2022 Western Medical Research Conference
What To Know About Triple-negative Breast Cancer
Triple-negative breast cancer (TNBC) is a rare type of breast cancer. It is harder to treat and much more aggressive.
Because it is aggressive and rare, fewer treatment options are available. It also tends to have a higher rate of recurrence.
This form of cancer accounts for around 10–15% of all breast cancer diagnoses.
In this article, we look at the risk factors, diagnosis, and available treatments for triple-negative breast cancer.
The term triple-negative breast cancer means that cancer cells do not have estrogen or progesterone receptors and do not produce large amounts of human epidermal growth factor receptor 2 (HER2).
When diagnosing cancer types, doctors will test for the presence of these receptors and protein production. If all three tests return negative results, a person has triple negative breast cancer.
Other types of breast cancer include:
If cancer cells are positive for these receptors, doctors can target the cancer with hormonal treatments.
However, no targeted therapies are available for triple-negative breast cancer. It is also more likely than other types of breast cancer to spread and recur.
Researchers have identified the following risk factors for developing triple-negative breast cancer over other types.
Obesity and inactivityStudies suggest that people with obesity and a higher body mass index (BMI) have a higher risk of developing triple-negative breast cancer. These categories tend to include those who are not very active.
GeneticsA 2018 study identified several genes associated with a high risk of triple-negative breast cancer. In particular, around 70% of breast cancers in people with a BRCA gene mutation are triple-negative.
AgeIndividuals under 50 years of age have a higher risk of developing triple-negative breast cancer.
RaceAfrican American and Hispanic women are more susceptible to triple-negative breast cancer.
PregnancyA small study from 2015 found that pregnancy-associated breast cancers affecting women up to 10 years after pregnancy were more likely to be triple-negative than those in women who had never had a pregnancy.
As with other types of breast cancer, a person may feel a small, hard bump on or near their breast. In other cases, a routine scan of the breasts may reveal an area of concern.
Upon detection of a growth, the doctor will collect tissue samples for assessment.
The results of these tests will highlight the type of breast cancer. A person whose cancer tests negative for the estrogen, progesterone, and HER2 receptors will receive a diagnosis of triple-negative breast cancer.
A doctor will then assign a stage to the cancer based on the findings of the biopsy and any follow-up scans. They calculate the stage based on tumor size and the spread, if any, of the cancer.
Here, learn more about how a biopsy works.
There are fewer treatment options for triple-negative breast cancer than for other types of breast cancer. Hormone therapies are not effective against triple-negative breast cancer, since it lacks estrogen and progesterone receptors.
However, several different treatments are available, and researchers are looking for additional medications to help treat and prevent this aggressive cancer.
Currently, treatment options for triple-negative breast cancer include:
Surgical options include the partial (lumpectomy) or full (mastectomy) removal of one or both breasts.
An important part of any treatment plan is remaining active and eating a variety of healthful foods. The side effects of cancer treatment can be difficult to manage, so maintaining a balanced diet, getting regular exercise, and resting can help improve how a person manages the adverse effects.
Find out all about chemotherapy here.
Researchers describe the outlook for cancer in 5-year survival rates. The prognosis for triple-negative breast cancer is worse than that for other types of breast cancer. The overall prognosis depends on the stage of the cancer at diagnosis.
Doctors may define a person's cancer as:
The American Cancer Society estimates relative 5-year survival rates to be:
However, survival and overall prognosis vary from person to person. Many factors can affect a person's outlook following treatment, including:
Catching cancer in its earliest stages and undergoing effective treatment may help improve the prognosis.
Breast Cancer Screening Should Start 10 Years Earlier At Age 40, According To US Task Force
© Ljubaphoto/Getty Images Seven years after changing their recommendation for women to begin breast cancer screening at their own discretion at some point in their 50s, the United States Preventive Services Task Force has revised their rule.
The task force is a panel of volunteers charged by the U.S. Congress with examining and making recommendations regarding clinical preventative services, according to the organization's website.
