Triple Negative Breast Cancer Day By Deborah After Breast Cancer Ambassador
Being diagnosed with breast cancer has been one of the most challenging things to live with to date but knowing that Breast cancer isnt just one type of cancer is something everyone should know. There are four main subtypes of breast cancer, with different characteristics, and therefore which require different treatments.
Each year 15 to 20 per cent of patients get diagnosed with Triple-negative breast cancer it is named this because it lacks estrogen, progesterone, and HER2 receptors it accounts for only 10 to 20 per cent of all invasive breast cancers, yet is responsible for a large proportion of breast cancer deaths because it is so aggressive, and is more likely to have already spread to other parts of the body at diagnosis.
Fortunately, Triple-negative breast cancer can be treated with other drugs, such as chemotherapy, radiation therapy and non-HER2 targeted therapy.
Most of us go through chemotherapy, surgery and radiation therapy. Ive had all 3 with 8 rounds of chemo, 2 major surgeries including Lumpectomy and Lymph Node Dissection and Breast Reconstruction.
What Is The Staging Of Triple
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.
Many women with breast cancer will require surgery. Broadly, the surgical therapies for breast cancer consist of breast-conserving surgery and mastectomy .
Types of chemotherapy include the following:
Other therapies for triple-negative breast cancer
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What Hormones Does Suzanne Somers Use
I use an estrogen cream every day and progesterone cream two weeks a month. Thats why, at 62, I dont require any pharmaceutical drugs. Fugh-Berman: Menopausal hormone therapy DOUBLES the risk of dementia, according to data from the Womens Health Initiative, and increases age-related memory problems, too.
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What Is The Life Expectancy For Triple
In general, about91% 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 11%.
Inoperable Breast Cancer Is Often Still Treatable
Stage 3C breast cancer is divided into operable and inoperable stage 3C breast cancer. However, the term inoperable is not the same as untreatable.
If your physician uses the word inoperable, it may simply mean that a simple surgery at this time would not be enough to get rid of all the breast cancer that is within the breast and the tissue around the breast. There must be healthy tissue at all of the margins of the breast when it is removed. Keep in mind that the breast tissue goes beyond the breast mound it goes up to the clavicle and down to a few inches below the breast mound. There must also be tissue to close the chest wound after the surgery is performed.
Another treatment method may be used first to shrink the breast cancer as much as possible before surgery is considered.
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Receptor Data And Study Population
The instructions to the tumor registrars in the Collaborative Stage Coding Manual regarding estrogen and progesterone assays were to record the pathologist’s interpretation of the assay value. However, it was noted that the College of American Pathologists had issued guidelines in late 2009 that if 1% or more of tumor cells stained positive, the ER/PR value was considered positive.
With regard to Her2 assays, the NCDB contains data on immunohistochemistry, fluorescence in situ hybridization, and chromogenic in situ hybridization, but the field we used for this study was one where the individual local tumor registrars determined the best assay result for each individual patient. The registrars were instructed to use gene amplification assays first, and then use immunohistochemistry assay for cases where the amplification assay was borderline or not performed.
The population used for this study consisted of all patients with invasive breast cancer diagnosed in 2010 and 2011 whose ER, PR, and Her2 were known to be positive or negative. This represented 88.4% of all invasive breast cancers in the database for those years. Cases were categorized as triple negative if all 3 receptors were known to be negative, and non-TNBC if any one of the receptors was known to be positive.
Management Of Metastatic Triple
Triple-negative breast cancers do not express ER, PR, or overexpress the HER2 protein and are immunohistochemically characterized by staining for basal markers cytokeratin 5/6 and 17. Histologically they tend to be high grade with central necrosis.258 Microarray expression profiling analyses have demonstrated that breast cancers can be systematically categorized into biologically and clinically distinct subgroups. Triple-negative tumors are mostly but not exclusively categorized as basal-like breast cancers in the intrinsic PAM50 classification scheme introduced in 2000 by Perou and colleagues.259 They are so named because they arise from the outer layer of the breast duct, the myoepithelial cells.258 On a molecular level, they demonstrate a high frequency of p53 mutations, deficiencies in homologous recombination DNA repair, and elevated levels of genomic instability.206
At this time, there are no specific treatment guidelines for this patient population, and so most patients are treated on the basis of standard algorithms devised from clinical trials in which most women had luminal cancers. Triple-negative tumors tend to be initially more chemosensitive than their hormone-responsive counterparts.259 Unfortunately, however, the genetic instability seen in triple-negative tumors probably results in an increased potential for the subsequent development of chemoresistance, making their management even more challenging.262
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Why Is Breast Cancer More Common In Black Women
Breast cancer is the most common cancer diagnosis for Black women.
Statistically, Black women are more likely than non-Black women to live with other conditions that increase the chance of breast cancer, such as:
2017 analysis found that breastfeeding decreases the risk of triple-negative breast cancer, particularly for younger Black women.
Additionally, Black women are more likely to experience stress from racism. Chronic stress that affects health is called , and it can impact breast cancer by contributing to:
- more aggressive tumors
- advanced stage at diagnosis
- reduced quality of life
Environmental exposures may increase the chance of breast cancer in some women. Beauty products are a source of this type of exposure because of the chemicals they contain. Some products that are marketed toward Black women have more of these chemicals.
Its important to consult a healthcare professional if you notice any symptoms of breast cancer. The sooner treatment begins, the more successful it can be.
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.
