Triple negative breast cancer: An ominous name for an aggressive breast cancer that targets black and Hispanic women
The name alone sounds frightening: triple negative breast cancer.
But women diagnosed with this often aggressive form of cancer that disproportionately affects black and Hispanic women should know that effective treatment exists and researchers are working to unearth more targeted treatments.
Most breast cancers are hormone sensitive. They have receptors for estrogen and progesterone or human epidermal growth factor 2 – HER2 -- and are treated with hormonal therapies or HER2-targeted medications, according to the Triple Negative Breast Cancer Foundation. Triple negative breast cancers are harder to treat because they do not have the receptors or express the HER2 gene, meaning they’re not likely to respond to those therapies.
“We don’t have that one thing that will treat it,” said Dr. Angela Soto Hamlin of theOakwood Breast Care Center in Mechanicsburg. “We don’t have as good a specific treatment as we do for these other cancers. The challenge right now is to find treatments that are more specific to these cancers.”
African-American women are three times more likely than white women to contract triple negative breast cancer, which accounts for 10 percent to 20 percent of all breast cancers, according to the nonprofit Breastcancer.org.
It typically affects younger women and “tends to grow faster so it tends to spread faster if it’s not caught early,” said Dr. Leah Cream, a breast medical oncologist at Penn State Hershey Medical Center. If people who have the inherited BRCA1 mutation develop breast cancer before 50 it is often found to be triple negative, according to TNBC Foundation statistics.
Typical treatment for triple negative cases includes surgery, chemotherapy and radiation, both doctors said. Some research has shown these cases can respond better to chemotherapy than cancers that are hormone-receptor-positive, breastcancer.org noted.
When women hear the cancer’s name “they get horrified” but most women with triple negative cancer are cured, Cream emphasized.
Fighting back
Defiance was the first thought of Susan Kuba, 61, of Susquehanna Township when diagnosed with triple negative breast cancer nearly three years ago.
“The first thing out of my mouth when I found out after the biopsy was: I’m not dying of breast cancer,” said Kuba, who has none of the risk factors and is white. “This is ridiculous. This is not how we die in this family.”
Kuba underwent a lumpectomy, 36 radiation treatments – one a day – and chemotherapy once every two weeks. She said since her cancer was caught early and had not spread, she looks forward to a 90 percent cure rate after three years.
“My scariest thing was after that surgery to see if it had spread,” said the Commonwealth Court retiree. “I knew that if it didn’t spread that I would be fine for now.”
“There’s a lot of uncertainty with cancer,” said Soto Hamlin. “There is not a point along the treatments where you get to do a test and see if it works. The only way you know you’re cured is that so much time has passed without a problem.”
Keeping a clear focus helped Kuba.
“You have to focus on what’s important and that’s not losing your hair, which is what (everyone) focuses on,” she said. “Go to your treatments and get through it and get on with your life. “
Both doctors recommended relying on a support system whether it’s close family and friends or a more formal group like the one in Soto Hamlin’s office called CHICKS– Celebrating Hope in Cancer Survivors.
“Every single person with breast cancer is different. It is not a one-size-fits-all situation,” Cream said. “What can be hard is ... everyone from the checkout clerk to your coworkers want to tell you what to do. You need to keep as much focus on your own life.”
Education and awareness
For 17 years, improving cancer survival rates of ethnic and minority persons has been the mission for the nonprofit CATALYST – Central Pennsylvania Coalition United to Fight Cancer.
“Cancer is not a death sentence,” said founder and president Barbara Jackson. “Where there is life, there is hope.”
Jackson said cancer mortality rates are higher in minority and underserved populations because of late diagnosis.
“Through education, prevention and early detection, life can be saved,” she said. “We promote the benefit of early detection by using a culturally sensitive approach in education.”
CATALYST was one of two local groups asked by the Auxiliary of the National Medical Association to get the word out about triple negative breast cancer. The ANMA is the volunteer service organization of spouses of active NMA members. The NMA represents African-American physicians and their patients.
