Komen's Research Fast Facts: Triple Negative Breast Cancer

Thank you Komen...

Susan G. Komen® | Prognosis of Triple-Negative Breast Cancer Varies By Age

Komen News press release:

Prognosis of Triple-Negative Breast Cancer Varies By Age

The prognosis of triple-negative breast cancer (TNBC) tends to be better among older women than among younger women, even though older women are less likely to receive aggressive treatment. These results were published in Breast Cancer Research and Treatment. 

Previous studies have reported that the prognosis of breast cancer tends to be better for women who are diagnosed at older ages, but few of these studies have focused specifically on triple-negative breast cancers (breast cancers that are estrogen receptor-negative, progesterone receptor-negative, and HER2-negative).  

The explore the relationship between age and prognosis, researchers conducted a study among 1,732 women with TNBC. Roughly 21% of the women were age 40 or younger at the time of diagnosis. 

Factors that were more common among younger women included non-white race, high-grade tumors, and treatment with chemotherapy.  

In spite of receiving more aggressive treatment, younger women tended to have worse disease-free and overall survival than older women. Median disease-free survival (survival without a recurrence or a new cancer) was 4 years among women who were diagnosed between ages 31 and 40, compared with 8 years among women diagnosed at age 60 or older. 

The relationship between age and prognosis persisted even after accounting for factors such as family history of breast cancer, tumor grade and size, and lymph node involvement.  

As has been reported for other types of breast cancer, older age tends to be linked with better outcomes among women with TNBC. Research into how the biology of TNBC varies by age may point the way toward new and more effective treatments for this condition. 

Reference: Liedtke C, Hess KR, Karn T et al. The prognostic impact of age in patients with triple-negative breast cancer. Breast Cancer Research and Treatment. Early online publication March 5, 2013. 

Posted March 19, 2013

Susan G. Komen® | Prognosis of Triple-Negative Breast Cancer Varies By Age

Stronger...

Melissa Paskvan is Going to Bat Against Breast Cancer 2013...

It's that time again... I'm going to bat against breast cancer until all of my sisters are safe. I'm going for honorary bat girl for the Detroit Tigers and I would appreciate your vote please. Thank you ♥
http://mlb.mlb.com/honorarybatgirl/2013/gallery.jsp 
(Click link to vote)

I Want Your VOTES!

In 2009, I found my lump by chance when I felt something along my bra band line under my breast. My heart just sunk, and I was in disbelief that my worst fear was now happening to me. I reacted fast and got in for a mammogram and an ultrasound 2 days later.  My 2cm. lump did not show up on the mammogram images, and it was thought to be just a cyst, but I insisted on a needle biopsy right then and there. I received that call from my doctor, I'm 41 and I have breast cancer... I was numb.  I was told that I have a rare and aggressive form of cancer ,Triple Negative Breast Cancer (TNBC), that tends to strike younger women. I opted for a lumpectomy, followed by chemotherapy, 33 radiation treatments and a clinical trial.  I am so passionate about putting Triple Negative Breast Cancer Awareness in the forefront  that I go to bat  for all of my sisters that are still battling. I have participated in many events including Komen for the Cure, Making Strides Against Breast Cancer, Relay for Life and most recently, Triple Negative Breast Cancer Inaugural Awareness Day where I raised $605 for the TNBC Foundation. I have created a blog documenting my journey to help others to have hope, give them strength to fight and to provide resources to get them the information they need to to know more about this TNBC subtype.  I'm going to bat until all of my sisters are safe... Breast self-exams saves lives! Now, let's play ball!

"As More Women Are Beating Breast Cancer, Survival Rates Among Triple Negative Breast Cancer Patients Have Not Improved For Many Women

"Only 10 to 20 percent of breast cancers are triple negative, but black women are twice as likely as white women to develop it. And women under 40 are twice as likely to get this type sub-type..."



http://wtvr.com/2013/04/06/buddy-check-6-breast-cancer-survival-rates-not-improving-for-some/ (Click link to story)

Do you Know Your Risk for Breast and Ovarian Cancer?