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As of May, the task force now advises women from 40 to 74 get screened for breast cancer every other year, an entire decade earlier than the previous recommendation. The new recommendation is in the draft phase of the development process, the task force website details. The public may comment on the draft recommendation until June 5. After the comment window closes, the task force will issue a final recommendation.
"We are also urgently calling for more research that will allow us to build on our existing recommendations and help all women live longer and healthier lives," the website states. "Specifically, we need to know how best to address the health disparities across screening and treatment experienced by Black, Hispanic, Latina, Asian, Pacific Islander, Native American, and Alaska Native women."
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According to the task force, this revision could save more than 20 percent more lives than the previous recommendation.
Ainel Sewell, diagnostic radiology and breast imaging specialist with Houston Methodist Willowbrook, said while the change is welcome, the previous recommendation may have already had a negative effect on detecting breast cancer before it progresses further.
"It was detrimental to women's health because they sent the message that mammograms don't really matter anymore," Sewell said. "We know that women have an increased risk of breast cancer starting at the age of 40. We do find that women between the ages of 40 and 50 actually tend to have more aggressive cancer."
Sewell said recommendations for breast cancer screening can be confusing due to several organizations having different standards.
For example, the American College of Radiology, the Society of Breast Imaging, and the American College of Obstetrics and Gynecology have all recommended beginning breast cancer screening at age 40 within recent years and before the 2016 recommendation from the task force.
Sewell said the change from 2016 has already done damage over its seven-year run, despite other organizations having different recommendations.
"I think it's not enough, but it's a step in the right direction," she said. "Because of what they did, we're seeing cancer cases that are more advanced and in later stages that have to involve chemotherapy and other aggressive treatments that, if we were to catch the cancer earlier, we would not have."
Even with more uniform recommendations, breast cancer risk can vary based on genetics, race, age, and background. Sewell said some women should consult with their physician to determine whether they should begin screening in their 30s if they are at higher risk.
Sewell said she sees a breast cancer patient in their 30s at least once a month, despite screenings generally being recommended for women in their 40s.
"Women of color, whether they be Hispanic or Black women, are at an increased risk for developing aggressive breast cancer," Sewell said. "Also, women who are of Ashkenazi Jewish ancestry should really start discussing screening early on."
As the task force works on their new recommendations, Sewell said she hopes they handle it with care. Previously, the task force published that repeated cancer screenings could cause possible risk to health.
Sewell said the risk from screening could not be greater than the risk that comes with breast cancer.
"Well, what about the harms of not screening?" she said. "Because that could mean somebody losing their life or having to undergo aggressive chemotherapy. That is a harm too."
chevall.Pryce@houstonchronicle.Com
Ovarian Cancer Stages: Survival Rates And Life Expectancy
Like other cancers, survival rates become lower as ovarian cancer progresses.
If you are living with ovarian cancer, you're probably wondering about your prognosis. While knowing your prognosis can be helpful, it's important to know that it's only a general guideline. Your individual outlook will depend on many factors, such as your age and overall health.
Read on to learn more about the 5-year survival rates for different ovarian cancer stages and what the numbers mean.
The 5-year relative survival rate for all types of ovarian cancer is 49.1 percent.
People with ovarian cancer will have one of three types of tumors. The type of tumor you have will impact your outlook.
About 90 percent of ovarian cancers involve epithelial tumors. Stromal tumors represent about 5 percent of ovarian tumors, while germ cell tumors are significantly rarer.
Early detection generally results in a better outlook. When diagnosed and treated in stage 1, the 5-year relative survival rate is 94 percent. Only about 20% of ovarian cancers are diagnosed in stage 1.
In this article, we will also cover survival rates for fallopian tube cancer. Doctors often treat this in the same way as ovarian cancer.
Both the stage and the type of ovarian cancer factor into your individual outlook. There are multiple methods doctors use to define cancer stages.
The Surveillance, Epidemiology, and End Results (SEER) registry program of the National Cancer Institute (NCI) is the authoritative source on cancer survival in the United States. It collects comprehensive information for different types of cancer in populations within the country.
The SEER registry can help you better understand the rate of survival for your stage of ovarian cancer for each year after diagnosis.
