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SagePatientAdvocates
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Posted: Aug 15 2009 at 7:27am |
Dear newalex,
My daughter was dx with TNBC in August 2004. She had a quadrantectomy.
Then we found out she is BRCA1+, a genetic mutation that predisposes women to an 85% chance to get breast cancer and a 45% chance of getting ovarian cancer.
Mary, I do not know what the recurrence figures are for non-BRCA mutation women but anecdotally, looking at the "signatures" of women on this site they are high.. with a BRCA mutation you have a 50% chance for a recurrence or new primary which is often in the contralateral breast.
Have either of you had genetic counseling/testing for the BRCA mutation?
85% of BRCA1+ women, who have breast cancer, have TNBC. The converse is not true but particularly with early-onset disease it is important to consider genetic counseling..
recognizing that the n=small in this study I think it is important.
": BMC Cancer. 2009 Mar 19;9:86. Links
The prevalence of BRCA1 mutations among young women with triple-negative breast cancer.
Young SR, Pilarski RT, Donenberg T, Shapiro C, Hammond LS, Miller J, Brooks KA, Cohen S, Tenenholz B, Desai D, Zandvakili I, Royer R, Li S, Narod SA.
Women's College Research Institute, Department of Public Health, The University of Toronto, Toronto, Canada. sryoung37@aol.com
BACKGROUND: Molecular screening for BRCA1 and BRCA2 mutations is now an established component of risk evaluation and management of familial breast cancer. Features of hereditary breast cancer include an early age-of-onset and over-representation of the 'triple-negative' phenotype (negative for estrogen-receptor, progesterone-receptor and HER2). The decision to offer genetic testing to a breast cancer patient is usually based on her family history, but in the absence of a family history of cancer, some women may qualify for testing based on the age-of-onset and/or the pathologic features of the breast cancer. METHODS: We studied 54 women who were diagnosed with high-grade, triple-negative invasive breast cancer at or before age 40. These women were selected for study because they had little or no family history of breast or ovarian cancer and they did not qualify for genetic testing using conventional family history criteria. BRCA1 screening was performed using a combination of fluorescent multiplexed-PCR analysis, BRCA1 exon-13 6 kb duplication screening, the protein truncation test (PTT) and fluorescent multiplexed denaturing gradient gel electrophoresis (DGGE). All coding exons of BRCA1 were screened. The two large exons of BRCA2 were also screened using PTT. All mutations were confirmed with direct sequencing. RESULTS: Five deleterious BRCA1 mutations and one deleterious BRCA2 mutation were identified in the 54 patients with early-onset, triple-negative breast cancer (11%). CONCLUSION: Women with early-onset triple-negative breast cancer are candidates for genetic testing for BRCA1, even in the absence of a family history of breast or ovarian cancer."
Edited by steve - Aug 15 2009 at 7:29am
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I am a BRCA1+ grandson, son and father of women affected by breast/oc-my daughter inherited mutation from me, and at 36, was dx 2004 TNBC I am a volunteer patient advocate with SAGE Patient Advocates
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Suzanne
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Posted: Aug 15 2009 at 8:06am |
Newalex, did anyone give you the info. you needed to add a signature to postings? If not, this is what you do:
Click on "settings", listed above. (You have to be logged in to see "settings".) Then click on "profile information". Scroll down until you see "signature". Add the information you want to the box to the right. Then click "update". That should do it.
Suzanne
Edited by Suzanne - Aug 15 2009 at 2:45pm
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1/2/07 IDC, stage 1 (T1c), 1.56cm, lumpectomy 1/8/07, triple neg., grade 3, sentinel lymph node biopsy negative, BRCA 1/2 negative; 4 AC/4 Taxol dose dense, 30 rads 2/07-7/07
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newalex
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Posted: Aug 15 2009 at 12:26pm |
steve
Do you mean the recurrence for TN is high with BRCA mutation based on signature reading?
How about recurrence for non-BRCA mutation and early stage?
Based on looking at the signature here, it may seem high. Is it because people tend to come on to these support boards when they have a problem either currently dealing with it or a recurrence?
I read once a study someone posted in another site, they say for stage 1 to 3 TN, overall rate of desease- free rate is like around 67%. With node negative TN it is 85% based on a Japanese study, not statistically significant comparing to ER+. That's all I found. TN is a recent term and they don't have long studies for it.
Edited by newalex - Aug 16 2009 at 3:42am
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Lillie
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Posted: Aug 16 2009 at 1:01pm |
Hi newalex,
I just sent you a PM but it was rejected. Your box is full. Please make room and notify me.
