Triple Negative Breast Cancer
The latest research and info on triple negative breast cancer.
Over the past 3-4 years researchers have begun focusing on a subgroup of breast cancer called “triple negative”. Simply put this type of breast cancer is estrogen-receptor negative, progesterone-receptor negative, and HER2 negative. These are the three types of bc with “known” causes, targeted treatments and specific followup to prevent recurrence based on what fuels the growth of those particular cancers. I first read about triple negatives in Cure
Previously I had been told by my oncologist that being negative for all those types of bc meant that my tumor was a nasty, ugly cancer that popped up out of nowhere and grew really fast. Somehow having a triple negative bc sounds more precise and medically correct. While I don’t worry a great deal about having had cancer on a regular basis, I do keep up on the latest findings and treatments…as much to prepare myself for the future as to know what my daughters and grand-daughters may be facing. magazine about a year-and-a-half ago. Sounds kind of silly, but I was tickled to have a label!
Most of the studies focusing on triple negatives have only been done in the past three – four years. It has always seemed to me that most of the research and information I could find on the other types of breast cancers didn’t quite apply to my situation. The research I’ve done off and on since I first heard of triple negatives has been pretty interesting, but still leaves alot of questions unanswered.
For instance, there is a much higher rate of triple negative bc in African-american women, hispanic and latino women then in caucasian women. We have one Cuban ancestor that we know of – could that really be enough to create a genetic predisposition to this type of cancer?
What follows is a summary of the most recent reading I’ve done on the subject:
According to researchers about 10-20 percent of breast cancers are found to be triple-negative, and anyone can develop triple-negative bc. However, studies have found that it is more likely to affect:
Younger people.
Triple-negative bc is more likely to occur before age 40 or 50
African-American and Hispanic women.
Triple-negative bc most commonly affects African-American women, followed by Hispanic women. Asian and non-Hispanic white women are less likely to develop this type of bc.
People with a BRCA1 mutation.
When people with the BRCA1 mutation develop bc, especially under age fifty, it is usually found to be triple-negative.
Triple negative breast cancer usually has the following characteristics:
Tends to be more aggressive.
Studies have shown that triple-negative bc is more likely to metastasize and more likely to recur. The studies I’ve read about show the risk is higher for the first three-five years. After five years the risks of the triple-negative bc recurring are similar to those risk levels for other types of bc.
The triple negatives are typically faster-growing than other bc types such as estrogen-receptor-positive bc. On a positive note this also may be why they are more sensitive to chemotherapy drugs that affect dividing cancer cells, so that they are in general more sensitive to chemotherapy agents
Five-year survival rates tend to be lower for triple-negative bc. A study done in 2007 of more than 50,000 women with all stages of breast cancer found that 77 percent of women with triple-negative bc survived at least 5 years, compared to 93 percent of women with other types of bc. *The recurrence and survival figures are averages for all women with triple-negative bc. A variety of factors influence an individual woman’s prognosis.*
Tends to be higher grade than other types of bc. 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 bc is often 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. Basal-like cancers tend to be more aggressive, higher grade cancers — just like triple-negative bc. Most triple-negative bc is believed to be of the basal-like cell type.
Best treatment for triple negatives:
Studies done to date show that the addition of taxanes such as Taxol or Taxotere to previous regimens has added benefit. There is also evidence to suggest that administering these regimens in the dose-dense method – or more frequent chemotherapy treatments, seems to improve the benefit. This appears to be true in triple-negative bc as it is in other subtypes, but even more so in triple-negative bc.
Followup for survivors: This is the biggest source of frustration for triple-negative survivors. And one of the reasons triple negative bc has become a “hot topic” for researchers. Because there is no known cause, and research has yet to determine what fuels the growth of these cancers, there are no focused therapies for prevention of recurrence or metastasis beyond chemotherapy and radiation.
The only real recommendations I’ve found have to do with low fat, high fiber diets and a healthy lifestyle that includes regular exercise. This is indicated for patients, survivors and those at high risk for any type of bc. What I found really interesting was a study by Dr. Pamela Goodwin regarding vitamin D3. In this study, patients who had low levels of vitamin D3 at the time of diagnosis were at greater risk for later recurrence.
While the study doesn’t prove that vitamin D3 prevents recurrence of bc, taking vitamin D3 is cheap, safe, and has been shown to be beneficial for bone health. In other words, taking it can’t hurt, it will help strengthen your bones, and it could possibly be found to prevent recurrence, or may even help to prevent bc to begin with.
The recommended therapeutic level is 1000-2000 IU of vitamin D3. Again, this isn’t proven, but is being suggested for both survivors to prevent recurrence, and as a potential preventative for women who are considered to be at high risk for developing bc.
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Renee Weeks | Oct 10, 2008 | Reply
My mother is 69 and has triple negative bc, what are her chances of suverial thru the chemo
kathi1964 | Oct 10, 2008 | Reply
I’m sorry to hear about your mom’s diagnosis. There are many factors that determine a patient’s chances of survival. Her physician would be the one to determine the best course of treatment and her chances for survival. I’ll keep both of you in my prayers.
