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Triple Negative Breast Cancer

Breast cancer is not just one form but actually includes many other types or sub forms. One of the most aggressive is the aptly terrifyingly named triple negative breast cancer. This aggressive form of breast cancer is gaining the attention of doctors and researchers as they try to uncover the causes of breast cancer. Their discoveries have lead to a greater understanding of how this cancer occurs and why it does not respond to standard hormonal treatments.

What is triple negative breast cancer? Isn’t negative a good thing to hear?
The triple negative refers to the negative results from tests conducted on the breast cells. It means that the breast cells tested negative – meaning having none of the following that should be present - for estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor receptor 2 (HER2). When these receptors are not found in women, the diagnosis is triple negative breast cancer.

Wait, what are receptors?
Hormone receptors are forms of protein found on each breast cell. Their function is to receive the messages sent to the cells that stimulate growth. In breast cancer, these cells do not perform properly. Around 75% of women with breast cancer have estrogen receptor positive results; at the same time 65% will have both estrogen and progesterone positive results. Essentially, these cancers are treated using hormonal therapy and chemotherapy depending on the individual patient.

Standard breast cancer treatments
Most of the time, breast cancer is treated by using ‘receptor targeted treatments’ - hormonal therapies such as tomoxafin or aromatase inhibitors that deal with the cancer present in the receptor cells. Because these receptor cells are not present in women with triple negative breast cancer, hormonal treatments will have no effect. Other common therapies like Herceptin (trastuzumab) that target the human epidermal growth factor receptors will also have no success.

A few other indicators
*Roughly 10 to 20 percent of breast cancer diagnoses are triple negative.

*While this sub form of cancer does respond to chemotherapy, it is considered one of the more aggressive cancers to treat. This form of cancer is most likely to spread beyond the breast area. They are also more likely to recur in patients.

*Five year survival rates tend to be lower for triple negative breast cancer patients; 77% compared to 93% of those with other types of breast cancer.

*These cells have a higher grade, usually 3 out of 1-3. This means that these cells have the least amount of resemblance to normal healthy breast cells.

*Triple negative breast cancer is considered ‘basal-like’ in that it is more aggressive and higher grade and resembles the basal cells found in breast ducts.

*Women at greater risk for triple negative breast cancer tend to be younger; around ages 40 or 50.

*African American women are more likely to develop this form of cancer. According to breastcancer.org, African American women generally have a lower risk of breast cancer. According to their findings, African American women may carry the particular gene for triple negative breast cancer (BRCA1 cell mutation, an inherited condition), along with discovering that these women are more often diagnosed in the later stages of the disease.

What treatments are used?
Surgery, radiation and chemotherapy are the standard treatments used to fight triple negative breast cancer. Mastectomy or lumpectomy may be considered but are not always in the best interests of the patient despite the aggressiveness of the disease. As with any cancer type, treatment varies from person to person. Discussing the various options with a healthcare provider will help determine which treatments are the most suitable.

Triple negative breast cancer is just one of the many sub forms of breast cancer. Its aggressiveness does not lend well to hormonal treatments, but there are ways to overcome this disease. There is still a long way to go, but research suggests that with greater awareness doctors will find ways to make an earlier diagnosis and incorporate more effective methods to combat this condition.

Learn more about breast cancer by checking out www.breastcancer.org and the latest findings on triple negative breast cancer.

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