Love in Christ,
Lillie
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Dx 6/06 age 65,IDC-TNBC Stage IIb,Gr3,2cm,BRCA- 6/06 L/Mast/w/SNB,1of3 Nodes+ 6/06 Axl. 9 nodes- 8/8 thru 11/15 Chemo (Clin-Trial) DD A/Cx4 -- DD taxol+gemzar x4 No Rads. No RECON - 11/2018-12 yrs NED
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SagePatientAdvocates
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Posted: Aug 16 2009 at 2:01pm |
Dear newalex,
it is my understanding that if a woman has breast cancer and she is BRCA1+
or BRCA2+ there is a very large risk of recurrence or mets. Something like 50%. It seems that 85% of women with the BRCA1+ mutation who have breast cancer have a TNBC.
It is also my understanding that the first three years(and certainly five years) after diagnosis is the highest risk period for women with TNBC. Here is an abstract of a study that mentions that.
: Clin Cancer Res. 2007 Aug 1;13(15 Pt 1):4429-34. Links
Comment in:
Clin Cancer Res. 2008 Jan 15;14(2):618; author reply 618-9.
Triple-negative breast cancer: clinical features and patterns of recurrence.
Dent R, Trudeau M, Pritchard KI, Hanna WM, Kahn HK, Sawka CA, Lickley LA, Rawlinson E, Sun P, Narod SA.
Department of Medical Oncology, Sunnybrook Health Sciences Center, University of Toronto, Ontario, Canada.
PURPOSE: To compare the clinical features, natural history, and outcomes for women with "triple-negative" breast cancer with women with other types of breast cancer. EXPERIMENTAL DESIGN: We studied a cohort of 1,601 patients with breast cancer, diagnosed between January 1987 and December 1997 at Women's College Hospital in Toronto. Triple-negative breast cancers were defined as those that were estrogen receptor negative, progesterone receptor negative, and HER2neu negative. The prognostic significance of triple-negative breast cancer was explored. RESULTS: The median follow-up time of the 1,601 women was 8.1 years. One hundred and eighty of 1,601 patients (11.2%) had triple-negative breast cancer. Compared with other women with breast cancer, those with triple-negative breast cancer had an increased likelihood of distant recurrence (hazard ratio, 2.6; 95% confidence interval, 2.0-3.5; P < 0.0001) and death (hazard ratio, 3.2; 95% confidence interval, 2.3-4.5; P < 0.001) within 5 years of diagnosis but not thereafter. The pattern of recurrence was also qualitatively different; among the triple-negative group, the risk of distant recurrence peaked at approximately 3 years and declined rapidly thereafter. Among the "other" group, the recurrence risk seemed to be constant over the period of follow-up. CONCLUSIONS: Triple-negative breast cancers have a more aggressive clinical course than other forms of breast cancer, but the adverse effect is transient.
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re: long term survival-my daughter is now almost five years NED...she was dx with TNBC in 2004...
all the best,
Steve
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I am a BRCA1+ grandson, son and father of women affected by breast/oc-my daughter inherited mutation from me, and at 36, was dx 2004 TNBC I am a volunteer patient advocate with SAGE Patient Advocates
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MaryTwinA
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Posted: Aug 16 2009 at 6:34pm |
I have not had genetic testing done. didn't know what the benefit of it would be. I was jsut wondering what the chances are of a recurrence if i didn't do the genetic testing. thanks for all the responses so far, although i am new to the site and it is hard for me to follow.
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sadierose2
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Posted: Aug 16 2009 at 7:15pm |
Hi Alex,
I am five years out and all of my rechecks have been clear.
Warmly,
Sadie
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kirby
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Posted: Aug 16 2009 at 8:11pm |
MaryTwinA
Benefit of genetic testing is that it is another tool to empower you with clearer decision making for not only your present and future but for relatives of same link.
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kirby
dx Feb. 2001. Age 44 Lumpectomy
2cm. no nodes stage 1 grade 3
4 rnds AC, 35 rads
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jody
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Posted: Aug 16 2009 at 8:27pm |
MaryTwinA
You are also more likely to get your insurance company to say yes to any tests that you would like to have done if you test positive for the gene.
