What Do You Attribute To The Hesitancy Black Women Have To Partake In Clinical Trials
RF: The traumatic history of exploitation and racism in the scientific and medical industries has understandably posed huge barriers of trust for women of color. Nearly a third of Black women believe scientists cannot be trusted, compared to only 4% of white women. As a result, the average participation by Black women in breast cancer clinical trials overall is less than 3%. This is where a platform like Ciitizen dedicated to democratizing health data and empowering patients to take charge of their treatment journey is critical. By giving Black patients tools to safely store and access their medical data, Ciitizen fosters trust between Black patients and researchers.
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What Is Lobular Carcinoma In Situ What Is Atypical Lobular Hyperplasia
Lobular neoplasia is when there are abnormal cells in the breasts lobules. It rarely becomes cancer. Types of lobular neoplasia include:
- Lobular carcinoma in situ , a condition that is not breast cancer or a precancer. Often, it does not become invasive cancer if its not treated.
- Atypical lobular hyperplasia , a condition that is not cancer. Its when there are more cells than usual in your breasts lobules. The extra cells are abnormal.
Both LCIS and ALH raise your risk of getting breast cancer in the future. If you have been diagnosed with either of them, talk with your doctor. Ask how often you should be screened for breast cancer and if you should have more screening tests.
What Is Metaplastic Carcinoma
Metaplastic carcinoma is a rare type of invasive breast cancer. It has a mix of 2 or more kinds of breast cancer cells, usually carcinoma and sarcoma. Its also called metaplastic breast cancer. Metaplastic means cancer that starts in cells that have changed into another kind of cell.
To treat metaplastic carcinoma, we first learn more about its genetics and biology. We find out if the tumor is more similar to carcinoma or sarcoma, because they have very different treatments.
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A Note About Statistics
Survival rates are statistics. As such, they tend to tell us how the average person will do with an average triple-negative breast cancer. But people and tumors arent statistics. Some people will do better, and some people will do worse.
Very importantly, statistics are usually several years old. In order to calculate five-year survival rates, a person would have to have been diagnosed at least five years prior, and there is lag time. The treatment of triple-negative breast cancer is changing, and new drugs have been approved.
What Is The Prognosis For Triple Negative Breast Cancer
Triple negative breast cancer can be more aggressive and difficult to treat. Also, the cancer is more likely to spread and recur. The stage of breast cancer and the grade of the tumor will influence your prognosis. Research is being done currently to create drug therapies that are specific for triple negative breast cancer.
Interested in learning more? i3Health is hosting an upcoming webinar Metastatic Triple-Negative Breast Cancer: Applying Treatment Advances to Personalized Care. Learn more here.
Material on this page courtesy of Johns Hopkins Medicine
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How Is Triple Negative Breast Cancer Diagnosed
The first step might be a mammogram to evaluate a suspicious mass or lump in your breast. Based on what they learn, healthcare providers might perform a biopsy to remove breast tissue. Then they examine the tissues cells to determine the cancer subtype. Identifying the cancer subtype is part of the staging process, which is when providers decide how to treat your cancer.
Sometimes providers use the following tests before treatment to check on your tumors size and whether it has spread, or after treatment to monitor response to treatment:
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What Is Invasive Lobular Carcinoma
Invasive lobular carcinoma starts in the breasts lobules. This cancer spreads to nearby tissue. ILC is the second most common type of invasive breast cancer, after invasive ductal carcinoma. Out of every 100 cases of breast cancer, 10 to 15 are ILC.
People who have ILC may notice a thick or full area that does not feel like the rest of the breast. ILC doesnt always form a lump.
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What Hormones Does Suzanne Somers Use
I use an estrogen cream every day and progesterone cream two weeks a month. Thats why, at 62, I dont require any pharmaceutical drugs. Fugh-Berman: Menopausal hormone therapy DOUBLES the risk of dementia, according to data from the Womens Health Initiative, and increases age-related memory problems, too.
How Common Is Triple
About 10 to 20% of breast cancers are found to be triple-negative. However, triple-negative cancer cells are found more often in people under the age of 50. This is about 10 years younger than the average age of 60 or older for other types of breast cancer diagnoses. Triple-negative breast cancer is also found in higher percentages of Black and Hispanic patients and less often in Asian and non-Hispanic patients.
Another population that is more likely to be diagnosed with this type of breast cancer has an inherited mutation of the BRCA gene. About 70% of those with triple-negative breast cancer also test positive for having the BRCA mutation. You may qualify for genetic testing based on your family history. Learn more about genetic testing for breast cancer.