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Palliative And Supportive Care
Living with advanced TNBC is often difficult, emotionally and physically. Its important to identify and make use of the support that is available, whether it be family, friends, therapists, support groups, financial counselors, social workers or members of the community. Let people know your concerns and what you need from someone, whether it is to watch the kids, provide a ride to your appointment, be another set of ears or a friend who can listen.Its also important to know what services are available to help deal with any physical symptoms that you have. Request a referral to Palliative Care as soon as you get your diagnosis. Palliative Care is there to help with the full range of emotional and physical issues you may encounter throughout the course of your illness.If you are experiencing financial problems, either related to your treatment or to your life, let your health care team know. There are resources that can help with those issues as well.
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What Does Grade 2 Mean In A Biopsy
The grade of a cancer depends on what the cells look like under a microscope. grade 1 cancer cells that resemble normal cells and arent growing rapidly. grade 2 cancer cells that dont look like normal cells and are growing faster than normal cells.
Is Stage 2 IDC curable?
If youve been diagnosed with stage 2 breast cancer, the outlook is very good. You are more likely to have chemotherapy and/or radiation therapy than if your tumor was stage 1, but these tumors are still very treatable.
What is grade 2 invasive ductal carcinoma prognosis?
Whats the survival rate? Overall, the prognosis for stage 2 breast cancer is generally good. According to the American Cancer Society, the 5-year relative survival rate is: 99 percent for localized breast cancer
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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.
Axillary Lymph Nodal Involvement And Tumor Size
Axillary lymph nodal involvement is an important factor to recognize the staging, prognosis, and treatment of progression-free survival and overall survival of breast cancer. The common methods for determine the lymph node involvement in breast cancer are sentinel node biopsy , clinical assessment, axillary dissection, and evaluation of imaging methods. The predictor of axillary lymph node metastasis in general should be easy reproducible, cost-effective, high accurate, and induces minimum side effects on patients. If lymph-node metastasis is present, there is high risk of metastasis while if there is no lymph-node involvement, a patient has a low risk of metastasis. In addition, the presence of more than four lymph-node metastasis is associated with very high risk of metastasis and generally predicts a poor prognosis .
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What Is The Prognosis For Triple
A good treatment result depends on several factors. Chemotherapy is what can really make a difference in the outcome. The size of the invasive part of the tumor, and the number of involved lymph nodes can also greatly influence your prognosis, Sun says, but adds that if the cancer has spread , the prognosis is less certain.
There is hope, even with this serious diagnosis, and staying optimistic is essential. It can be stressful and scary to go through chemo, but positive thinking can make a difference. You have to believe that its doing you good, and for most people, it does.
Breast Cancer Treatment at Johns Hopkins
The breast cancer program at Johns Hopkins is made up of a diverse group of nationally-recognized specialists in breast cancer research and treatment.
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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Triple Negative Breast Cancer Genetics
In the case of triple-negative breast cancer, 10% to 15% of Caucasians with triple-negative breast cancer have a BRCA1 gene mutation, while 35% of African Americans with triple-negative breast cancer have a BRCA1 gene mutation.
What Does Triple Negative Mean
Triple-negative breast cancer is cancer that tests negative for estrogen receptors, progesterone receptors, and excess HER2 protein. These results mean the growth of the cancer is not fueled by the hormones estrogen and progesterone, or by the HER2 protein. So, triple-negative breast cancer does not respond to hormonal therapy medicines or
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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
- the size of the cancer and whether it has spread
- how abnormal the cells look under the microscope
- your general health
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.
Breast Cancer By Ethnicity
Breast cancer is common in people of all ethnicities. While more common in White peple, it is more deadly in Black people.Between 2013 and 2017, the breast cancer death rate was 40% higher in Black people than White people.
The most dangerous subtype of breast cancer, triple-negative breast cancer, is more common in Black people. The prevalence of this more deadly type may cause some of the disparity in death rates, but it is not the only reason. Black women are also more likely to be diagnosed with more advanced disease due to inequalities in care.
Breast cancer in men is also more common and more dangerous for Black people. The incidence of breast cancer in Black men is 1 in 50,000, while the mortality is 1 in 200,000. In White men, these numbers are slightly lower: 1 in 77,000 are diagnosed with male breast cancer and 1 in 333,333 die from it.
|Incidence and Death Rates of Female Breast Cancer by Ethnic Group|
|American Indian and Alaska Native||0.6||0|
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Factors Associated With More Rapid Spread
Some types of breast cancer, as well as molecular subtypes, are more likely to spread and spread earlier than other types. Ductal carcinoma is more likely to spread than lobular carcinoma, among tumors that are the same size and stage.
While many breast cancers do not spread to lymph nodes until the tumor is at least 2 cm to 3 cm in diameter, some types may spread very early, even when a tumor is less than 1 cm in size.
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Chemotherapeutic Agents Used In Combination With Immunotherapy
It is generally accepted that most TNBC is chemotherapy-sensitive, but the optimal treatment regimen continues to be investigated. Most chemotherapy regimens include anthracyclines, taxanes, and/or platinum compounds, dose-dense AC , or TC . The addition of platinum to standard chemotherapy has shown to increase the pathologic complete response rate . Multiple guidelines support the use of chemotherapy in the neoadjuvant setting for early stage TNBC . Often a surrogate endpoint for clinical trials, pathological complete response after neoadjuvant chemotherapy is predictive of long-term survival outcomes . Administration of anthracycline and taxane-based chemotherapy sequentially is the most common neoadjuvant approach, with the consideration of adding carboplatin, as it has been demonstrated to improve the pathologic complete response rate .
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