Treatment of "triple positive" subtype of BC with anti-HER2 agents and chemotherapy remain standard until stronger evidence will be available. Whether "triple positive" category should be regarded as a separate entity with distinct characteristics and management has to be demonstrated in future better designed trials. Publication types
Full Answer
What are the treatment options for metastatic triple positive breast cancer?
Metastatic triple positive breast cancer is usually treated differently from metastatic HER2 positive breast cancer. Unlike tumors which are HER2 positive alone, there appears to be a clear and significant survival benefit to using chemotherapy along with HER2 blocking therapy.
How effective is chemotherapy for triple-positive breast cancer?
Hormonal therapy may be less effective, and chemotherapy, at least with early-stage tumors, may also be less effective. 1 Triple-positive breast cancers are also more likely to have positive lymph nodes than those that are ER-positive alone.
What do we know about triple positive HER2 positive breast cancer?
"Triple positive" subtype has apparently similar outcome when treated with chemotherapy alone, compared to chemotherapy and anti-HER2 agents treatment. It resembles more to luminal A breast cancer, with positive HR and HER2 negative. However, most of the clinical evidence is provided by retrospective trials with multiple potential biases.
What is the difference between Triple positive and triple negative cancer?
Triple-Positive vs. Triple-Negative At first glance, it would seem triple-positive breast cancer would offer the best prognosis, followed by tumors that are ER-positive or HER2-positive, with triple-negative tumors having the worst outcomes. However, that doesn't appear to be the case.
Does triple-positive breast cancer have a high recurrence rate?
During the study period, recurrences were reported in 11 of 169 patients (6.5%) with triple-positive breast cancer, 29 of 724 patients (4.0%) with the luminal A subtype, and 22 of 206 patients (10.7%) with the HER2-enriched subtype.
Can you survive triple-positive breast cancer?
Metastatic triple-positive breast cancer is usually treated differently from metastatic HER2-positive breast cancer. Unlike tumors that are HER2-positive alone, there appears to be a clear and significant survival benefit to using chemotherapy along with HER2-blocking therapy.
What is the survival rate of HER2 positive breast cancer?
But new treatments like chemotherapy plus trastuzumab have boosted early-stage HER2 positive breast cancer survival rates: 7-year disease-free: Around 93% 10-year disease-free: About 70%-75% Overall: 80%-85%
What causes HER2 triple-positive breast cancer?
This is caused by a mutation in the HER2 (human epidermal growth factor receptor 2) gene. When the HER2 gene mutates, it causes cells in the breast to grow and divide at an uncontrolled rate, leading to tumor growth.
Is Triple positive cancer aggressive?
Abstract. Background: Triple negative (TN) and triple positive (TP) breast cancers both are aggressive types but TN generally has a shorter survival.
What foods to avoid if you have estrogen positive breast cancer?
What foods to avoid if you have estrogen-positive breast cancer?Deep-fried foods.Margarine.Non-dairy creamers.Packaged cookies and crackers.Cake mixes.Pies.Pastries.Processed snacks.
Is HER2-positive breast cancer a death sentence?
Current treatment algorithms for invasive HER2-positive disease has transformed the face of a disease with a death sentence to one with prolonged and overall survival benefit.
Do you need chemo if you are HER2-positive?
Because HER2-positive cancer is considered more aggressive than HER2-negative breast cancer, it is usually treated with chemotherapy after surgery to reduce recurrence risk.
What is worse triple negative or HER2-positive?
Conclusions: The triple negative subtype has the worst survival regardless of stage. HER2-positive cancers are heterogeneous and not all have poor survival. ER and PR must be considered. ER status appears to influence 5-year survival more than HER2 status.
Is HER2-positive cancer curable?
HER2-positive breast cancer is highly curable because of the availability of these HER2-targeted therapies, so we treat patients fairly aggressively upfront to reduce the risk of them experiencing a stage IV recurrence.
Can HER2-positive breast cancer spread to brain?
Up to 50% of patients with HER2-positive (HER2+) metastatic BC will develop brain metastasis (BM) during the course of the disease, often leading to worse morbidity and shorter survival [3]. Current treatment strategies for BM in patients with HER2+ BC incorporate local therapies and systemic therapies.
Is triple positive breast cancer the same as HER2-positive?
"Triple-positive" refers to breast tumors that are ER-, PR- and HER2-positive. It means the cancer cells grow in response to estrogen (ER), progesterone (PR) and a growth-promoting protein that's on the outside of all breast cells known as HER2.
Ovarian Ablation Or Suppression
In women who have not yet experienced the menopause, oestrogen is produced by the ovaries.
What Is Her2 And What Does It Mean
HER2 is a protein that helps breast cancer cells grow quickly. Breast cancer cells with higher than normal levels of HER2 are called HER2-positive. These cancers tend to grow and spread faster than breast cancers that are HER2-negative, but are much more likely to respond to treatment with drugs that target the HER2 protein.