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What Is Triple Negative Breast Cancer
A diagnosis of triple negative breast cancer means that the three most common types of receptors known to fuel most breast cancer growthestrogen, progesterone, and the HER-2/neu gene are not present in the cancer tumor. This means that the breast cancer cells have tested negative for hormone epidermal growth factor receptor 2 , estrogen receptors , and progesterone receptors .
Since the tumor cells lack the necessary receptors, common treatments like hormone therapy and drugs that target estrogen, progesterone, and HER-2 are ineffective. Using chemotherapy to treat triple negative breast cancer is still an effective option. In fact, triple negative breast cancer may respond even better to chemotherapy in the earlier stages than many other forms of cancer.
Types Of Stage 3 Breast Cancer
These days, people with breast cancer can know more about the tumor than ever before.
In addition to staging, oncologists can now determine a tumors grade and subtype. This information helps the doctor describe the tumor and cancer stage in a more detailed way so that other members of the care team can understand the cancer better.
The tumor grade and subtype of breast cancer can vary between people. Most doctors will test tumors to determine which genes they express, so that treatment options can adapt to the results.
Doctors define different types of stage 3 breast cancer by:
- Tumor grade: This is a measurement of how much the cancer cells differ from healthy cells under a microscope. This also provides a measure of how quickly the cancer cells are likely to grow.
- ER status: This describes whether the cancer cells have receptors for the hormone estrogen.
- PR status: This indicates whether the cancer cells have receptors for the hormoneprogesterone.
- HER2 status: This describes whether the cancer cells are making the HER2 protein.
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Systemic Therapy Neoadjuvant And Adjuvant Treatments And Ongoing Clinical Trials
General Algorithm Guiding Adjuvant Chemotherapy Decisions in the treatment of Early Stage Triple Negative Breast Cancer as adapted by www.NCCN.org, Version 1.2013, Invasive Breast Cancer
The principles that govern the decision to proceed with neoadjuvant versus adjuvant chemotherapy are similar between TNBC and other subtypes of breast cancer. These principles are largely driven by resectability of the primary tumor and lymph nodes to achieve negative margins and the ability to cytoreduce a breast cancer to facilitate breast conservation, as opposed to a mastectomy. Historically and as guided by the landmark study National Surgical Adjuvant Breast and Bowel Project B-2725, chemotherapy sequenced prior to surgery does not appear to improve survival. However, response to chemotherapy, particularly achievement of pathologic complete response , can help identify those patients with better prognosis. Basal-like/TNBC has consistently been shown to be more sensitive to neoadjuvant chemotherapy than Luminal breast cancers. Collectively, however, TNBC patients experience poorer overall outcomes as compared to other breast cancer subtypes. The poorer prognosis of Basal-like/TNBC has been explained by a higher likelihood of relapse in those patients in whom pCR was not achieved and has been termed the âtriple negative paradox. 26,27
What You Need To Know
- Triple-negative breast cancer accounts for about 10% to 20% of all breast cancer cases.
- Every cancer diagnosis is unique, but in general, triple-negative breast cancer is a more aggressive type of tumor with a faster growth rate, higher risk of metastasis and recurrence risk. Therefore, it often requires chemotherapy as part of the treatment.
- Surgery is also an important part of treatment, but if a tumor is small and localized, mastectomy may not be necessary. Chemotherapy can shrink triple-negative breast tumors, and patients can become candidates for less-extensive surgery.
- Triple-negative cancers are more common in patients with hereditary genetic mutations, and genetic counseling and testing should be considered.
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Do I Need Genetic Counseling And Testing
Your doctor may recommend that you see a genetic counselor. Thats someone who talks to you about any history of cancer in your family to find out if you have a higher risk for getting breast cancer. For example, people of Ashkenazi Jewish heritage have a higher risk of inherited genetic changes that may cause breast cancers, including triple-negative breast cancer. The counselor may recommend that you get a genetic test.
If you have a higher risk of getting breast cancer, your doctor may talk about ways to manage your risk. You may also have a higher risk of getting other cancers such as ovarian cancer, and your family may have a higher risk. Thats something you would talk with the genetic counselor about.
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What Is The Risk For Triple
The disease can affect anyone, but is more likely to show up in those who are:
- Younger than age 50 .
- Black or Latinx.
- Living with a genetic condition called BRCA mutation that increases the risk for breast cancer and other forms of cancer. Most cancers diagnosed in people with the BRCA1 mutation are triple negative.
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Symptoms Of Triple Negative Breast Cancer
The symptoms of triple negative breast cancer are similar to other breast cancer types.
Symptoms can include:
- a new lump or thickening in your breast or armpit
- a change in size, shape or feel of your breast
- skin changes in the breast such as puckering, dimpling, a rash or redness of the skin
- fluid leaking from the nipple in a woman who isnt pregnant or breast feeding
- changes in the position of nipple
Make an appointment to see your GP if you notice anything different or unusual about the look and feel of your breasts.