Kelly Painter | Dec 14, 2008 | Reply
Being a Survivor of Triple Negative Breast Cancer, I am trying to live again. Life after this cancer is hard, I can’t seem to find my “new” normal. Thank you so much for this information. Like you, I find myself doing research to try and find the latest discoveries for my “sub-type” of cancer. All information is good information at this point.
hani76 | Mar 18, 2009 | Reply
My mom has been diagonized with triple negative breast cancer recently. She is 57 years old. She had a modified radical mastectomy and will be starting her chemo regimen in a week or two. What kind of chemo do people with triple negative breast cancer get in the U.S. My mom is in India.
Sheryl Ellinwood | Jul 3, 2009 | Reply
I have triple negative breast cancer (node negative) and had a simple bilateral mastectomy a month ago. My oncologist recommended following up with chemo, but I refused. The National Cancer Institute recently released a study showing that the chemo drug Taxol(and that family of drugs) does not work for women who are HER2 negative. I was not willing to submit to a toxic treatment that doesn’t work and can cause harm to other parts of my body. I suggest taking Sulforaphane (from broccoli seed extract). First discovered by doctors at Johns Hopkins. Two products contain the right dose Oncoplex and BroccoMax. Do some research on those.
Leslie | Sep 16, 2009 | Reply
I have been diagnosed with Triple negative breast cancer at age 32 while pregnant. The treatment I have undergone so far is 2 chemos of FAC. After delivery, I will continue with either 2 or 3 chemos of FAC, followed by 12 weeks of taxol,have surgery of removal of the lump in my right breast, and then undergo radiation. Hope this helps. I am getting treatment from MD Anderson CAncer Center in Houston, TX.
Great Dane Mom | Sep 17, 2009 | Reply
I was diagnosed with triple negative breast cancer last year at the age of 37. I went through 8 treatments of Adriamycin and cytonin every other week, then 12 weekly treatments of taxoter. In November I started radiation and finished in January. With the support of my family and one very loving blue great dane, I finished my treatments even though I hated it. Although the doctors think I am fine and I feel okay most of the time, I still have bad days, like others I can’t find a new normal. I haven’t been able to return to work. I am a hairstylist, and with the nerve damage from the taxoter, I’m unable to stand for long periods of time and the end of my fingers are still numb. I am happy about the new “Breast Cancer Protection Act” but not only do women need to have more time in the hospital it also needs to include that the insurance companies change the age of mammograms to 25. As for everyone walking this journey, I will be praying for you. Know that you’re not alone in this walk. Keep your head held high and keep walking even when you don’t feel like it.
Mimi | Sep 18, 2009 | Reply
Thanks for the article. I had triple negative breast cancer last year at the age of 34. Actually, the recurrence pattern is different after the first 3 years. Although recurrence in that time period is at a higher rate than for other subtypes, it falls after that. Recurrence rates after 5 years are very low — much lower than for women with estrogen/progesterone positive breast cancer.
Linda | Sep 20, 2009 | Reply
Leslie, I also had triple negative breast cancer and went thru the treatment at MD Anderson in Houston. I completed my treatment in April of this year. I am still under their care, of course, and feel very lucky that I got to go to MDA. If you’d like to contact me please feel free. Take advantage of the wellness program there if you can. I may have some helpful hints for you while you go thru this. I would be glad to share.
Linda | Sep 20, 2009 | Reply
Also, ladies, please go to the triple negative breast cancer foundation website at tnbcfoundation.org. Go to forum or discussions, etc. There are many many wonderful ladies on there that have walked in our shoes and so many helpful hints to get you thru this. I learned so much from them. Believe me, we are all in this together.
Kwalsh | Sep 25, 2009 | Reply
Thank you for this very informative article on Triple Negative BC. I have been researching for a long time and this information was very helpful. I was diagnosed with TNBC in January of 2006. I had a lumpectomy, 2 mammosite radiations, 6 rounds of chemo (adrymiacin, cytoxin, taxol), 5 1/2 weeks of radiation. Nothing in the lymph nodes. I was 57 with no history of breast or ovarian cancer on either side of the family. My Braca was negative and I am caucasian. I did suffer a compression fracture in my back from the chemo and radiation. I am three years out and recently found out that I am extremely vitamin D deficient. My joy over being three years out with no reoccurance is now over shadowed with anxiety about the vitamin D dificientcy and what it could mean. I am taking 2000 units of vitamin D daily and will be rechecked in 6 months. Since finishing chemo I have been going every 6 months for a mammogram and blood work. My doctor says if I have no reoccurance at five years she will consider me cured.
Tiffany Bowe | Oct 5, 2009 | Reply
My mom has been diagnosed with Triple Negative Breast Cancer at the age of 52. They are starting her off with 6 months of chemo, then surgery, then more chemo. She just started her chemo last week (Oct. 1st) and was good up until Saturday. Up all night with vomiting and major constipation. She was in sever pain. I went to the store and bouth all kinds of stool softners for her (so far senokot seems to be the best). She says she feels really week. Does anyone know if her symptoms will get worse with each treatment?