Part of ANMA president Sharon Melvin’s platform is to provide education nationwide on TNBC this year to targeted communities and board member Regina White, also a member of the midstate African-American social service sorority Alpha Kappa Alpha Epsilon Sigma Omega Chapter, jumped on the nationwide education rollout.
Armed with a $1,000 grant from Pfizer, she got all three groups together and staged an awareness and information event in Harrisburg in June for nearly 100 attendees.
“I have two great organizations to help me pull this off in Harrisburg and recognize community partners that share the same missions,” White said.
“The objective is to reach at least 100 women who then spread the word,” said Sheila Dow Ford, sorority member and chair of its health committee. “This is a serious health risk that many African Americans and Latinos don’t know about. It’s very important that women get to know about this. Knowledge is power.”
The future
Clinical trials, which study how a particular treatment works, can help lead the way to advances in care. Soto Hamlin encourages patients to learn more about them but notes that not everyone is eligible or necessarily interested in participating.
“To be involved in something that not only benefits you but women who come after you ... is a good thing to do,” she said.
“An extreme amount of work is being done [to] understand this type of cancer and figure out what the drivers are so we can intervene,” Cream said. “There are a lot of trials going on to look at newer treatment for triple negative breast cancer” which she expects will change the standard of care over the next few years.
Soto Hamlin noted that researchers are “beginning to be able to look at the genetic structure of individual cancers ... your particular cancer cell and get clues on how to best treat them with a very individual treatment plan.”
Meanwhile, Cream emphasized that women need to see a doctor immediately if they find a lump in their breast. Soto Hamlin cited research that found eating a high-fiber, low-fat diet with five daily servings of fruits and vegetables combined with a regular exercise program can cut the risk of developing breast cancer by half.
“It’s important that we as women take seriously taking care of ourselves. A whole lot of people count on us -- two generations, maybe three,” Soto Hamlin said. “It’s important that women find out how to and then take care of themselves.”
http://www.pennlive.com/bodyandmind/index.ssf/2013/06/triple_negative_breast_cancer.html?utm_medium=referral&utm_source=t.co
But women diagnosed with this often aggressive form of cancer that disproportionately affects black and Hispanic women should know that effective treatment exists and researchers are working to unearth more targeted treatments.
Most breast cancers are hormone sensitive. They have receptors for estrogen and progesterone or human epidermal growth factor 2 – HER2 -- and are treated with hormonal therapies or HER2-targeted medications, according to the Triple Negative Breast Cancer Foundation. Triple negative breast cancers are harder to treat because they do not have the receptors or express the HER2 gene, meaning they’re not likely to respond to those therapies.
“We don’t have that one thing that will treat it,” said Dr. Angela Soto Hamlin of theOakwood Breast Care Center in Mechanicsburg. “We don’t have as good a specific treatment as we do for these other cancers. The challenge right now is to find treatments that are more specific to these cancers.”
African-American women are three times more likely than white women to contract triple negative breast cancer, which accounts for 10 percent to 20 percent of all breast cancers, according to the nonprofit Breastcancer.org.
It typically affects younger women and “tends to grow faster so it tends to spread faster if it’s not caught early,” said Dr. Leah Cream, a breast medical oncologist at Penn State Hershey Medical Center. If people who have the inherited BRCA1 mutation develop breast cancer before 50 it is often found to be triple negative, according to TNBC Foundation statistics.
“This is not a new type of breast cancer,” Cream said, but it has gained attention as researchers have developed individualized therapy for other types.
"My scariest thing was after that surgery to see if it had spread,''€ said TNBC survivor Susan Kuba
“I don’t think we should look at triple negative breast cancer as different from every other cancer,” Soto Hamlin said. “Breast cancer in general is a challenge to treat.”Typical treatment for triple negative cases includes surgery, chemotherapy and radiation, both doctors said. Some research has shown these cases can respond better to chemotherapy than cancers that are hormone-receptor-positive, breastcancer.org noted.
When women hear the cancer’s name “they get horrified” but most women with triple negative cancer are cured, Cream emphasized.
Fighting back
Defiance was the first thought of Susan Kuba, 61, of Susquehanna Township when diagnosed with triple negative breast cancer nearly three years ago.