Assess Your Risk

This interactive tool was created to take you on a journey and help you better understand some of the common factors that can influence your personal cancer risk. By combining your family's health history and accounting for lifestyle factors, you will not only learn more about your risk, but also what actions you can take starting today to be brighter with your breast and ovarian health.

Disclaimer: This tool is available for educational purposes only and should not be interpreted as medical advice. Be sure to partner with your medical provider to develop the best personal care strategy for you.

http://www.brightpink.org/knowledge-is-power/assess-your-risk/ 
(Click link to quiz)

Dr Lisa Newman research on Triple Negative Breast Cancer in African-American Women and women of Ghana, Africa

Stroll for Strides Against Breast Cancer 2013

"Hello, welcome to Chico's. My name is Melissa and I
am a 3½ yr. Triple Negative Breast Cancer Survivor!"

I participated in Stroll for Strides as a breast cancer survivor store greeter at Chico's of Levis Commons, Perrysburg as part of their scavenger hunt event for prizes and store discounts. An evening of good company and yummy appetizers with my survivor friends from The Victory Center. 

Melissa and Making Strides Honoree, Kathleen Walsh.
Kathleen is an Inflammatory Breast Cancer Survivor
whom I've met in our support group at The Victory Center.

My Story and my message to you... 

The Ethical Implications of Gene Patenting

"Do genes qualify as a property that a single individual or corporation is allowed exclusive rights to? This spring, the Supreme Court will hear a case that could dictate the future of biomedicine. Currently, Myriad Genetics Corporation, a biotechnology outfit in Utah, has patented two human genes known as BRCA1 and BRCA2. These genes are known to greatly elevate a woman's risk of breast and ovarian cancer. This patent allows Myriad Genetics to block all others from using these genes for the purposes of breast cancer diagnostics, research and treatment...."

http://www.empowereddoctor.com/the-ethical-implications-of-gene-patenting (Click link to full story)

UPDATE: Published June 13, 2013
"Human genes may not be patented, the Supreme Court ruled unanimously on Thursday. The decision is likely to reduce the cost of genetic testing for some health risks, and it may discourage investment in some forms of genetic research.  The case concerned patents held by Myriad Genetics, a Utah company, on genes that correlate with an increased risk of hereditary breast and ovarian cancer."
http://www.nytimes.com/2013/06/14/us/supreme-court-rules-human-genes-may-not-be-patented.html?_r=0 
(Click link to story)

March 2013 Ask the Expert: Diet and Nutrition for Long-Term Survivors

Question: Is there any evidence that avoiding dairy products might lessen the chance of breast cancer recurrence?

Ms. Barkai: The relationship between an initial breast cancer and dairy consumption has been examined in many studies. Some researchers have hypothesized that the fat content and possible hormone residue in dairy foods could increase risk for breast cancer, while others have speculated that the vitamin D that is added to some dairy foods could have a protective effect. However, dairy food consumption has not been consistently associated with breast cancer risk or progression in either pre- or postmenopausal women in the studies.

Question: What are your recommendations on total calcium daily intake after breast cancer treatment? Please specify how much calcium in foods vs. in supplements. Is there a difference in your recommendations based on whether one had chemo or not?

Ms.Barkai: Women diagnosed with breast cancer are at increased risk for osteoporosis and should consume 1,200 mg of calcium per day. Ideally the calcium will come from foods such as low-fat dairy products, dark leafy greens and fortified products, because these foods provide other nutrients as well.

A serving of low-fat dairy product (one cup of low-fat milk or yogurt or one ounce of cheese) will supply about 300 mg of calcium. Following the recommendation of three dairy food servings per day and increased vegetable intake will thus result in adequate calcium consumption. 

Vitamin D is important for absorbing calcium, and since many dairy products are fortified with vitamin D, consumption of low-fat dairy foods will help by providing vitamin D as well. Dark leafy greens (such as kale, spinach, collards and others) are also rich in magnesium and vitamin K which are important for bone health.

Nevertheless, if you know you are not getting 1,200 mg of calcium from foods, you can benefit by taking a supplement. The maximum safe level for calcium consumption is 2,000 mg, so it’s important not to go over that level. Calcium absorption is best at levels of up to 500 mg at a time, so if you need to take more than that, split the dose and take it twice a day. 