The SEER registry uses a simplified approach to staging. It roughly correlates with other staging systems as follows:
Since fewer women have stage 1 or "localized" ovarian cancer, the overall prognosis for regional or distant disease can be broken down by year since diagnosis.
For example, factoring in all tumor types, for women with distant spread (or stage 4 disease) of ovarian cancer, the percentage of women in the U.S. Population surviving 1 year is over 69%.
For more details, including a visual graph, see the SEER registry of survival rates for ovarian cancer by stage and time since diagnosis.
The exact type of ovarian cancer you have can also affect your survival rate.
The 5-year survival rates for epithelial ovarian cancer The 5-year survival rates for ovarian stromal tumors The 5-year survival rates for ovarian germ cell tumors The 5-year survival rates for fallopian tube cancerOne of the first things you'll want to know is the stage of your ovarian cancer. Staging is a way of describing how far the cancer has spread and can indicate how aggressive your cancer is. Knowing the stage helps your cancer care team formulate a treatment plan and gives you some idea of what to expect.
As well as the above SEER stages, doctors can determine ovarian cancer stages using the FIGO (International Federation of Gynecology and Obstetrics) staging system.
This system defines ovarian cancer in one of four stages and takes into account:
Doctors can more accurately determine the size of the primary tumor through surgery. Accurate staging is important in helping you and your cancer care team understand the chances that your cancer treatment will be curative.
Stage 1In stage 1, the cancer has not spread beyond the ovaries, according to the American Cancer Society.
Stage 1A means the cancer is only in one ovary. In stage 1B, the cancer is in both ovaries.
Stage 1C means that one or both ovaries contain cancer cells, and one of the following situations is also found:
In stage 2 ovarian cancer, the cancer is in one or both ovaries and has spread to elsewhere within the pelvis.
Stage 2A means it has gone from the ovaries to the fallopian tubes, the uterus, or to both.
Stage 2B indicates the cancer has migrated to nearby organs like the bladder, sigmoid colon, or rectum.
Stage 3In stage 3 ovarian cancer, the cancer is found in one or both ovaries, as well as in the lining of the abdomen, or it has spread to lymph nodes in the abdomen.
In Stage 3A, the cancer is found in other pelvic organs and in lymph nodes within the abdominal cavity (retroperitoneal lymph nodes) or in the abdominal lining.
Stage 3B is when the cancer has spread to nearby organs within the pelvis. Cancer cells may be found on the outside of the spleen or liver or in the lymph nodes.
Stage 3C means that larger deposits of cancer cells are found outside the spleen or liver, or that it has spread to the lymph nodes.
Stage 4Stage 4 is the most advanced stage of ovarian cancer. It means the cancer has spread to distant areas or organs in your body.
In stage 4A, cancer cells are present in the fluid around the lungs.
Stage 4B means that it has reached the inside of the spleen or liver, distant lymph nodes, lungs, and bones.
Doctors base ovarian cancer survival statistics on the stage in which ovarian cancer was first diagnosed.
They are estimates and don't take into account factors that may improve your outlook, such as your age, overall health, and how well your cancer responds to treatment.
Because these statistics relate to people who were diagnosed with ovarian cancer at least 5 years previously, treatments have improved since then, so their outlook may be better today.
The general trend has been lower numbers of new cases, about 1 to 2 percent each year between the 1980s and 2017. Analysis of outcomes has also shown better survival rates — an increase of 1 to 2 percent per year between 2009 and 2018.
Relative 5-year survival rate estimates the percentage of people with cancer who will survive 5 years after diagnosis, in relation to the general populace.
Researchers calculate the number by dividing the percentage of patients with cancer who survive the period, by the percentage of the general population of the same sex and age who are also alive at the end of the 5 years.
Honest talks with your healthcare professionals will help you make informed decisions about your treatment for ovarian cancer.
These are some of the questions to ask your cancer care team:
Keep in mind that ovarian cancer survival rates are estimates and do not take into account other factors that may affect your personal outlook.
Your cancer care team can determine your most effective treatment options based on the stage and type of your ovarian cancer when it is first diagnosed.
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