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Doctor studying TNBC & Treatment

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    Posted: May 15 2009 at 4:34am
The doctor who is doing this study says that some tri negs respond to chemotherapy but the ""majority do not".  That woke me up this morning.
 
 
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Post Options Post Options   Thanks (0) Thanks(0)   Quote NINASUZIE Quote  Post ReplyReply Direct Link To This Post Posted: May 15 2009 at 5:08am
CensoredConfusedAngry  I realize she is an expert, but in the land of "reality", we all have to do our level best to deal with having TNBC!!!!!!!
 
I may not know much, but I know we all are smart, courageous women who have ALL made THE best decisions we possibly can make...and there are MANY here and elsewhere that are surviving years beyond year 5/10!
 
Love and hugs to all (even as I go for MY first onc visit this am!!!!!Wink
Suzie
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Dx: 1/09 Metaplastic TN IDC/3.5CM/DCIS/1.0;4/09 L mastectomy;6-11/09 Cytoxan/Taxotere X6;BRACA-; Recurrance 11/10 bone mets broke arm;Lung mets;rads X15; chemo/parp tbd 1/11
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Post Options Post Options   Thanks (0) Thanks(0)   Quote trip2 Quote  Post ReplyReply Direct Link To This Post Posted: May 15 2009 at 5:17am
You bet Suzie, it is hard to read words like that, don't think I have run across something so blunt as her statement.  Is this true I wonder??
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Post Options Post Options   Thanks (0) Thanks(0)   Quote husb Quote  Post ReplyReply Direct Link To This Post Posted: May 15 2009 at 5:31am
Pam,
I saw the same article and it didn't make me happy. Most of the reading I've done suggests chemo IS effective for TNBC, like this from medscape:

Triple-negative tumors do not respond to endocrine agents or trastuzumab and can only be treated with chemotherapy. Fortunately, increasing evidence suggests that the triple-negative subgroup derives substantial and preferential benefit from chemotherapy.

There's got to be truth here someplace and we'd all like to know what it is.

Steve
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Sunris Quote  Post ReplyReply Direct Link To This Post Posted: May 15 2009 at 2:06pm
I feel possibly misled ? I believed my onc when she said TN tumors respond better to chemo than non TN .... Puzzling ?
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Post Options Post Options   Thanks (0) Thanks(0)   Quote mefowler Quote  Post ReplyReply Direct Link To This Post Posted: May 15 2009 at 2:43pm
Yes, the five-year survival rate for triple-negative is less than that of hormone receptor positive breast cancer, but  the five year survival is still 80% as compared to 93%.  Those women who have a complete pathologic response to neoadjuvant chemo have a 5-year survival as high as 95%.  Those who have a partial pathologic response have somewhat lower survival as do those who have no response to neoadjuvant chemotherapy.  Still, 80 % overall is alot better than whatever it is if we do nothing at all.
 
Everyone has to make their own decisions, but I will never forget a young woman I saw in the ER in med school who had been taking coenzyme Q-10 because her husband did not "believe" in chemo (or antibiotics for that matter).  There was an unbelievable smell in the room, which I found was due to her tumors, which had broken through the skin and were rotting!  Her husband told me that people did not understand, but the coenzyme Q-10 was pushing the tumor out and she would be cancer-free when it had all been pushed out.  In retrospect, she was most likely triple negative based on her demographics, but I have no evidence of that.  So compared to no treatment, whatever we can do looks pretty good to me.
 
Maire
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Post Options Post Options   Thanks (0) Thanks(0)   Quote trip2 Quote  Post ReplyReply Direct Link To This Post Posted: May 15 2009 at 5:51pm

Maire,

Thank you for your comments, I enjoy reading what you have to say since you are in the medical field.

I have to ask you a question.  In the information you posted above you refer to neoadjuvant, many of us have adjuvant treatment.  Is there going to be a difference in response?  I will look that up to see what I can find.

 

Here are a couple of links on Dr. O'Regan.

 

http://whsc.emory.edu/home/news/releases/2009/04/oregan-chair-breast-cancer-research.html

 
 
 
I would like to do some searching on some of her studies over the week-end.
 
