Who Is Most Likely To Have Tnbc
Triple negative breast cancer appears more frequently in women age 40 and younger than in older women. Black and Latina women are more likely to develop TNBC than white women. Women who have the gene change BRCA1 are more likely to develop TNBC than other women. When the BRCA1 gene mutates, it stops preventing cancer and appears to make your bodys cells more vulnerable to cancer.
Association With Brca1 Mutation Status
It has been observed that a high percentage of BRCA1- associated hereditary and sporadic breast cancers are triple negative and express a high proportion of basal like cytokeratins , as well as P-Cadherin and HER1/EGFR . Gene expression studies support this association among patients with BRCA1 mutations that breast tumours tend to cluster within the basal like category .
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 heterogeneous 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.
We will look at factors that may affect survival or recurrence as well as the statistical rates of both. We will also look at life expectancy with stage 4 triple-negative breast cancers and recent case reports of a few long-time survivors.
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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.
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.
National Institute for Health and Care Excellence , July 2018
Biology and management of patients with triple negative breast cancerP SharmaThe Oncologist. 2016, Volume 21, Issue 9
4th ESOESMO International Consensus Guidelines for Advanced Breast CancerF Cardoso and othersAnnals of Oncology,2018, Volume 29, pages 16341657
Early breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-upF Cardoso and others
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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.
Progress In Treating Her2
HER2-positive and triple-negative breast cancer are among the most aggressive forms of breast cancer and traditionally have had lower survival rates than other types of the disease. However, early detection with routine screening has contributed to improved survival for both in recent years. Further, treatment advancesall available at Regional Cancer Care Associates , one of the nations largest networks of cancer specialists with locations in New Jersey, Maryland, and Connecticutalso have helped improve outcomes in HER2-positive cancer. Meanwhile, intensive research and emerging therapeutic strategies are offering new hope for women with triple-negative breast cancer.
Four RCCA medical oncologists recently explained what drives the development of these breast cancers, how they are treated, and how women can play an important and potentially life-saving role in identifying the cancers in their earliest stages, when they can be treated most effectively.
Aileen Chen, MD, a board-certified medical oncologist practicing with RCCA in Freehold and Holmdel, NJ says, Its an exciting time in the fight against breast cancer. Next-generation sequencing technology is detecting genetic mutations that we can treat with targeted therapies in many forms of the disease. This has enhanced our ability to practice personalized medicine by customizing a patients treatment based on her molecular and genetic profiles.
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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.
Uvm Scientist Wins Grant To Tackle Aggressive Forms Of Breast Cancer
A University of Vermont scientist recently won a $450,000 grant to continue his research that could one day lead to a new approach to treating a rare, more aggressive form of breast cancer.
These are cases of what’s known as triple negative breast cancer, which tends to be more aggressive and is associated with poorer prognosis. The main option for women with this kind of cancer is a general chemotherapy, which kills healthy cells along with cancerous ones.
But in the course of studying basic cell division in the body, UVM’s Jason Stumpff began investigating a specific protein. And it turns out this molecule could hold a key to how these aggressive tumor cells associated with triple negative breast cancer proliferate.
Stumpff has been studying how human body cells divide and reproduce for about two decades.
He wasn’t focused specifically on breast cancer until one day “a serendipitous observation” led him to realize that certain breast cancer tumor cells “require one of the proteins we’ve been working on in my lab for division.”
That’s the hypothesis Stumpff’s lab will be testing.
The molecule Stumpff is studying is a kind of kinesin, which is a protein involved in the process of mitosis.
Tackling the more aggressive breast cancers
Patients advising lab scientists
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What Matters Most To You
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have chemotherapy after surgery
Reasons not to have chemotherapy
I want to do everything possible to treat my breast cancer.
I would rather wait and see if my cancer comes back before I have more treatment.
Breast Cancer Symptoms In Black Women
Breast cancer usually does not have any symptoms in its early stages when the tumor is small and hard to notice. This stage is also when breast cancer will be easiest to treat, which is why screening mammograms are important.
Black women with breast cancer may first notice a painless lump in their breast. Lumps are usually not cancer and can be a common occurrence. However, if you notice a lump in your breast that feels unusual, its something you will want to discuss with your doctor as soon as possible.
Its good to know what is normal for you in terms of how your breasts usually feel. That way, if there are changes, you will be more likely to notice them.
Some changes to your breast tissue can be a sign of cancer and are something that you should not ignore. These include:7
- New lump in the breast or underarm
- Thickening or swelling of part of the breast
- Irritation or dimpling of breast skin
- Redness or flaky skin in the nipple area or the breast
- Pulling in of the nipple or pain in the nipple area
- Nipple discharge other than breast milk, including blood
- Change in the size or the shape of the breast
- Pain in any area of the breast
If breast cancer runs in your family or you have other risk factors, finding a lump is going to be scary and you might think the worst. However, there are many other causes of breast lumps that are not cancer.
While a lump may or may not be cancerous, there are other symptoms of breast cancer that you should know about.
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Triple Negative Breast Cancer Risk Factors
As with so many complicated health conditions, experts arent quite sure what causes triple negative breast cancer. Doctors dont understand for certain what causes breast cancer in general, Dr. Mayer says, much less the complex triple negative kind. They have some ideas about risk factors involved, though.
