I promise

"I promise, Suzy... Even if it takes the rest of my life." - Nancy G. Brinker, founder of Susan G. Komen for the Cure

What is Triple Negative Breast Cancer?


Just in recent years, Triple Negative Breast Cancer has sparked interest in the news where instead of calling the tumor as ER-negative, PR-negative, and HER2-negative; researchers began using the shorthand term, "Triple Negative," dubbed the "new type" type of cancer. Being Triple Negative, you don't have a targeted therapy and that your only treatment option is chemotherapy.

Triple Negative is seen in about 15% of all breast cancers. Triple Negative is a very aggressive cancer that tends to strike younger women, pre-menopause, especially among African-American women and women who have BRCA1 mutations. The tumor tends to be fast growing and is less likely to show up on an annual mammogram. TN is more likely to metastasis early on; has a high rate of recurrence in the first 2-3 years from diagnosis and has a poorer prognosis than other types of breast cancer due to lack of specific, targeted treatment for TNBC.

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Seize Each new Day with Renewed Strength,
Believe in Yourself, Go forward with
Courage and faith
to face whatever Tomorrow may bring.

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Enjoy life. Laugh a lot.
Work hard. Play hard.
Be thankful for our blessings.
Share the wisdom. Give back

Friday, April 29, 2011

Dr. Lisa Carey, World-Wide Expert In Triple Negative Breast Cancer

Lisa A. Carey, M.D.
Associate Professor
Breast Cancer

Clinical Interests
Dr. Carey is board-certified in both Internal Medicine and Medical Oncology. Her clinical interest is in breast cancer, and she is the Medical Director of the UNC Breast Center.
Research Interests
Dr. Carey's research interests also focus upon breast cancer, including examination of different subtypes of breast cancer, evaluation of new chemotherapy agents in early breast cancer, and examination of tumor characteristics that predict response to therapy.

Dr. Carey has worked extensively with scientists across Lineberger Comprehensive Cancer Center and the UNC Gillings Global School of Public Health to better understand and characterize the molecular subtypes of breast cancer so that we may develop better prevention and treatment strategies. With Drs. Perou and Millikan, she identified the elevated risk of the poor-prognosis basal-like breast cancer subtype in young African-American women. She is a world-wide expert in triple negative breast cancer, and led the first trial looking at a new drug regimen in this breast cancer subtype. She is now the leader of a group of UNC clinician researchers using a variety of new drugs in different molecular subtypes of breast cancer based upon biologic information learned from scientists at Lineberger.

For example, the members of the UNC Breast Center have a long commitment to improving treatment of early (nonmetastatic) breast cancer, and have been early investigators in the use of neoadjuvant, or preoperative, chemotherapy for breast cancer. In part based upon work performed at UNC, we now know that women do just as well if their chemotherapy is given before surgery as after, however the chemotherapy-first approach means that they are more likely to save their breast. In addition, with preoperative therapy it is possible to tell if the drugs are working since the tumor is still measurable when the chemotherapy is given first. Part of Dr. Carey's clinical research program investigates new drugs and combination of drugs in preoperative therapy. As part of this neoadjuvant chemotherapy program, she is involved in several studies, including a multiinstitutional trial sponsored by the National Cancer Institute, of genetic and molecular markers in breast cancer as predictors of response to chemotherapy, and she is the lead investigator of a national study of new drug combinations in HER2-positive breast cancer.

Dr. Carey is also the principal investigator of a highly collaborative study examining genes that might interact with other genes or with the environment to impact on a woman's risk of developing breast cancer.
Recent Accomplishments and Honors

For her work, she was awarded a Doris Duke Clinical Scientist Award in 1999, a career development award from the National Cancer Institute in 2000, was inducted into the Johns Hopkins Society of Scholars in 2008, and was honored to serve as UNC?s commencement speaker in December, 2009.

M.D., Johns Hopkins School of Medicine 1990
Resident, Internal Medicine, Johns Hopkins 1990-3
Fellow, Medical Oncology, Johns Hopkins 1993-8
Sc.M., Clinical Investigations, Johns Hopkins School of Public Health 1994-8

Lisa Carey is an Associate Professor in the UNC Department of Medicine, Division of Hematology-Oncology. She graduated from Wellesley College in 1984 with a BA in Biology and Art History, before receiving a MS in Physiology from the University of Kentucky. She received an MD from the Johns Hopkins University School of Medicine in 1990. After a residency in Internal Medicine also at Johns Hopkins, she stayed at Johns Hopkins for a fellowship in Medical Oncology. During her fellowship she completed a ScM. in Clinical Research. Dr. Carey joined the UNC faculty in 1998. She has served since 2003 as the Medical Director of the UNC Breast Center and is the UNC-Lineberger Comprehensive Cancer Center (UNC-LCCC) Protocol Office Executive Committee Breast Disease Group Leader as well as the UNC-LCCC Protocol Review Committee Breast Cancer Chair.

Dr. Carey has a well-defined interest in clinical/translational research in breast cancer, with a particular interest in the clinical implications of different molecular subtypes of breast cancer. She both designs and leads clinical trials as well as working often and well with laboratory investigators. She has successfully translated bench efforts from laboratory science collaborators into clinical research. She was the lead author of a recently published article in JAMA examining racial disparities among breast cancer subtypes. She is the principal investigator (P.I.) of several clinical trials, including a multicenter inter-SPORE (Specialized Program of Research Excellence, National Cancer Institute [NCI]) Phase II study of targeted therapy in metastatic basal-like breast cancer (a subtype identified by gene expression array). This heavily funded trial includes both clinical and laboratory participation from UCSF, Dana Farber, Duke University, Georgetown, Johns Hopkins, Baylor, Washington University, University of Alabama-Birmingham, Mayo, and M.D. Anderson Cancer Center, and is a testament to her ability to provide clinical leadership in translational and early clinical research.
Dr. Carey is the P.I. of a recently published multicenter Phase II study incorporating biologic therapy into chemotherapy for locally advanced breast cancer as well as a proposed cooperative group neoadjuvant trial examining several HER2-targeted strategies for Stage II-III HER2-positive breast cancer. She is the clinical liaison for several correlative science collaborations, including both institutional and cooperative group trials that correlate nucleic acid and protein characterization of breast cancers with response to neoadjuvant therapy.
Dr. Carey has served on the American Society of Clinical Oncology (ASCO) Scientific Program Committee and as faculty for the ASCO annual meeting for several years. She was named to the Cancer and Leukemia Group B (CALGB) Breast Core Committee in 2003. She was awarded a Doris Duke Clinician Scientist Award in 1999 and a Career Development Award from the NCI in 2000. 

Telephone: (919) 966-4431
FAX: (919) 966-6735
Address: 3009 Old Clinic Bldg. Chapel Hill, NC 27599-7305 

Biologic Differences in Breast Cancer: An Expert Interview With Dr. Lisa Carey http://www.medscape.org/viewarticle/572082

Next Generation Treatment for Triple-Negative and Basal-Cell Breast Cancer http://www.cancernetwork.com/conference-reports/mbcc2011/content/article/10165/1817148

List of Triple-Negative Sensitive Genotoxic Agents
Cyclophosphamide (Cytoxan)
Carboplatin (Paraplatin)
Cisplatin (Platinol)
Doxorubicin (Adriamycin)
Epirubicin (Ellence)
Mitomycin C (MTC / Mitomycin / Mutamycin)
Radiation (Radiotherapy
PARP Inhibitors

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