Have a good evening,
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Post Options Post Options   Thanks (0) Thanks(0)   Quote mainsailset Quote  Post ReplyReply Direct Link To This Post Posted: May 15 2009 at 6:10pm
All I can bring to this discussion is that my tumor at the time I started chemo was between 13-14 cm, a giant. I had 3 lymph nodes involved. My path report came back after surgery and showed that none of the lymph nodes showed any signs of cancer and the tumor had shrunk to 2 mm. In plain language, originally the tumor was the size of a weizened organic banana and now is the size of my baby fingernail.
 
For this patient, the chemo did its job to shrink the tumor and deal with the lymph nodes. I can only pray that more and more TNBC patients will see the same results.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote NINASUZIE Quote  Post ReplyReply Direct Link To This Post Posted: May 16 2009 at 5:23am
Pam,
 
Is this the dr. who was quoted from Emory yesterday that was very discouraging about positive tx outcomes/prognosis for TNBC?  I think so.
 
This makes me realize that even these high up "experts" should be treated by us with detachment when gathering opinions and information on treatment decisions.  I have been to the "best" as others have and had some serious expectations if I admit it, rather giving up my own power.  A good lesson learned for me!  Hugs,
Suzie
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Dx: 1/09 Metaplastic TN IDC/3.5CM/DCIS/1.0;4/09 L mastectomy;6-11/09 Cytoxan/Taxotere X6;BRACA-; Recurrance 11/10 bone mets broke arm;Lung mets;rads X15; chemo/parp tbd 1/11
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Jessie Quote  Post ReplyReply Direct Link To This Post Posted: May 16 2009 at 5:11pm
This is all very confusing.  Half the time I can't remember the difference between neoadjuvant and adjuvant.  Wacko 
 
I'm surprised by the 80% survival rate quoted by Maire.  The prognosis given to me by my onc was about 60% and increased to 65% with chemo.  What part of the puzzle am I missing here?
 
Jessie
IDC,Stage I,Grade 3,dx 4/06
dbl mast 5/06,
systemic MRSA post surgery
septic shock, heart attack
triple bypass 1/07
no chemo due to infections and heart issues
so far NED!
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Post Options Post Options   Thanks (0) Thanks(0)   Quote trip2 Quote  Post ReplyReply Direct Link To This Post Posted: May 16 2009 at 7:02pm

It seems so many of the studies are inline with your doc.  I tried finding the exact study today but too many distractions at home.  Did pull up some info on her.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Jessie Quote  Post ReplyReply Direct Link To This Post Posted: May 17 2009 at 8:50am
  I wonder how the age factor plays into the survival calculation.  Logic tells me that everything else being equal (cancer or not) a 65 year old is going to have a lower % of 5 year survival than a 30 year old --- else life insurance rates wouldn't go up as we age!   Dismay
 
Could it account for a difference as great as 20% ?!?!?




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Post Options Post Options   Thanks (0) Thanks(0)   Quote dmwolf Quote  Post ReplyReply Direct Link To This Post Posted: May 17 2009 at 12:25pm
Life insurance goes up as we age because we are more likely to get cancer and other diseases, not because if we do get them we are more likely to die of it.  If anything, being older can be a good thing with cancer, because cancers in old people tend to grow slower than those in young.  The young are well-oxygenated and bouncy, and so are their tumors. 

Different studies give different survival stats.  VERY different survival stats.  I don't understand why they are so different.  I've seen as low as 50-60% for TNS, and as high as 75%.   The study I'm analyzing now has about 73% survival for TNs (though most started with large tumors and/or pos nodes).

-d
DX 2/08@43 stg II IDC; gr2,0 nodes. Neoadj chemo, first ACx2 (fail) then CarboTaxotereX6(better). Lump, Rads done 11/08; Clodronate. False alarm queen: PetCT lung & TM marker. NED. PBM w/recon 9/10.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote trip2 Quote  Post ReplyReply Direct Link To This Post Posted: May 17 2009 at 5:44pm
Denise,
 
Sweet lady I have to disagree with you about your statement that getting cancer and being older is a good thing.  There is nothing good about it.  Actually it makes things even worse because we probably have other health issues.  Not fun.
I don't know what you consider old but I was older than most of you when I was diagnosed with tri neg twice and I know we have several ladies on here in their fifties, sixties and a couple I though older plus the daughter who posted about her 80 something year old mother with tri neg.
 
