Triple Negative Breast Cancer (TNBC)
What is Triple negative breast cancer
It is only in the last few years that professionals studying breast cancer have concluded that breast cancer is not one disease, but many different forms of cancer all originating in the breast. Depending on its stage of diagnosis, triple negative breast cancer can be extremely aggressive and more likely to recur and metastasize than other subtypes of breast cancer. It typically is responsive to chemotherapy, although it can be more difficult to treat because it is unresponsive to the most effective receptor targeted treatments.
Understanding Triple Negative Breast Cancer
It is now commonly understood that breast cancer is not one form of cancer, but many different "subtypes" of cancer.
These subtypes of breast cancer are generally diagnosed based upon the presence, or lack of, three "receptors" known to fuel most breast cancers: estrogen receptors, progesterone receptors and human epidermal growth factor receptor 2 (HER2). The most successful treatments for breast cancer target these receptors.
Unfortunately, none of these receptors are found in women with triple negative breast cancer. In other words, a triple negative breast cancer diagnosis means that the offending tumor is estrogen receptor-negative, progesterone receptor-negative and HER2-negative, thus giving rise to the name "triple negative breast cancer." On a positive note, this type of breast cancer is typically responsive to chemotherapy. Because of its triple negative status, however, triple negative tumors generally do not respond to receptor targeted treatments. Depending on the stage of its diagnosis, triple negative breast cancer can be particularly aggressive, and more likely to recur than other subtypes of breast cancer. Betterdays Cancer Care is devoted to finding targeted treatment for triple negative breast cancer. With your help, we will find a cure.
To understand triple-negative breast cancer, it's important to understand "receptors," which are proteins found on the surface of many breast cancer cells. These receptors enable the cells to receive signals to grow.
Hormone receptors receive growth signals from the hormones estrogen and progesterone. About 75% of women with breast cancer have cancer cells that are estrogen-receptor-positive, and about 65% have cells that are both estrogen- and progesterone-receptor-positive. A smaller percentage of breast cancers - about 20-30% - have too many HER2 receptors (human epidermal growth factor receptor). HER2 receptors receive signals that stimulate the growth of breast cancer cells. The more HER2 receptors the cancer cells have, the more likely the breast cancer is to grow.
Hormonal therapies and HER2-targeted therapies interfere with these signals and stop cancer cells from getting the messages to grow.About 10-20% of breast cancers are found to be triple-negative. Having triple-negative breast cancer means that, in the lab, your cells tested negative for hormone receptors and HER2 receptors. Therefore, the cancer will not respond to hormonal therapies, including tamoxifen, Arimidex (chemical name: anastrozole), Aromasin (chemical name: exemestane), Femara (chemical name: letrozole), and Faslodex (chemical name: fulvestrant). Triple-negative breast cancer also will not respond to medications that target HER2, such as Herceptin (chemical name: trastuzumab) or Tykerb (chemical name: lapatinib). However, triple-negative breast cancer can be treated with chemotherapy and radiation therapy.
Tends to be more aggressive than other types of breast cancer.
Studies have shown that triple-negative breast cancer is more likely to spread beyond the breast and more likely to recur (come back) after treatment. These risks appear to be greatest in the first few years after treatment. For example, a study of more than 1,600 women in Canada published in 2007 found that women with triple-negative breast cancer were at higher risk of having the cancer recur outside the breast - but only for the first 3 years. Other studies have reached similar conclusions. As years go by, the risks of the triple-negative breast cancer recurring become similar to those risk levels for other types of breast cancer. Five-year survival rates also tend to be lower for triple-negative breast cancer. A 2007 study of more than 50,000 women with all stages of breast cancer found that 77% of women with triple-negative breast cancer survived at least 5 years, versus 93% of women with other types of breast cancer. Another study of more than 1,600 women published in 2007 found that women with triple-negative breast cancer had a higher risk of death within 5 years of diagnosis, but not after that time period. The recurrence and survival figures in these and other studies are averages for all women with triple-negative breast cancer. Factors such as the grade and stage of the breast cancer will influence an individual woman's prognosis.
Tends to be higher grade than other types of breast cancer.
The higher the grade, the less the cancer cells resemble normal, healthy breast cells in their appearance and growth patterns. On a scale of 1 to 3, triple-negative breast cancer often is Grade 3.
Usually is a cell type called "basal-like.
"Basal-like" means that the cells resemble the basal cells that line the breast ducts. This is a new subtype of breast cancer that researchers have identified using gene analysis technology. Like other types of breast cancer, basal-like cancers can be linked to family history, or they can happen without any apparent family link. Basal-like cancers tend to be more aggressive, higher grade cancers - just like triple-negative breast cancers. It's believed that most triple-negative breast cancers are of the basal-like cell type.
It is perfectly natural to feel concerned when you learn you have a form of breast cancer that (1) is often more aggressive than other types and (2) does not respond to treatments such as hormonal therapy and Herceptin. However, remember that triple-negative breast cancer is a treatable disease. Researchers also are paying a great deal of attention to triple-negative breast cancer and working to find new and better ways to treat it. More and more people are talking about triple-negative breast cancer, which should make it easier to find other women who share your concerns.
It is only in the last few years that professionals studying breast cancer have concluded that breast cancer is not one disease, but many different forms of cancer all originating in the breast. Depending on its stage of diagnosis, triple negative breast cancer can be extremely aggressive and more likely to recur and metastasize than other subtypes of breast cancer. It typically is responsive to chemotherapy, although it can be more difficult to treat because it is unresponsive to the most effective receptor targeted treatments.