Both calcium carbonate and calcium citrate are effective. Calcium carbonate products should be taken with food, while calcium citrate can be taken on an empty stomach. When choosing a supplement, look for a brand-name supplements with proven reliability. Look for labels that have the USP (United States Pharmacopeia) symbol.

Chemotherapy has some adverse effects on bone. Because women who have been diagnosed with breast cancer are at increased risk for fragile bones for multiple reasons in addition to chemotherapy, they should consume 1,200 mg of calcium per day.

Question: If being overweight can give you cancer and you had a mastectomy, is this still true or is your risk lower because you don't have breasts any longer and you don't have to worry about the extra weight? Or can you get cancer elsewhere?

Ms.Barkai: Breast cancer can come back as a local recurrence (since you had a mastectomy, it can come back at the mastectomy scar area, for example) or somewhere else in the body (most often in the lymph nodes, bones, liver, lungs or brain). Body fat increases estrogen levels, insulin levels and inflammation that promotes cancer cell growth regardless of the site. We don’t know yet if weight loss will reduce breast cancer recurrence rate (this is what current studies are testing), but there is a good reason to believe it could.

Regardless, if you are overweight or obese, losing 5-10 percent of your body weight reduces risk for other diseases such as heart disease and diabetes. Thus, losing this weight is recommended. 

Question: I am bombarded by information suggesting that if I eat or had eaten a healthier diet, I would not have breast cancer. I have been told that weight correlates to breast cancer, and the implication is that if I have a BMI of 18, I am less likely to relapse than if I have a BMI of 23. Is there any medical evidence to sustain this? What is your opinion?

Ms.Barkai: Postmenopausal women with a healthy body mass index (BMI) of 18.5–24.9 are less likely to get breast cancer than overweight or obese women. Some of the possible mechanisms in which fat increases cancer cell growth are elevated estrogen, insulin and inflammation levels that result from extra body fat. 

BMI below 18.5 is considered underweight and is not necessarily indicative of good health. Most studies do not differentiate the healthy BMI range of 18.5–24.9 to subcategories when looking at breast cancer and recurrence rates, so there is no evidence on which to base conclusions about different degrees of risk across that range.  

Question: There is conflicting information about soy in the diet of breast cancer survivors. What is most prudent? 

 Ms. Barkai: For women diagnosed with breast cancer, current research finds no harmful effects from eating soy foods. However, soy or isoflavone supplements are not recommended because there is not sufficient research data on whether high dose concentrated supplements influence risk for cancer recurrence or progression.

Question: As a lifelong  tai chi practitioner I get daily range-of-motion exercise. However, this does not elevate my heart rate. I do it because I love practicing the forms, but is this kind of exercise also helpful for breast cancer survivors?

Ms. Barkai: Tai chi is an excellent mind-body practice that reduces stress, improves range of motion and balance and, to some degree, also improves muscle strength. However, in order to improve your aerobic fitness and help with fat loss (if needed), incorporating a daily aerobic workout (such as walking, biking or swimming) will be beneficial. Enjoyment is a big part of a keeping a healthy lifestyle, so please keep enjoying tai chi and add an aerobic workout to your daily routine.

Question: Is it best to buy all organic fruits and vegetables? I have triple-negative breast cancer.

Ms. Barkai: Vegetables and fruits provide healthy bioactive food components such as phytochemicals, vitamins and fiber and are a big part of a healthy diet. When measuring the nutritional content, studies have generally found that organically grown vegetables and fruits are no different than those that are conventionally grown. Currently there are no studies that show any risk in eating conventionally grown vegetables and fruit. Taste and budget should lead your choice.

However, if you are concerned about pesticides and herbicides, purchase organic produce if the conventional ones might possibly have higher levels of pesticides. (The Environmental Working Group maintains a list of such fruits and vegetables.) Whether organically grown or not, it is important to always wash your fruits and vegetables before consuming them.

Question: I spoke with a nutritionist when I was first diagnosed with metastatic breast cancer. She advised no alcohol at all. Would you agree with that? I know other stage IV patients have an occasional glass of wine.