Maybe what you say works for the majority of people I have no idea just know we have alot of ladies in here 50 and up against what they say for the profile of tri neg.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote NINASUZIE Quote  Post ReplyReply Direct Link To This Post Posted: May 18 2009 at 10:45am
Denise,
 
Would you post that article you found 75% survival rate for?  I wish that age was an indicator of who well a woman would do DFS, let alone OS with TN in particular.  Sadly, many of us found out that just being older, put us at MUCH higher risk of getting BC in the first place (I didn't know that when I started.)  I have read some of the younger womens' journeys (dearest Heather comes to mind as the spotlight story 33 yr old TNr) who has endured a heartwrenching hellish time with treating her TN (love to you, dearest Heather!). 
 
Today I wish for a magic wand.  One that would make all of us, any age, any race, faith, country, marital status FREE of CANCER.  In my heart, I see you and everyone of us that way...let's keep reading, sharing and lovingHeart
Suzie
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Dx: 1/09 Metaplastic TN IDC/3.5CM/DCIS/1.0;4/09 L mastectomy;6-11/09 Cytoxan/Taxotere X6;BRACA-; Recurrance 11/10 bone mets broke arm;Lung mets;rads X15; chemo/parp tbd 1/11
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Post Options Post Options   Thanks (0) Thanks(0)   Quote dmwolf Quote  Post ReplyReply Direct Link To This Post Posted: May 18 2009 at 12:26pm
I don't know where I saw the 75% figure.  i've looked a lot of articles, and am mainly remembering the range, not the particular study.  If you want refs, go to pubmed and type in key words like 'triple negative breast cancer survival'.  There are lots of ASCO abstracts with this type of info, also.  The numbers are truly all over the map.
d
DX 2/08@43 stg II IDC; gr2,0 nodes. Neoadj chemo, first ACx2 (fail) then CarboTaxotereX6(better). Lump, Rads done 11/08; Clodronate. False alarm queen: PetCT lung & TM marker. NED. PBM w/recon 9/10.
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Galina2 Quote  Post ReplyReply Direct Link To This Post Posted: May 18 2009 at 6:42pm

Breast Cancer Cases/Deaths Per Year (U.S. and World)

Doctors have a statistical tool how to calculate "patient" survival. It depends on "individual" and a doctor attitude (what he enters into the program! There are several attributes: the most important the type of chemo, if one gets the 3rd generation of chemo, the "statistical survival" is better. I cannot find the link, but I have found this article.

Somebody asked about neo- and adjuvant therapy. Neoadjuvant therapy is BEFORE surgery and adjuvant AFTER surgery. This give the opprortunity to see, if the chemo WORKS ON THE TUMOR! And, if it doesn't work the ONC can switch chemo. Hug
 
 
Breast cancer is the second leading cause of cancer deaths in women today (after lung cancer) and is the most common cancer among women, excluding nonmelanoma skin cancers. According to the American Cancer Society, about 1.3 million women will be diagnosed with breast cancer annualluy worldwide about 465,000 will die from the disease. Breast cancer death rates have been dropping steadily since 1990, according to the Society, because of earlier detection and better treatments. About 40,910 breast cancer deaths are expected in 2007.

According to the American Cancer Society, in general, breast cancer rates have risen about 30% in the past 25 years in western countries, due in part to increased screening which detects the cancer in earlier stages. In the United States, though, breast cancer rates decreased by 10% between 2000-2004, due in part to a reduction in the use of hormone replacement therapy. Although breast cancer rates are rising in many western countries, deaths from the disease have decreased in some countries as a result of improved screening and treatment.

The lifetime probability of developing breast cancer in developed countries is about 4.8%, according to the American Cancer Society (the probability is about 13% for any type of cancer). In developing countries, the lifetime probability of developing breast cancer is about 1.8%.