Understanding Triple Negative Breast Cancer
It is now commonly understood that breast cancer is not one form of cancer, but many different "subtypes" of cancer.
These subtypes of breast cancer are generally diagnosed based upon the presence, or lack of, three "receptors" known to fuel most breast cancers: estrogen receptors, progesterone receptors and human epidermal growth factor receptor 2 (HER2). The most successful treatments for breast cancer target these receptors.
Unfortunately, none of these receptors are found in women with triple negative breast cancer. In other words, a triple negative breast cancer diagnosis means that the offending tumor is estrogen receptor-negative, progesterone receptor-negative and HER2-negative, thus giving rise to the name "triple negative breast cancer." On a positive note, this type of breast cancer is typically responsive to chemotherapy. Because of its triple negative status, however, triple negative tumors generally do not respond to receptor targeted treatments. Depending on the stage of its diagnosis, triple negative breast cancer can be particularly aggressive, and more likely to recur than other subtypes of breast cancer. Betterdays Cancer Care is devoted to finding targeted treatment for triple negative breast cancer. With your help, we will find a cure.
To understand triple-negative breast cancer, it's important to understand "receptors," which are proteins found on the surface of many breast cancer cells. These receptors enable the cells to receive signals to grow.
Hormone receptors receive growth signals from the hormones estrogen and progesterone. About 75% of women with breast cancer have cancer cells that are estrogen-receptor-positive, and about 65% have cells that are both estrogen- and progesterone-receptor-positive. A smaller percentage of breast cancers - about 20-30% - have too many HER2 receptors (human epidermal growth factor receptor). HER2 receptors receive signals that stimulate the growth of breast cancer cells. The more HER2 receptors the cancer cells have, the more likely the breast cancer is to grow.
Hormonal therapies and HER2-targeted therapies interfere with these signals and stop cancer cells from getting the messages to grow.About 10-20% of breast cancers are found to be triple-negative. Having triple-negative breast cancer means that, in the lab, your cells tested negative for hormone receptors and HER2 receptors. Therefore, the cancer will not respond to hormonal therapies, including tamoxifen, Arimidex (chemical name: anastrozole), Aromasin (chemical name: exemestane), Femara (chemical name: letrozole), and Faslodex (chemical name: fulvestrant). Triple-negative breast cancer also will not respond to medications that target HER2, such as Herceptin (chemical name: trastuzumab) or Tykerb (chemical name: lapatinib). However, triple-negative breast cancer can be treated with chemotherapy and radiation therapy.
Tends to be more aggressive than other types of breast cancer.
Studies have shown that triple-negative breast cancer is more likely to spread beyond the breast and more likely to recur (come back) after treatment. These risks appear to be greatest in the first few years after treatment. For example, a study of more than 1,600 women in Canada published in 2007 found that women with triple-negative breast cancer were at higher risk of having the cancer recur outside the breast - but only for the first 3 years. Other studies have reached similar conclusions. As years go by, the risks of the triple-negative breast cancer recurring become similar to those risk levels for other types of breast cancer. Five-year survival rates also tend to be lower for triple-negative breast cancer. A 2007 study of more than 50,000 women with all stages of breast cancer found that 77% of women with triple-negative breast cancer survived at least 5 years, versus 93% of women with other types of breast cancer. Another study of more than 1,600 women published in 2007 found that women with triple-negative breast cancer had a higher risk of death within 5 years of diagnosis, but not after that time period. The recurrence and survival figures in these and other studies are averages for all women with triple-negative breast cancer. Factors such as the grade and stage of the breast cancer will influence an individual woman's prognosis.
Tends to be higher grade than other types of breast cancer.
The higher the grade, the less the cancer cells resemble normal, healthy breast cells in their appearance and growth patterns. On a scale of 1 to 3, triple-negative breast cancer often is Grade 3.
Usually is a cell type called "basal-like.
"Basal-like" means that the cells resemble the basal cells that line the breast ducts. This is a new subtype of breast cancer that researchers have identified using gene analysis technology. Like other types of breast cancer, basal-like cancers can be linked to family history, or they can happen without any apparent family link. Basal-like cancers tend to be more aggressive, higher grade cancers - just like triple-negative breast cancers. It's believed that most triple-negative breast cancers are of the basal-like cell type.
It is perfectly natural to feel concerned when you learn you have a form of breast cancer that (1) is often more aggressive than other types and (2) does not respond to treatments such as hormonal therapy and Herceptin. However, remember that triple-negative breast cancer is a treatable disease. Researchers also are paying a great deal of attention to triple-negative breast cancer and working to find new and better ways to treat it. More and more people are talking about triple-negative breast cancer, which should make it easier to find other women who share your concerns.
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DID YOU KNOW?
An estimated 19,540 new cases of breast cancer are expected to occur among African American women in 2009.
The overall incidence rate of breast cancer is 10% lower in African American women than white women.
More Facts.....
An estimated 19,540 new cases of breast cancer are expected to occur among African American women in 2009.
The overall incidence rate of breast cancer is 10% lower in African American women than white women.
More Facts.....
Dr. Funmi Olopade discusses breast cancer genetics, risk assessment, patient rights, the need for personalized care, and the role of the ASBD in translating research into clinical practice.
For more information, visit www.asbd.org
For more information, visit www.asbd.org
Pioneer doctor Lisa Newman searches for answers to an aggressive form of breast cancer that targets black women.