How To Know If Breast Cancer Has Spread
The only way to truly know whether cancer has spread is to consult with a trained medical provider. With that being said, certain symptoms can suggest that breast cancer has spread to another area of the body. These symptoms will vary depending on the body part being affected. For example:
- Bones If breast cancer has spread to the bones, it can cause sudden bone pain that persists or worsens even when treated with rest or conservative techniques, as well as numbness or muscle weakness within an arm or leg. Metastasis to a bone can also increase calcium levels within the blood, which can cause fatigue, dehydration, nausea and reduced appetite.
- Liver When breast cancer travels to the liver, it can lead to a host of issues, including pain and swelling , reduced appetite, nausea, vomiting, unexplained weight loss, persistent hiccups, yellowing of the skin or eyes , anemia, overwhelming fatigue, drowsiness and confusion.
- Lungs If breast cancer spreads to a lung, someone may experience lung pain, coughing , wheezing and shortness of breath.
If youve been diagnosed with breast cancer and you begin experiencing any of these symptomsor any other noticeable symptomsyou should reach out to your physician as soon as possible so that they can order any necessary diagnostic testing and confirm whether your cancer has metastasized.
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Unique Biology Of Triple Negative Breast Cancer
As above, TNBC is defined clinically as lack of ER, PR and HER2 expression by IHC . As per the most recent ASCO/CAP guidelines, ER and PR negativity is strictly defined as < 1% expression, as opposed to older definitions allowing up to 1 â10% âborderlineâ ER/PR expression7. Interestingly and in an analysis of > 1,700 breast tumors, while the majority of TNBCâs fall into the basal-like subtype by gene expression analysis , borderline cases were more commonly luminal or HER2-enriched 8 Based on this observation, it is recommended that clinical trials aimed at enrolling women patients with TNBC/basal-like breast cancer should adhere to the ASCO/CAP guideline recommended definition of ER/PR < 1% when developing inclusion/exclusion criteria.
Triple Negative Breast Cancer Day By Deborah After Breast Cancer Ambassador
Being diagnosed with breast cancer has been one of the most challenging things to live with to date but knowing that Breast cancer isnt just one type of cancer is something everyone should know. There are four main subtypes of breast cancer, with different characteristics, and therefore which require different treatments.
Each year 15 to 20 per cent of patients get diagnosed with Triple-negative breast cancer it is named this because it lacks estrogen, progesterone, and HER2 receptors it accounts for only 10 to 20 per cent of all invasive breast cancers, yet is responsible for a large proportion of breast cancer deaths because it is so aggressive, and is more likely to have already spread to other parts of the body at diagnosis.
Fortunately, Triple-negative breast cancer can be treated with other drugs, such as chemotherapy, radiation therapy and non-HER2 targeted therapy.
Most of us go through chemotherapy, surgery and radiation therapy. Ive had all 3 with 8 rounds of chemo, 2 major surgeries including Lumpectomy and Lymph Node Dissection and Breast Reconstruction.
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Stages Of Breast Cancer
The stage of breast cancer is based on the size and location of the tumor, as well as whether the cancer has spread beyond the part of the breast in which it originated. To determine the stage of breast cancer, healthcare professionals use a scale of stage 0 to stage 4.
Stage 0 breast cancers are isolated in one part of the breast, such as a duct or lobule, and show no sign of spreading into other tissue.
Stage 1 is typically localized, although further local growth or spread may cause the cancer to move into stage 2.
In stage 3, the cancer may be larger and has affected the lymph system. Stage 4 cancer has spread beyond the breast and nearby lymph nodes, and into other organs and tissues of the body.
In addition to stages, breast cancers are given grades based on the size, shape, and activity of the cells in the tumor. A higher-grade cancer means a greater percentage of cells look and act abnormal, or they no longer resemble normal, healthy cells.
On a scale of 1 to 3, with 3 being the most serious, TNBC is often labeled grade 3.
American Cancer Society , the symptoms of TNBC can be the same as those for other types of breast cancer. ACS recommends regular screenings such as mammograms to detect breast cancer before symptoms appear, the time when treatment is most effective.
Other signs of breast cancer include:
Any of these signs can be caused by other conditions. But it is always good to have them checked out by your healthcare professional.
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How Does Breast Cancer Spread
As was mentioned above, breast cancer can spread to distant areas of the body. How exactly does this happen? First, some of the cancerous cells break away from the original tumor. Then, they attach themselves to the outer wall of either a blood vessel or a lymph vessel. Once the cancer cells penetrate this outer wall, they can begin flowing with blood or lymphatic fluid and eventually reach another organ or lymph node.