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diagnosed 4/16/08 stage 1, node neg TN grade 3,lumpectomy 4/30/08 chemo a/c 6 rnds, finished 9/08. Radiation begins 11/6/08 La Verne, California
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SagePatientAdvocates
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Posted: Aug 16 2009 at 8:41pm |
Dear MaryTwinA,
well taking a wild guess here but are you a twin? identical? well if you tested and were found to have the gene mutation your twin if she was identical would have the mutation as well...and you inherited the gene
from either your mom or dad so they should test(generally the first to test would be the one with breast or ovarian cancer directly or in their family tree) as well to ascertain their risks..
by the way my daughter with TNBC has a twin brother so he is at a 50-50 risk to inherit the mutation from me as my daughter did. Also, lots of times the mutation is "hidden" in the dad because often the dads don't get cancer and die of something else...I am 65 and I have never had cancer (that I know of).
if you don't test, your risk is the same...it is what it is....without testing you don't have as good an idea of what your risks are..
right now, in my opinion, without testing you don't have as good an idea of what your risks are of recurrence as when you have tested...
if you have any questions please ask away or send me a PM...the best person, however, to speak to about this though is a Certified Genetic Counselor..
There are women who test before they have cancer if they know e.g. their mom or sister had TNBC and is BRCA1+. They want to have the information because at some point they may consider risk-reducing surgeries..
all the best,
Steve
Edited by steve - Aug 17 2009 at 8:13pm
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I am a BRCA1+ grandson, son and father of women affected by breast/oc-my daughter inherited mutation from me, and at 36, was dx 2004 TNBC I am a volunteer patient advocate with SAGE Patient Advocates
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newalex
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Posted: Aug 16 2009 at 10:19pm |
Steve
I don't know if one has BRCA gene means she has higher chance of recurrence. Maybe. How about those without BRCA gene? Do you know?
I just recall I read a study in Japan and italy, they say node negative TN have similar mets free rate as those ER +. They did not break down to BRCA or not just a total.
I agree after 4 yrs, TN rarely has a recurrence or mets but ER + can have a recurrence even after 20 years.
My doctor showed me a Anderson study that TN has a bit higher recurrence risk than ER+ during the first 4 years but my doctor said the difference is not that high. So he considers TN early stage risk is to be similar to those ER+ woman. That's what he told me. But ofcourse for stage 3 TN has much higher risks than ER+ .
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Sunday22
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Posted: Aug 17 2009 at 6:39am |
I was four years NED when my cancer grew overnight. The original one was TNBC. The onc said this new one is a local recurrence, and it is also TNBC, but very slightly er positive. I'll know more after the bmx.
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sfcindy
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Posted: Aug 17 2009 at 9:12am |
Can someone tell me what NED stands for? Cindy
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newalex
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Posted: Aug 17 2009 at 9:12am |
sunday22
what kind of dx and tx you had the first time?
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newalex
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Posted: Aug 17 2009 at 9:15am |
sunday 22
Are you Adnerb in breast cancer.org?
I read Adnerb in breast cancer.org has same as you, first TN and second time weakly ER+ after 4 yrs apart. Just wonder. I post there too on that site. Do you?
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kirby
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Posted: Aug 17 2009 at 9:16am |
NED = no evidence of disease
the term currently used rather than remisssion
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kirby
dx Feb. 2001. Age 44 Lumpectomy
2cm. no nodes stage 1 grade 3
4 rnds AC, 35 rads
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newalex
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Posted: Aug 17 2009 at 9:17am |
Kirby
Was your orginal dx an IDC not medullary?
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sfcindy
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Posted: Aug 17 2009 at 9:39am |
I don't know if you are asking me (Cindy) but I updated my profile with my details. I think they will now come with my signature. I haven't been on this site much and am still getting the hang of it. Let me know if this message comes with my dx details. thanks Cindy
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Cindy, 60, dx: 4/09 st 1, gr 3, chemo 5/09 - 7/09 in clin. trial at Stanford: gemcitabine, carboplatin & BSI 201 (PARP inhibitor) lumpectomy 8/10/09, 3 nodes, all neg. Add'l chemo recommended.
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sfcindy
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Posted: Aug 17 2009 at 9:40am |
thanks Kirby.
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Cindy, 60, dx: 4/09 st 1, gr 3, chemo 5/09 - 7/09 in clin. trial at Stanford: gemcitabine, carboplatin & BSI 201 (PARP inhibitor) lumpectomy 8/10/09, 3 nodes, all neg. Add'l chemo recommended.
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kirby
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Posted: Aug 17 2009 at 9:47am |
newalex,
yes, my dx was IDC. I am uncertain of what medullary is. I
Edited by kirby - Aug 17 2009 at 9:49am
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kirby
dx Feb. 2001. Age 44 Lumpectomy
2cm. no nodes stage 1 grade 3
4 rnds AC, 35 rads
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