“The first thing out of my mouth when I found out after the biopsy was: I’m not dying of breast cancer,” said Kuba, who has none of the risk factors and is white. “This is ridiculous. This is not how we die in this family.”
Kuba underwent a lumpectomy, 36 radiation treatments – one a day – and chemotherapy once every two weeks. She said since her cancer was caught early and had not spread, she looks forward to a 90 percent cure rate after three years.
“My scariest thing was after that surgery to see if it had spread,” said the Commonwealth Court retiree. “I knew that if it didn’t spread that I would be fine for now.”
“There’s a lot of uncertainty with cancer,” said Soto Hamlin. “There is not a point along the treatments where you get to do a test and see if it works. The only way you know you’re cured is that so much time has passed without a problem.”
Keeping a clear focus helped Kuba.
“You have to focus on what’s important and that’s not losing your hair, which is what (everyone) focuses on,” she said. “Go to your treatments and get through it and get on with your life. “
Both doctors recommended relying on a support system whether it’s close family and friends or a more formal group like the one in Soto Hamlin’s office called CHICKS– Celebrating Hope in Cancer Survivors.
“Every single person with breast cancer is different. It is not a one-size-fits-all situation,” Cream said. “What can be hard is ... everyone from the checkout clerk to your coworkers want to tell you what to do. You need to keep as much focus on your own life.”
Education and awareness
For 17 years, improving cancer survival rates of ethnic and minority persons has been the mission for the nonprofit CATALYST – Central Pennsylvania Coalition United to Fight Cancer.
“Cancer is not a death sentence,” said founder and president Barbara Jackson. “Where there is life, there is hope.”
Jackson said cancer mortality rates are higher in minority and underserved populations because of late diagnosis.
“Through education, prevention and early detection, life can be saved,” she said. “We promote the benefit of early detection by using a culturally sensitive approach in education.”
CATALYST was one of two local groups asked by the Auxiliary of the National Medical Association to get the word out about triple negative breast cancer. The ANMA is the volunteer service organization of spouses of active NMA members. The NMA represents African-American physicians and their patients.
Part of ANMA president Sharon Melvin’s platform is to provide education nationwide on TNBC this year to targeted communities and board member Regina White, also a member of the midstate African-American social service sorority Alpha Kappa Alpha Epsilon Sigma Omega Chapter, jumped on the nationwide education rollout.
Armed with a $1,000 grant from Pfizer, she got all three groups together and staged an awareness and information event in Harrisburg in June for nearly 100 attendees.
“I have two great organizations to help me pull this off in Harrisburg and recognize community partners that share the same missions,” White said.
“The objective is to reach at least 100 women who then spread the word,” said Sheila Dow Ford, sorority member and chair of its health committee. “This is a serious health risk that many African Americans and Latinos don’t know about. It’s very important that women get to know about this. Knowledge is power.”
The future
Clinical trials, which study how a particular treatment works, can help lead the way to advances in care. Soto Hamlin encourages patients to learn more about them but notes that not everyone is eligible or necessarily interested in participating.
“To be involved in something that not only benefits you but women who come after you ... is a good thing to do,” she said.
“An extreme amount of work is being done [to] understand this type of cancer and figure out what the drivers are so we can intervene,” Cream said. “There are a lot of trials going on to look at newer treatment for triple negative breast cancer” which she expects will change the standard of care over the next few years.
Soto Hamlin noted that researchers are “beginning to be able to look at the genetic structure of individual cancers ... your particular cancer cell and get clues on how to best treat them with a very individual treatment plan.”
Meanwhile, Cream emphasized that women need to see a doctor immediately if they find a lump in their breast. Soto Hamlin cited research that found eating a high-fiber, low-fat diet with five daily servings of fruits and vegetables combined with a regular exercise program can cut the risk of developing breast cancer by half.
“It’s important that we as women take seriously taking care of ourselves. A whole lot of people count on us -- two generations, maybe three,” Soto Hamlin said. “It’s important that women find out how to and then take care of themselves.”
http://www.pennlive.com/bodyandmind/index.ssf/2013/06/triple_negative_breast_cancer.html?utm_medium=referral&utm_source=t.co
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