Much of the conversation about breast cancer risk factors revolves around hormone exposure since most breast cancers grow in response to hormones. But thats not an issue with triple negative breast cancer, so other factors take center stage.
In general, breast cancer risk rises as you get older, according to the Mayo Clinic. But triple negative breast cancer is actually more common in premenopausal people than in older ones, Dr. Nanda says. This could be because of triple negative breast cancers link with BRCA gene mutations, which are often implicated in cases of people developing breast cancer before age 50.
Mutations in the BRCA1 and BRCA2 genes can raise your risk of breast and ovarian cancers, according to the CDC. When these genes function normally, they help to suppress tumor growth, the National Cancer Institute explains. When they have mutations, however, your cells may divide and change too quickly, leading to cancerous tumors. Theres a lot of scientific interest surrounding a possible association between these mutations and triple negative breast cancer, though experts dont yet know how exactly they might be connected.
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
- Are under 40
- Have what your doctor will call a BRCA mutation , especially the gene BRCA1
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Where Do These Numbers Come From
The American Cancer Society relies on information from the SEER* 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.
Research Into Triple Negative Breast Cancer
Researchers are working to find new treatments for triple negative breast cancer. Much of this research involves looking for molecules in the body that are involved with cancer growth, and formulating a drug that will disable how that molecule works.
Clinical trials are in progress to determine whether these new drugs are better than the current standard treatment. If you would like more information on clinical trials, visit the clinical trials section of our website.
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What Else Do You Need To Make Your Decision
Check the facts
- No, it’s not a main treatment. Chemotherapy is an added treatment, a sort of insurance policy designed to kill any cancer cells that may still be in your body after surgery.
- You’re right. Chemotherapy is an added treatment, a sort of insurance policy designed to kill any cancer cells that may still be in your body after surgery.
- It may help to go back and read “Get the Facts.” Chemo is an added treatment, a sort of insurance policy designed to kill any cancer cells that may still be in your body after surgery.
- No, not every woman will need chemo. It depends on what type of breast cancer she has and how far it has spread.
- You’re right. Not every woman will need chemo. It depends on what type of breast cancer she has and how far it has spread.
- It may help to go back and read “Get the Facts.” Not every woman will need chemo. It depends on what type of breast cancer she has and how far it has spread.
- No, some women are not bothered by side effects. Your doctor can give you other medicines to help you deal with side effects like nausea and vomiting.
- That’s right. Some women are not bothered by side effects. Your doctor can give you other medicines to help you deal with side effects like nausea and vomiting.
- It may help to go back and read “Get the Facts.” Some women are not bothered by side effects.
- Increased chance of bruising, bleeding, and infection.
- Memory and concentration problems.
Long-term side effects of chemotherapy can include:
How Is Triple Negative Breast Cancer Diagnosed
The first step might be a mammogram to evaluate a suspicious mass or lump in your breast. Based on what they learn, healthcare providers might perform a biopsy to remove breast tissue. Then they examine the tissues cells to determine the cancer subtype. Identifying the cancer subtype is part of the staging process, which is when providers decide how to treat your cancer.
Sometimes providers use the following tests before treatment to check on your tumors size and whether it has spread, or after treatment to monitor response to treatment:
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Clinical Trials For Her2
Some women with triple negative and HER2-negative breast cancers choose to partake in clinical trials to test therapies that arent yet available to the public. Additionally, clinical trials help researchers determine whether new treatments are safe and effective.
You may want to consider participating in a research study if your cancer isnt responding to therapy or has spread to other areas of your body.
You can search for a clinical trial in your area at ClinicalTrials.gov.
What Is The Risk For Triple
The disease can affect anyone, but is more likely to show up in those who are:
- Younger than age 50 .
- Black or Latinx.
- Living with a genetic condition called BRCA mutation that increases the risk for breast cancer and other forms of cancer. Most cancers diagnosed in people with the BRCA1 mutation are triple negative.
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Making Decisions After A Triple
One of the vicissitudes of cancer is the enormous amount of information to take in and process, she wrote in a blog about her cancer journey. How does one slow down the onslaught of details, decisions, and choices? I attempted to go with the flow. I chose a plastic surgeon, had genetic testing, and waited for my surgery.
Take It From Jan: Early Detection Is Key To A Better Breast Cancer Outcome
But, with each subsequent checkup that showed no sign of cancer recurrence, Jan found more and more reason to be optimistic. A private person, she did not share much about her cancer diagnosis and treatment with people outside her closest friends and family until it was over. Afterward, she became more open about her experience, particularly since early detection was key in having such a positive outcome for her. I felt it was important to tell people my story because even though there are many new treatments out there, the best outcome is still early detection, she says.
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New Medications For Metastatic Breast Cancer
The immunotherapy drugs called checkpoint inhibitors have led to a significant improvement in survival rates for lung cancer and melanoma. In March of 2019 the first immunotherapy drug, Tecentriq was approved for triple-negative breast cancer that is metastatic . As noted above, there are at least a few people who have had excellent responses in clinical trials prior to approval.
PARP inhibitors are also a class of medications 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 treating both metastases, and may reduce 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.
In addition, for some people treated with immunotherapy, local radiation may sometimes improve the response of immunotherapy, something known as the abscopal effect. Since immunotherapy is such a recent addition to breast cancer, it’s not known how common this response may be or if it will be seen at all.