Sharon A Greer | Oct 11, 2009 | Reply
I was 41years old when I was diagnosed with TNBC 11/2008 and have had 8 surgeries and 6 rounds of chemotherapy, my last chemo was 7/10/09 and my last surgery was 9/18/09. I’m having problems with my heart from the chemo, my left ventricle is not pumping properly and my left arm and hand are swollen from the lymphadema, caused by having all my lymph nodes removed under the left arm pit. I am glad to be cancer free, but would like to know when to expect to have the feeling back to normal in my hands and feet? I can tell Tiffany Bowe, that my chemo side effects got worse with each treatment. But it is worth it, when you finish, and have that CT-Scan that confirms that you are cancer free. I have appreciated reading all of your comments and thank you, for any suggestions that you can share.
Andrea | Oct 15, 2009 | Reply
Leslie, I also was dx with TNBC at 37 while pregnant. I had two lumpectomies, 12 weeks of Adriamycin and Cytoxin while pregnant, and then had a healthy boy 4 weeks early so that I could get back on chemo. Then I did 12 weekly rounds of Taxol (yuck for me) and then 7 weeks of radiation. Baby born on 2/17/09 and finished radiation in August.
I am in Baltimore but feel free to contact me if you would like to talk.
ENGR.MOHD.SHAFIUL ALAM. | Oct 21, 2009 | Reply
My wife is 51 yrs.old now.Since Oct.2008.she has been treated for tripple negative disease by Radiothraphy & Chemothraphy.Earlier she had breast cancer,stage-II in 2005.(MAY) from that period till oct.2008,she was under routine check-up under the on-cologist at TAWAM HOSPT.AL-AIN.UAE.Since metastatic was diagonosed,she was marked at stage IV.Recently it has been seen that,she is loosing the eye sight also & her fingers are also shaking.Could you please advise me,what may be the lenght of her survival?
With Regards.
Engr.Mohd.Shafiul Alam
e-mail:-shafiq_123@hotmail.com
De | Oct 23, 2009 | Reply
I have just read many of the comments from the women and husband of a women with TNBC. While I would not wish BRCA on anyone and especial TNBC, I found it was reasuring to know I was not alone with the questions that run through my mind.
I was diagnosed 3 years ago at 52 years old. Had dose-dense chem ACT followed by a double masectomy. It is PET scan time so I always start to get a few of those what if running thoughts. Try not to focus on it but it is there. Sister in the fight
Sarah Tweed | Nov 2, 2009 | Reply
Hi I am 29 years old and have just been diagnosed with triple negative breast cancer. I am currently 25 weeks pregnant with my first child and have just had my first chemo treatment (AC). I plan to deliver the baby when he is 36 weeks and before that get three more chemo treatments. My doctor is an alumni of MD Anderson. I just wanted to connect with you and see if we could chat and compare our treatment plans. I am wondering what the F is in your chemo treatment. I was also wondering how far along you are in your pregnancy and when you plan on delivering. Let me know if your interested in chatting. Thanks, Sarah Tweed
Sheryl Ellinwood | Nov 7, 2009 | Reply
As I mentioned in my earlier comment, I too have triple negative breast cancer. Like all of you, I wanted to know why I got breast cancer. This prompted much in depth research and resulted in a book, a web site and a blog that I invite all of you to visit (www.pinkempower.com). While there is not enough space here to tell you everything I learned, here are a few important things:
1) Have your Iodine levels checked—low iodine is linked to breast cancer (mine was low). This cannot be determined through a thyroid profile. Must be a 24 hour urine test. Go to web site for ZRT labs and breastcancerchoices.org for more info.
2) reduce the amount of meat and dairy you consume (to zero if possible).. A protein, called casein, that is present in all dairy products promotes the growth of cancer (all cancers).
3) Have your hormone levels checked (through a saliva test–not a blood test). We all assume that since our BC is not hormone receptive we don’t have to worry about hormones. Estrogen and progesterone are only 2 of the hormones we produce, imbalances in other hormones like insulin, cortisol, DHEA, etc increase chances of metastases
4) STOP eating all refined sugars and processed foods. Dr. Otto Warburg won the Nobel Prize for discovering that glucose (blood sugar) is the only food that cancer cells can use.
5) It is no mystery what causes cancer, including breast cancers, simply put it involves cellular damage caused by various toxins in our food and environment, coupled with a weak immune system.
6) Get your digestive system in order. Most of your immune system is in your digestive system. Taking Glutamine every day will help the beneficial flora on your digestive tract. Several scientists have linked breast cancer with digestive enzyme deficiencies. these can be determined in a hormone test too.
7) I agree on another woman’s comment on taking Vitamin D supplements.
You have a better chance of preventing recurrence through dietary changes than you do through chemo or radiation. Unfortunately, doctors know absolutely zero about nutrition so they won’t tell you this.
Sheryl Ellinwood
author, Empowered: A Woman-to-Woman Guide to Preventing & Surviving Breast Cancer