Ms. Barkai: Although alcohol consumption has been consistently linked with modestly higher risk of incident (first) breast cancer, the evidence that it might contribute to recurrence or affect survival is mixed. Unless there is a contraindication with medications or a specific medical condition (such as liver insufficiency), enjoying a glass of wine occasionally is unlikely to pose adverse effects or affect survival.

Question: I am  getting ready to start chemo for triple-negative breast cancer and I'm in Germany, which can at times be a different world. The gynecologists here deal with female cancers. I asked about nutrition and what to eat last week when I met my chemo gyno. I'm already vegetarian. His response was that I should eat what I want and should eat meat. Can you generally outline what you consider a healthy diet for chemo and after?

Ms. Barkai: The American Cancer Society Nutrition and Physical Activity Guidelines for Cancer Survivors working group of experts thoroughly review diet and exercise through cancer treatment and after. The summary of evidence and recommendations is available at http://www.cancer.org/cancer/news/news/guidelinesaddress-diet-exercise-and-weight-control-for-cancer-survivors. 

Breast Cancer Survivor Exercising Safely Guidance...

"The benefits of weight lifting for survivors was studied in the PAL trial, which showed that starting very light and progressively lifting heavier weights might be better than not exercising an arm at risk for lymphedema after breast cancer. The PAL trial found that women who followed the weight lifting plan were stronger, had a better body image, and had less body fat than women who didn’t lift weights. Additionally, women who were diagnosed with lymphedema at the start of the PAL trial who followed the weightlifting plan were 50% less likely to have the lymphedema get worse..."
http://www.breastcancer.org/tips/exercise/safe (Click link to story)

Copper Depletion Therapy Keeps High-Risk Triple-Negative Breast Cancer at Bay

(February 13, 2013) — An anti-copper drug compound that disables the ability of bone marrow cells from setting up a "home" in organs to receive and nurture migrating cancer tumor cells has shown surprising benefit in one of the most difficult-to-treat forms of cancer — high-risk triple-negative breast cancer.

The median survival for metastatic triple-negative breast cancer patients is historically nine months. However, results of a new phase II clinical trial conducted by researchers at Weill Cornell Medical College and reported in the Annals of Oncology shows if patients at high-risk of relapse with no current visible breast cancer are copper depleted, it results in a prolonged period of time with no cancer recurrence...

http://weill.cornell.edu/news/releases/wcmc/wcmc_2013/02_13_13.shtml

(Click link to story)

Anti-CD47 Antibodies Destroys a Variety of Human Cancers Study to Advance to Human Trials...

"It is the first antibody treatment shown to be broadly effective against a variety of human solid tumors, and the dramatic response — including some overt cures in the laboratory animals — has the investigators eager to begin phase-1 and –2 human clinical trials within the next two years..."
http://med.stanford.edu/ism/2012/march/cd47.html
(Click link to story)

TGF-b Inhibitors Needed to Target Stem-Like Cancer Cells In Triple Negative Breast Cancer

"A new study by Vanderbilt-Ingram Cancer Center investigators suggests drugs that block or inhibit the TGF-b signaling pathway in cancer cells enhance the effect of chemotherapy and may prevent recurrences of treatment-resistant TNBC..."
...Chemotherapy drugs are designed to attack fast-dividing cancer cells. Recent research suggests that after an initial response to chemotherapy a small population of slower growing cells known as cancer stem-like cells (CSCs) survives and regenerates, causing metastatic tumor recurrences...
http://news.vanderbilt.edu/2013/03/breast-cancer-study-explores-therapy-to-slow-recurrence/
(Click link to story)

Breast Cancer Risk Genetic Testing Covered Under the Affordable Care Act?

Today (March 6), Myriad Genetics, the company that makes the test for the breast cancer genes BRCA1 and BRCA2, said that the U.S. government considers these tests to be preventive services. This means that private insurance plans are required to cover the cost of the tests, including co-pays, deductibles and coinsurance, provided that the plans do not have a "grandfathered" status.
http://www.myhealthnewsdaily.com/3590-genetic-testing-breast-cancer-insurance-coverage.html (Click to story)