of African-American descent.
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Breast Cancers Survival Is Influenced By Tumor Grade
Grade identifies the size and shape of the malignant breast cancer cells. At the event the breast cancer cells look very different than normal breast tissue cells, and random in appearance, they can be called, that was badly differentiated and described as âhigh gradeâ. Higher level breast cancer cells tend to really have a poorer prognosis.
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.
Material on this page courtesy of Johns Hopkins Medicine
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How Is Invasive Ductal Carcinoma Diagnosed
Same Day Results
At the Johns Hopkins Breast Center, we know how quickly patients want results from a biopsy or scan if there is a suspicion of breast cancer. We follow strict guidelines for biopsies and pathology reports. Most of our patients will receive the probability of cancer immediately following their biopsy procedure and a pathology confirmation within 24 hours.
Learn more about the steps of diagnosis, including:
- Digital mammography
- Biologic targeted therapy
What Is Triple Negative Breast Cancer
A diagnosis of triple negative breast cancer means that the three most common types of receptors known to fuel most breast cancer growthestrogen, progesterone, and the HER-2/neu gene are not present in the cancer tumor. This means that the breast cancer cells have tested negative for hormone epidermal growth factor receptor 2 , estrogen receptors , and progesterone receptors .
Since the tumor cells lack the necessary receptors, common treatments like hormone therapy and drugs that target estrogen, progesterone, and HER-2 are ineffective. Using chemotherapy to treat triple negative breast cancer is still an effective option. In fact, triple negative breast cancer may respond even better to chemotherapy in the earlier stages than many other forms of cancer.
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How Is Dcis Diagnosed
DCIS is usually diagnosed by a stereotactic core needle biopsy. This is a biopsy of the breastthat is guided by mammography.
Same Day Results
At the Johns Hopkins Breast Center, we are sensitive to the anxiety a possible diagnosis of breast cancer creates for our patients. If the radiologist who read your mammogram suspects you have DCIS, he or she will arrange for you to have a stereotactic biopsy. The biopsy can sometimes be done the same day, but is always done within a week. On the day of your breast biopsy, you will be given the probability that the biopsy is a breast cancer. Firm confirmation will follow within 24 hours.
Is Triple Negative Breast Cancer An Aggressive Form Of Cancer
Its true that triple negative breast cancers can grow quickly. But your prognosis or expected outcome depends on more factors than your cancer subtype. Healthcare providers will also consider your tumors size and whether it has spread to your lymph nodes and other parts of your breast. Its also helpful to know researchers are focusing on ways to slow the spread of TNBC.
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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.
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.
- Chills.
- Persistent nausea and vomiting.
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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.
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Options For Luminal Breast Cancer
with luminal or other types of HR-positive breast cancer receive hormone therapy. Some people call this endocrine therapy.
Triple-negative breast cancer does not respond to hormone therapy because it is HR-negative.
Anti-estrogen therapy
Anti-estrogen therapy works by preventing estrogen from attaching to the estrogen receptors of breast cancer cells.
The four different types of anti-estrogen therapy are:
- selective estrogen-receptor response modulators, such as tamoxifen
- aromatase inhibitors
- estrogen-receptor downregulators, such as fulvestrant
- luteinizing hormone releasing agents, including goserelin and leuprolide , prevent the ovaries from producing estrogen
The type of anti-estrogen therapy a person receives depends on various factors, including:
- the stage of the breast cancer
- whether the person has any other medical conditions
- whether the person has been through menopause
A person usually continues hormone therapy for at least .
Other hormone therapies
In some cases, HR-positive breast cancer may not respond to the above treatments. Consequently, a doctor may recommend one of the following hormone therapies for more advanced cancer:
- progestin medications, such as megestrol
- an anabolic steroid, such as fluoxymesterone
Targeted therapies
Targeted therapies focus on specific genetic mutations that play a role in a cancers growth and spread. These drugs are usually combined with hormone therapy.
Examples of CDK4/6 inhibitors include:
- abemaciclib
- palbociclib
- ribociclib
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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.
How Is Triple
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.
Treating Triple Negative Breast Cancer
Triple negative breast cancer can be treated with a combination of
Research has shown chemotherapy generally has a larger benefit for triple negative breast cancer compared to oestrogen receptor positive breast cancer. Chemotherapy for triple negative breast cancer is often given before surgery. The drugs used are likely to include carboplatin or cisplatin.
Some breast cancer treatments, such as hormone therapy and HER2 targeted therapies are of no benefit to people with triple negative breast cancer.
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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.