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 TNBC

WHAT IS TRIPLE NEGATIVE BREAST CANCER?

Just in recent years, Triple Negative Breast Cancer (TNBC) 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" of breast cancer. Being Triple Negative, you don't have a targeted therapy and your only treatment option is chemotherapy.

Triple Negative Breast Cancer is seen in about 15% of all breast cancers. TNBC 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. TNBC 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.

Friday, April 8, 2011

Triple Negative Breast Cancer, The Ugly Truth

I have been advocating the importance of self breast exams especially among younger women since most triple-negative tumors are not detected by mammograms due to the breast tissue density in women. Also, triple-negative tumors may be growing rapidly between image screenings. Many women that have asked me about my cancer, I have told them that if you suspect a lump, don't delay, you need to see your doctor and get a mammogram; early detection is the key to having a better outcome with a triple-negative diagnosis.


Tho, we do not know what fuels Triple Negative Breast Cancer, I have been told that changing my life style; low-fat diet, regular exercise, less stress and being physically fit significantly reduces your chance of TNBC recurrence.

We need to bring awareness to this sub-type,Triple Negative Breast Cancer and BRCA testing; helping younger women realize the importance of self breast exams and that early detection will save more lives from this dreaded disease. Women need to be educated and many are not; on the importance of BRCA genetic counseling which is highly recommended at time of TNBC diagnosis to determine the best course of treatment. Patients having both TNBC and being BRCA1 positive; doctors often recommend the option of bilateral mastectomy and removal of ovaries and fallopian tubes as part of their treatment to greatly reduce the risk of further breast cancer and ovariarian cancer in which BRCA is associated with.

Just a few years ago, no one even heard of TNBC, a type of breast cancer that researchers knew a little about. Triple-Negative is one of the most aggressive tumors ever seen by doctors. The first reference of "Triple Negative" Breast Cancer in medical literature was in October 2005. Focused studies for TNBC had only been conducted in the last few years. Triple Negative Breast Cancer had recently become a hot area of research for targeted therapy and the latest in clinical trials in the study of breast cancer at all of the big research institutions including top-rated cancer center in the country, MD Anderson, which is the first institution to look exclusively at women with Triple Negative Breast Cancer.

Triple Negative tumors lacks expression of estrogen receptor (ER) and progesterone receptor (PR), along with the absence of human epidermal growth factor receptor-2 overexpression (HER2) portraying a critical clinical challenge because this type of cancer doesn't respond to hormone therapy or other available targeted agents; Standard Chemotherapy remains the only treatment available and only effective in about 40% of patients; and in those that do relapse, the cancer becomes highly resistant and quickly results in death.

Triple Negative Breast Cancer accounts for about 15% of all breast cancers and is responsible for about 25% of all breast cancer deaths. Triple-Negative is characterized as a rapid growing breast cancer with a relatively poorer outcome; usually diagnosed at a late stage, shorter survival rate, more likely to metastasize and has a high risk of early recurrence between 2-3 years after diagnosis. One study on distant recurrence concluded that 56 out of 61 TNBC patients that had relapsed had died, and the average time from recurrence to death is about 9 months.

Pre-menopause women in their 20's or 30's are more susceptible to Triple Negative Breast Cancer and, African-American women are at highest risk. The 5 year survival rate among African-American women with TNBC is about 14% and is the #1 cause in breast cancer deaths in African-American women . "Dr. Nanda said it’s not entirely understood why African American women are more susceptible to triple negative breast cancer. It could be genetic or environmental causes. The causes of the disease are just as mysterious for young women."

Many women who are diagnosed with Triple Negative Breast Cancer are often left in the dark about what triple-negative means for them at time of diagnosis. Often, these women turn to the internet searching for answers and are terrified with learning the aggressiveness of triple-negative and poorer prognosis due to no effective targeted therapy for this type of breast cancer. Also, TNBC " shows substantial overlap with basal-type and BRCA-1 related breast cancers, both of which also have aggressive clinical courses." Inherited BRCA -1 gene mutation carriers has an upward 80% life time risk of developing breast cancer and about 50% risk of developing ovarian cancer. 90% of BRCA-1 carriers are also Triple Negative but 20% of TNBC has BRCA mutations.

The clinical drug, PARP inhibitors that prevents cancer cells from repairing it's own DNA; are showing promising results in improving prognosis for Triple Negative Breast Cancer and BRCA Positive patients. "Important limitations still need to be overcome in the next few years if any significant clinical strides are to be made."

A research study conducted at The City of Hope's Division of Tumor Cell Biology of the natural fruit, blueberries gave preliminary promising results of controlling tumor growth, reduction of metastasis, and causing cell death in triple-negative breast cancer cells, at more than double the rate observed in untreated cells.

In 2009, Susan G. Komen for the Cure and Triple Negative Foundation teamed up to fund a $7.5million Promise Grant over 5 years to researchers looking at an antibody in hope of developing a targeted long-term therapy for triple negative tumors.

News correspondent, Jennifer Griffin and news anchor, Robin Roberts are TNBC survivors. I've link you to their stories.


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