It can be very disturbing and daunting to unearth that one has TNBC (Triple negative breast cancer), a type of breast cancer which oftentimes has greater aggressiveness as compared to the other forms and is not sensitive to therapies like Trastuzumab. It is one of the most dangerous types of breast cancer and accounts for ten to seventeen percent of the breast cancers.
What makes Triple negative breast cancer stand out from the other breast cancer forms is that females diagnosed with the condition are lacking trio hormone receptors – namely, progesterone, estrogen and Human Epidermal Growth Factor Receptor 2 (HER2). It is this absence which is the key reason for the condition being named as Triple Negative breast cancer.
Lately, an interesting finding by scientists that appeared in the ‘Journal of Clinical Investigation’ last year showed that there are actually 6 different sub-types of triple negative breast cancer namely M, MSL, BL (1 and 2), LAR and IM. The mesenchymal-like sub-groups (M, MSL) showed response to Sprycel (BMS-354825) cancer drug while basal-like morphology of tumor cells showed sensitivity to the trial medicine BEZ235 and luminal (LAR) sub-type showed response to Casodex drug. This identification indicates that targeted chemotherapy prescription based on the particular sub-group of triple negative breast cancer would yield favourable results in treatment.
One of the greatest challenges that oncologists face is the elevated rate of triple negative breast cancer recurring or relapsing post-treatment and a greater likelihood of metastasis in affected women. Once the disease recurs then there is a tendency of it becoming fatal. The 5-year survival rates and prognosis of females with triple negative breast cancer also tend to be grim as compared to the other kinds of breast cancer.
Prevalence And Risk Factors Of Triple Negative Breast Cancer
Triple negative breast cancer is a major health issue from the viewpoint that eleven percent females from the Caucasoid race, twenty-five percent from the Afro-American race and seventeen percent Latino Americans are affected by it.
It is widely observed that Afro-American females are identified with this type of breast cancer. Females having a family history of the gene mutation (BRCA1 or breast cancer 1, early onset) are at the highest risk. Discovery of the key breast cancer causative gene, BRCA1 was done almost two decades ago and females who inherently have the flawed gene are at a greater risk of developing breast cancer which tends to develop quite earlier on in their life.
Duo most recently conducted large-scaled studies that collected information from over 1,50,000 females who signed up in the WHI (Women’s Health Initiative) and in that research it uncovered that being obese (higher BMI or body mass index), sedentary existence, gestation and having more than one child augments risk for this cancer type. Coincidentally, Triple negative breast cancer cases are also observed to be prevalent among females who don’t nurse or breastfeed their kids.
Since the tumor cells are lacking certain hormone receptors hence hormone therapies like AIs (Aromatase Inhibitors) and HER2-targeted medicines would be ineffective in such women. However, if patients respond favourably to chemotherapy then there is a good likelihood of treating the disease.
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The standard line of therapy for this disease might comprise of:
1) Radiotherapy, Adjuvant Chemotherapy ensued by surgical intervention (breast-conservation, simple mastectomy, MRM or modified radical mastectomy) and dissecting the lymph node for examining cancerous presence.
2) Clinical trial that entails the usage of more than one chemotherapy medicine at an instant for treating the cancer or different chemotherapy drug combinations.
3) Clinical trial that entails the use of PARP inhibitor as a targeted therapy for cancer.
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Duo study results that were printed in the recent edition of ‘the New England Journal of Medicine’ indicate that the use of Avastin drug prior to undergoing surgery for breast cancer might shrivel tumors and lessen their likelihood of recurring among females having less prevalent but more aggressive types of breast cancer.
Every young female, irrespective of her race, must discuss with her physician about conducting a risk evaluation for the gene mutation BRCA1. In case there is presence of a family history then such females are screened from twenty-five years of age onwards rather than waiting till they turn forty to undergo their foremost mammography.
Several of these females are now able to survive and beat the likelihood of dying by following preventative strategies to lesser their risk of mortality.