Breast Cancer Worldwide

Breast (All ages) Incidence Deaths
China
Zimbabwe
India
Japan
Brazil
Singapore
Italy
Switzerland
Australia
Canada
Netherlands
UK
Sweden
Denmark
France
United States

18.7
19
19.1
32.7
46
48.7
74.4
81.7
83.2
84.3
86.7
87.2
87.8
88.7
91.9
101.1

5.5
14.1
10.4
8.3
14.1
15.8
18.9
19.8
18.4
21.1
27.5
24.3
17.3
27.8
21.5
19

Note: numbers are per 100,000.Source: J. Ferlay, F. Bray, P. Pisani and D.M. Parkin. GLOBOCAN 2002. Cancer Incidence, Mortality and Prevalence Worldwide. IARC CancerBase No. 5, version 2.0. IARCPress, Lyon, 2004.

Incidence By Age

This risk model is based on population averages. Each woman's breast cancer risk may be higher or lower, depending upon a several factors, including family history, genetics, age of menstruation, and other factors that have not yet been identified.

Probability of Developing Breast Cancer Within the Next 10 years

   By age 20
   By age 30
   By age 40
   By age 50
   By age 60
   By age 70
   Lifetime
  1 out of 1,985
  1 out of 229
  1 out of 68
  1 out of 37
  1 out of 26
  1 out of 24
  1 out of 8
Source: Among those cancer free at age interval. Based on cases diagnosed 2000-2002. "1 in" are approximates. Source: American Cancer Society Breast Cancer Facts & Figures, 2005-2006.

While breast cancer is less common at a young age (i.e., in their thirties), younger women tend to have more aggressive breast cancers than older women, which may explain why survival rates are lower among younger women.

Five Year Survival Rate By Age

  Younger than 45
  Ages 45-64
  Ages 65 and older
  81%
  85%
  86%
Source: American Cancer Society

Incidence By Ethnic Group

All women are at risk for developing breast cancer. The older a woman is, the greater her chances of developing breast cancer. Approximately 77% of breast cancer cases occur in women over 50 years of age.

According to the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute:

  • White, Hawaiian, and African-American women have the highest incidence of invasive breast cancer in the United States (approximately four times higher than the lowest group).
  • Korean, American Indian, and Vietnamese women have the lowest incidence of invasive breast cancer in the United States.
  • African-American have the highest death rate from breast cancer and are more likely to be diagnosed with a later stage of breast cancer than White women.
  • In the age groups, 30-54 and 55-69 years, African-American women have the highest death rate from breast cancer, followed by Hawaiian women, and white non-Hispanic women. However, in the 70 year old age group, the death rate from breast cancer for white women is higher than for African –American.

Incidence Rates by Race

Race/Ethnicity
Female
  All Races
  White
  Black
  Asian/Pacific Islander
  American Indian/Alaska Native
  Hispanic
  127.8 per 100,000 women
  132.5 per 100,000 women
  118.3 per 100,000 women
  89.0 per 100,000 women
  69.8 per 100,000 women
  89.3 per 100,000 women
Source: National Cancer Institute, SEER Cancer Statistics Review, 2007. Statistics based on data, 2000-2004. See www.cancer.gov for more information.


Death Rates by Race

Race/Ethnicity
Female
  All Races
  White
  Black
  Asian/Pacific Islander
  American Indian/Alaska Native
  Hispanic
  25.5 per 100,000 women
  25.0 per 100,000 women
  33.8 per 100,000 women
  12.6 per 100,000 women
  16.1 per 100,000 women
  16.1 per 100,000 women
Source: National Cancer Institute, SEER Cancer Statistics Review, 2007. Statistics based on data, 2000-2004. See www.cancer.gov for more information.

Staging and Survival Rates

Staging is the process physicians use to assess the size and location of a patient’s cancer. This information helps determine the most optimal form of treatment. Breast cancer stages range from Stage 0 (very early form of cancer) to Stage IV (advanced, metastatic breast cancer). Click here for a detailed explanation of each stage of breast cancer.