Her2 Breast Cancer Treatment
Targeted therapy is the hallmark of treatment for HER2-positive cancer. The drug used most often is trastuzumab . Trastuzumab interferes with HER2 production and slows or prevents the cancer cells from growing. It is often administered with the chemotherapy agent emtansine in a combined drug called T-DM1.
Do I Need Genetic Counseling And Testing
Your doctor may recommend that you see a genetic counselor. Thats someone who talks to you about any history of cancer in your family to find out if you have a higher risk for getting breast cancer.
Side Effects Of Her2 Targeted Drug Therapy
The side effects of HER2 targeted drugs are often mild, but some can be serious. Discuss what you can expect with your doctor. If you are pregnant, you should not take these drugs. They can harm and even cause death to the fetus. If you could become pregnant, talk to your doctor about using effective birth control while taking these drugs.
Targeted Therapy For Women With Brca Gene Mutations
Olaparib and talazoparib are drugs known as PARP inhibitor s. PARP proteins normally help repair damaged DNA inside cells. The BRCA genes also help repair DNA , but mutations in one of those genes can stop this from happening. PARP inhibitors work by blocking the PARP proteins.
Tests On Your Breast Cancer Cells
After a biopsy or surgery to remove breast tissue, a sample of cells is sent to the laboratory. A doctor called a pathologist does various tests on the cells. This can diagnose cancer and also show which type of cancer it is.
What is triple positive breast cancer?
"Triple-positive" refers to breast tumors that are ER-, PR- and HER2-positive . It means the cancer cells grow in response to estrogen (ER), progesterone (PR) and a growth-promoting protein that's on the outside of all breast cells known as HER2. These cancers tend to grow and spread quickly but are very responsive to medical treatment. In Carol's case, the tumor was small (2.5 cm), but cancer had spread to a lymph node.
What advice does Carol have for cancer patients?
For those beginning their cancer journey, Carol has two bits of advice. "Definitely don't put off getting anything suspicious checked." She doubts she would have found the cancer early if she weren't seeing Dr. Khoo regularly. "Lastly, know that cancer never leaves you. Post-cancer PTSD [post-traumatic stress disorder] and anxiety is real, even after treatment ends, and that's OK."
Who designed the treatment plan for Carol?
Dr. Dormady designed a personalized plan of treatment for her, but before beginning Carol sought a second opinion outside the El Camino Health network. She needed more assurance that she wasn't going to be overtreated and left infertile. The second opinion concurred with Dr. Dormady 's recommended treatment plan.
Stage 1b Breast Cancer Means One Of The Following Descriptions Applies
What is the meaning & survival rate of triple negative breast cancer? -Dr. Nanda Rajaneesh
Dcis Can Happen At Any Age
âDCIS can happen to anybody, anytime,â says Dr. Meyers, but itâs usually diagnosed in women over 40, the age at which many women begin getting mammograms. According to the American Cancer Society, DCIS rates increase with age, and peak around age 70 to 79.
Options For Luminal Breast Cancer
with luminal or other types of HR-positive breast cancer receive hormone therapy. Some people call this endocrine therapy.
Histological Grade And Ki67
Histological grade information was available from the ICD-O-3 code and categorized as low , intermediate and high according to the Elston-Ellis modification of the Scarff-Bloom-Richardson grading system . Women with anaplastic carcinoma were excluded, leaving n =24,137 women for the analysis .
Er Pr Her2 And Ihc Subtypes
Information on ER, PR and HER2 status was obtained from pathology reports for the whole study period . From 2005 to January 2010, tumours were classified as ER negative if < 10% ER expression, and from February 2010 onwards if < 1% ER expression. PR-negative tumours were defined as < 10% PR expression throughout the study period.
New Medications For Metastatic Breast Cancer
Immunotherapy drugs called checkpoint inhibitors have led to a significant improvement in survival rates for lung cancer and melanoma.
A Note About Statistics
Survival rates are statistics. As such, they tend to tell us how the average person will do with an average triple-negative breast cancer. But people and tumors arent statistics. Some people will do better, and some people will do worse.
Stage 4 progression, goddamit
Stage 4, and I just made it past median survival. Had my scan this week before my regular check-up with my oncologist on Tuesday 13 and got the report yesterday. I'd had no real progression in 3 years, but since the last scan 3 months ago everything's tripled in size.
Fun at the ER and Covid
Last night my wife had a temp that hovered around 100.3 and then finally went to 100.7. We went to the ER to get her checked out. They did a rapid test which came back positive for Covid. Still waiting on results of PCR test. Crazy and unexpected. Sent us home around 11:30pm. Today she has no fever. Hoping the rapid test was wrong.
A Rant..
God i hate this. I hate this so much. I hate how miserable I am & how miserable I make everyone around me. I hate how there is no joy right now only drudgery, misery & sorrow. I hate how all I can think of what I should be doing & how I have no energy to sustain anything for long enough to complete it.
Shit is getting real, fighting off an anxiety attack
This Wednesday is my sentinel node surgery and I am sitting here entering in all of my pre-op and post-op appointments into my calendar, trying to determining which ones I can do on my own and making sure my husband knows which ones I need him to take me to (he just started a new job).
