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Triple Negative Cancers

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Getting the diagnosis of breast cancer is a daunting time in any woman’s life, and then your doctor tells you you have triple negative breast cancer. What does that mean? Hopefully after you have read this article, you will have a better idea of what triple negative cancer is and what it means for you.

Triple negative cancer is a type of breast cancer composed of cells that do not have receptors for the hormones estrogen, progesterone or the protein human epidermal growth factor 2 (HER2/neu). These receptors are used as markers when examining breast cancer tissue to determine what type of cells the cancer is made of. Knowing which receptors are on the cancer cells helps determine the best way to treat the cancer. Cancers that are negative for all three of these receptors are called “triple negative”. Unfortunately, this makes treating the cancer more difficult because many of the cancer drugs that we currently use are directed towards these different receptors. If the cancer cells do not have these receptors, the drugs cannot target them. For example, the breast cancer drug Tamoxifen binds to and blocks estrogen receptors on cancer cells, thus preventing the cancer cells from growing. Similarly, the drug Herceptin is directed against HER2/neu, which stops cancer cells from growing that rely on this particular protein. The good news is that there is active research going on right now to develop new cancer drugs specifically to treat triple negative cancers by targeting other biochemical pathways.[1] [2]

While any woman can be diagnosed with triple negative breast cancer, research has shown that African and African-American women are more likely to develop this particular cancer. One study conducted by the University of Michigan looked at the different types of breast cancer in 581 African American women and 1,008 Caucasian women in Detroit, MI and 75 African women in a teaching hospital in Ghana and found that 82% of the African women and 26% of the African American women had the triple negative form compared to 16% of Caucasian women.[3] The Ghanaian women were also more likely to present with more advanced cancer, followed by African American women. Another study conducted at Boston University found that the odds of black women having triple negative cancer were 3 times higher than non-black women. [4] These studies may indicate a genetic link to developing this type of cancer. More research is being done in this area and to determine if there is a similar link in Hispanic women. [2]

While we cannot change our genetic make-up, patients can take control of their health before a cancer diagnosis. This is why early detection is so important. All women should be performing monthly self-breast exams and women over 50 should be having mammograms every 2 years, according to new guidelines. These guidelines may be different for women with a family history of breast or ovarian cancer so it is important to talk to your doctor. The best way to stay healthy is to stay informed.

Please visit the following website for more information.:

http://www.tnbcfoundation.org/understandingtnbc.htm

Rachel Spoelhof, Shikha Jain MD

References:

[1] C. Laino. “New Drugs May Treat Triple Negative Breast Cancer”. WebMD. 2009 June 2. http://www.webmd.com/breast-cancer/news/20090602/new-drug-for-hard-to-treat-breast-cancer

[2] S. Reynolds. “Triple Negative Breast Cancer Disproportionately Affects African American and Hispanic Women. NCI Cancer Bulletin. [cited 2007 July 24] 4(22) http://www.cancer.gov/aboutnci/ncicancerbulletin/archive/2007/072407/page7

[3] Stark, A., Kleer, C. G., Martin, I., Awuah, B., Nsiah-Asare, A., Takyi, V., Braman, M., E. Quayson, S., Zarbo, R., Wicha, M. and Newman, L. , African ancestry and higher prevalence of triple-negative breast cancer. Cancer, n/a. doi: 10.1002/cncr.25276 http://onlinelibrary.wiley.com/doi/10.1002/cncr.25276/full

[4] Stead, L., Lash, T., Sobieraj, J., Chi, D., Westrup, J., Charlot, M., Blanchard, R., Lee, J., King, T., Rosenberg, C. Triple-negative breast cancers are increased in black women regardless of age or body mass index. Breast Cancer Res., 11(2): R18. 2009 Mar 25. doi: 10.1186/bcr2242. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2688946/?tool=pubmed