The five-year survival rate for breast cancer is calculated based on averages. Each patient’s individual tumor characteristics, state of health, genetic background, etc. will impact her survival. In addition, levels of stress, immune function, will to live, and other unmeasurable factors also play a significant role in a patient’s survival.

Stage 5-year Relative
Survival Rate

0

100%

I

100%

IIA

92%

IIB

81%

IIIA

67%

IIIB

54%

IV

20%
Source: American Cancer Society

Breast cancer survival also continues to decline after five years. Survival after ten years depends on the stage; early stage breast cancers are associated with high survival rates than late stages cancers.

Overall Survival Rate

  After 5 years
  After 10 years
  After 15 years
  After 20 years
  88%
  80%
  71%
  63%
Source: American Cancer Society

Statistics on Mammography

The key to surviving breast cancer is early detection and treatment. According to the American Cancer Society, when breast cancer is confined to the breast, the five-year survival rate is close to 100%. The early detection of breast cancer helps reduce the need for therapeutic treatment and minimizes pain and suffering, allowing women to continue leading happy, productive lives.

Beginning at the age of 20, every woman should practice monthly breast self-exams and begin a routine program of breast health, including scheduling physician performed clinical breast exams at least every three years. As a woman ages, her risk of breast cancer also increases. About 77% of women with breast cancer are over age 50 at the time of diagnosis. Women between the ages of 20 and 29 account for only 0.3% of breast cancer cases. Beginning at the age of 40, all women should have annual screening mammograms, receive clinical breast exams each year, and practice breast self-exams every month.

Percent of American Women Over 40 Who Have Had a Mammogram Within Past 2 Years
White
Black, Non-Hispanic
Hispanic
American Indian/Alaska Native
Asian American
70.4%
70.4%
66.1%
68.6%
58.8%
69.3%
Source: American Cancer Society, 2005. Based on 2003 data.

Links to Other U.S. Breast Cancer Statistics

Updated: January 23, 2008

Believing is 50%!Dx 7/10/07, Lumpectomy 8/24/07, double mast/no recont. 10/01/07, IDC, 3 cm, Grade 3, 0/4 nodes, Stage IIA, ER-/PR- HER2- Age 48, chemo 11/23/07 lung spots 3/08
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Galina2 Quote  Post ReplyReply Direct Link To This Post Posted: May 18 2009 at 7:08pm
Something positive! Heart Drink your teas, eat your veggies! Cool
 
The growing amount of evidence from studies in epidemiology, cell cultures and animal tumor models demonstrates that a large number of natural compounds from the diet could lower cancer risk and some of them could sensitize tumor cells in anti-cancer therapies.
 
Many plant-derived, dietary polyphenols have been studied for their chemopreventive and chemotherapeutic properties against human cancers, including green tea polyphenols, genistein (found in soy), apigenin (celery, parsley), luteolin (broccoli), quercetin (onions), kaempferol (broccoli, grapefruits), curcumin (turmeric).
 
It is generally agreed that the cancer chemopreventive effects of green tea Tongueare mediated by its abundant polyphenol, epigallocatechin gallate [(-)-EGCG]. Read more at : http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2635719
Believing is 50%!Dx 7/10/07, Lumpectomy 8/24/07, double mast/no recont. 10/01/07, IDC, 3 cm, Grade 3, 0/4 nodes, Stage IIA, ER-/PR- HER2- Age 48, chemo 11/23/07 lung spots 3/08
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Post Options Post Options   Thanks (0) Thanks(0)   Quote HolliBeri Quote  Post ReplyReply Direct Link To This Post Posted: May 19 2009 at 6:10am
I think with TNBC prognosis is very individualized, case by case.


Edited by HolliBeri - May 19 2009 at 6:30am
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Post Options Post Options   Thanks (0) Thanks(0)   Quote HolliBeri Quote  Post ReplyReply Direct Link To This Post Posted: May 19 2009 at 6:27am
DX age 45:12/08 IDC & DCIS TNBC. 2/09:lumpectomy, 2 cm, grade 3, -nodes, stage IIa, BRCA- Chemo:Taxotere/Cytoxan x4.Double mastectomy 6/09. Zometa   http://www.caringbridge.org/visit/hollisimpsongough
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