My bc story
Hi! I am 52 and on Sept 10, 2020 I got the call from the dr telling me I had stage 0 breast cancer in my left breast. Sept 29 I am in the hospital having a double mastectomy. The double was my best option given the choices I had. 3 months of expanders. Dec 10, 2020 I am having reconstructive surgery with nipple reconstruction.
Life After Treatment..
I finished 14 rounds of kadcyla on May 19 and got my port out on June 7. I don't know what I thought life was gonna look like, but it wasn't this. I feel like I'm just starting to process how much my body has gone through bc I tried so hard not to think about it while it was happening. I've been worried about how much damage the chemo did.
Mentioned that chemo seems to be affecting my mood and got such an uncaring response, just need to vent
Screenshot of conversation here. This is like…one of the most important people in my life. We dated for 2.5 years and ended things in February. Im still very much in love with him and this response just hurt so badly. I was being so vulnerable and really just needed to hear that it’s okay to be sad and angry. He’s my person, my best friend.
Just a rant - with an update
So when I typed this out a week ago, I had no idea how my life would change in just a short couple of days.
TNBC diagnosis
I didn't think I'd be joining this group, I looked on here while waiting for results from my breast ultrasound and biopsy and was so amazed with the strength you all show. But here I am.
Breast cancer playlist
I find music to be one of the most important influences when it comes to my attitude. What I found is that most breast cancer playlists are full of sad country songs with tragic lyrics that made me want to cry. I couldn’t find a playlist that made me feel fierce and strong and positive so I made one!
Tamixofen Hold!
I just saw my med onc. I lost my cool in there and started crying so hard. I felt like a baby, but she was really nice about it. I've been on Tamixofen for 6 weeks. I have really bad hip pain. I'm only 45, and I hobble around like a much older woman. I've also had a lot of trouble with memory.
Shaved my head today
I’d been putting it off because my family was freaking out about the idea of me with no hair. But the bald patches ain’t going away, so my friend came over and shaved it all off this afternoon! Please give me your scarf tips, favorite scarf-tying videos, info on favorite hats, whatever worked for you.
First appointment is tomorrow
Tomorrow is my first appointment since I was told. I meet with the surgeon for an hour, radiology for half an hour and oncology for half an hour. I'm scared and nervous and don't know what to expect or hope for. I just had my biopsy Tuesday and got the results Wednesday and got a call Thursday to schedule this.
Tumor Behavior
Prevalence
- It's thought that roughly 20% to 25% of breast cancers are HER2-positive, though the range is 15% to 30% in some studies.2 Roughly 70% of breast cancers are estrogen-receptor, or ER, positive, with most of these being progesterone-receptor-positive as well.1 Of cancers that are HER2-positive, around 50% are also ER-positive, although the ER expression, may be at lower levels.1 …
Triple-Positive vs. Her2-Positive
- Breast cancers that are HER2-positive can vary significantly. In general, tumors that are HER2-positive tend to be: 1. More aggressive 2. Associated with lower survival rates 3. Less responsive to hormonal therapy HER2-positive tumors that are also ER-positive (triple-positive), however, may behave more like ER-positive tumors and HER2-negative tumors, being less aggressive and mor…
Triple-Positive vs. Er-Positive
- Tumors that are triple-positive tend to be more aggressive than those that are ER-positive alone. Hormonal therapy may be less effective, and chemotherapy, at least with early-stage tumors, may also be less effective.1 Triple-positive breast cancers are also more likely to have positive lymph nodes than those that are ER-positive alone. This may influence the triple-positive breast cancer …
Triple-Positive vs. Triple-Negative
- At first glance, it would seem triple-positive breast cancer would offer the best prognosis, followed by tumors that are ER-positive or HER2-positive, with triple-negative tumors having the worst outcomes. However, that doesn't appear to be the case. While some triple-positive tumors act more like ER-positive tumors, some of these tumors bear similarities to triple-negative tumor…
Treatment Approaches
- It would seem that tumors that are both ER- and HER2-positive would respond twice as well to treatment. Sadly, this isn't the case. For some tumors, using these two therapies together is less effective and may increase the risk of side effects. Studies looking at early breast cancers have found less benefit from HER2-targeted therapies when the level of both receptors is high. These …
Prognosis
- In general, the behavior and response of triple-positive breast cancer tumors are similar to estrogen-positive/HER2-negative tumors. A retrospective study done from the California Cancer Registry looked at 123,780 cases of stages 1–3 primary invasive breast cancer in women. The difference in 5-year survival between those with triple-positive tumors and those with estrogen-p…
A Word from Verywell
- There is uncertainty regarding the best treatment approach for triple-positive tumors, and it appears that there are different subsets based on the degree of expression of ER and more. In addition, the potential for decreased response to drugs that target one type is a concern. Further research is needed to look for answers, as well as ways to reduce the crosstalk that leads to resi…