What is triple negative breast cancer?
If you’ve been diagnosed with breast cancer, one of the first things your doctor will do is determine whether the cancer cells are hormone receptive. Knowing if your cancer responds to certain hormones will help direct your treatment, and it can offer insight about your outlook.
Hormone receptors tell your cells how to behave. Some cancer cells have receptors for the hormones estrogen and progesterone, as well as an overexpression of the human epidermal growth factor receptor 2 (HER2) gene. If HER2 genes are overexpressed, the cells make too much of the protein HER2.
If your cells have hormone receptors, the hormones they receive will actually support the growth of your cancer cells. Not all breast cancer cells have these receptors, and not all cancers overexpress the gene HER2. If your cancer isn’t receptive to these hormones and doesn’t have an increased amount of HER2, it’s called triple-negative breast cancer (TNBC). TNBC represents 15-20 percent of all breast cancers.
Hormone therapy stops hormones from causing cancer growth. Because TNBC cells lack estrogen and progesterone, and their HER2 genes aren’t overexpressed, the cells don’t respond well to hormone therapy or medications that block HER2 receptors. Instead of hormone therapy, treating TNBC often involves chemotherapy, radiation, and surgery.
Like other types of breast cancer, TNBC can often be treated successfully if it’s caught early. But in general, survival rates tend to be lower with TNBC compared to other forms of breast cancer. TNBC is also more likely than some other types of breast cancer to return after it’s been treated, especially in the first few years after treatment.
A 2007 study of more than 50,000 women with all stages of breast cancer found that 77 percent of women with TNBC survived at least 5 years. Ninety-three percent of women with other forms of breast cancer survived at least five years. A 2009 study, however, found that the 5-year survival rate for women with TNBC was similar to the survival rates for women with other cancers of similar stages. The 2009 study only included 296 women, so the study size was a lot smaller than the 2007 study group.
A separate study released in 2007 found that 5 years after their diagnosis, women with TNBC no longer had a higher risk of death.
Outlook for TNBC
Even though TNBC doesn’t usually respond to treatment with hormone therapy, new medications called poly ADP-ribose polymerase (PARP) inhibitors are offering researchers hope. Finding a better treatment for TNBC is a major focus of breast cancer research.
In fact, research has found that there are six different subtypes of TNBC. Each one has its own abnormalities, but drugs geared toward those unique abnormalities are helping people with TNBC. Even though TNBC can be an especially aggressive type of breast cancer, your doctor may or may not recommend aggressive treatment. The standard of care for TNBC is a chemotherapy backbone, either alone or in combination with other conventional therapies. Ongoing clinical research is being conducted to improve on the current practice and future direction of TNBC treatment.
It’s also important to remember that no one, not even your doctor, can forecast exactly how your breast cancer will progress or respond to treatment. Survival rates are based on statistics, but everybody has an individual experience with the disease that cannot be predicted..
After Chiara D’Agostino’s 2014’s breast cancer diagnosis, she left her career as an Italian teacher to fulfill her lifelong dream of becoming a model.
“I had chemo, two single mastectomies, many implant infections, it was clear to me that I couldn’t go back to the job that I had,” D’Agostino explains. “I was getting a lot of compliments as how my hair was growing
What was your hardest moment (or moments) and how did you you get through it/them? It’s hard for me to identify my scariest moment, I’ve had many since becoming a Cancer Grad, like deciding what kind of surgery to have and with which doctor, losing my breasts, losing my hair, being broken up with and told to move out the week after surgery, fear of recurrence, burying a good friend who died of stage 4, being diagnosed with stage 4 cancer and deciding which treatment to take that has a possibility of saving my life, and now – facing death.
I’ve gotten through those moments by crying, talking to friends and other women with breast cancer, talking at breast cancer support groups, blogging, taking anti-depressants prescribed by my doctor, seeing my therapist regularly, energy healing, Reiki, massage, praying, meditating, also taking walks in nature, speaking to the hospital oncology social worker, and attending chi-gong, mindful meditation, and stress relief classes for cancer patients.
Any helpful (tangible) tips or tricks you discovered for dealing with your symptoms and/or cancer? Recently, I’ve experienced depression, so to trick myself into getting off the couch and out of the house, I started drinking decaf coffee and I don’t keep any in the house, so it forces me out every day to get that treat. To help my chemo brain, I make a list everyday of just a few things to do so at the end of the day I feel accomplished. Today’s list was mail letters and get the car washed.
How did/do you find joy during this experience? I find joy in playing with children, laughing with good friends, travel and spending time on a sunny beach, so I just continued to do more of that as needed. I also FINALLY followed my dream to become a fashion model, so being styled and photographed is bring me joy!
Did you learn anything about yourself? If so, what was it? I learned that I don’t need mounds on my chest to feel like a woman, that I’m even more resilient than I ever thought I was, and that, at least at this moment in time, I’m leaning towards not being afraid of dying.
How do you feel being a flat chested woman? I feel fantastic! I never thought I’d say that (I’d prefer to have my original breasts), but I like that I have sensation in all of my body again, it feels like I have my body back.
Chiara has appeared in Oprah magazine twice, walked the runway at New York’s fashion week and more. In 2016, Chiara was diagnosed again, but this time with stage four breast cancer which has now spread to her lungs, sternum, lymph nodes and liver. She began a blog, “Beauty Through the Beast,” and an instagram page where she shares very honest photos of her journey living with breast cancer.
“I like to post pictures of myself mostly topless, some of me feeling really sick,” she says. “I like to show all the different stages of breast cancer, the realness of it and I hope it’s inspiring to other women at any age. I’ve gotten a lot of feedback from the page, so I’m happy to hear when someone says that it gives them confidence or courage.”