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Expert Advice re Triple Negative

Posted 8/30/2013

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  First an explanation: I had planned to post this entry tomorrow, but our travel plans have changed, and it clearly is wiser to do so this evening. I realize, as I type this, that it is likely no one will even notice, but I do, and I want to explain on the off chance that anyone is curious. We had hoped to depart for Maine in early to mid afternoon, but things got busy at work, and, by the time we could depart, it clearly would have made no sense. It seems much wiser to get up very early tomorrow morning than to sit in horrible holiday weekend traffic and arrive very late at night.

  So, having said that, the topic of the moment is treatment of triple negative breast cancer. As most of you know, the term refers to breast cancers that are ER negative, PR negative, and her2 negative. This means that none of the known targeted therapies (including hormonal therapies) have any value, but these cancers are especially sensitive to chemotherapy, and many women do just fine.

  This is from Living Beyond Breast Cancer (www.lbbc.org) and is another in their ongoing excellent series of interviews with cancer experts. This time, the conversation is with Dr. Carey Anders and Dr. Hope Rugo. Here is the beginning and then a link; you can read the whole thing online or download and print it or listed to it as a podcast.

August 2013 Ask the Expert: Triple-Negative Breast Cancer Highlights

Question: After the chemo-surgery-radiation treatment for TNBC, what are your thoughts on metformin, diet, exercise, aspirin and anything else to consider with the goal of decreasing risk of recurrence?

Dr. Anders: Following traditional chemotherapy, surgery, and radiation therapy for TNBC, leading a generally healthy lifestyle is a proactive way to help reduce the risk of recurrence and to ward off other illnesses. Studies have shown that regular exercise (approximately 5 times a week) and a healthy diet full of fruits and vegetables (5 servings combined) may reduce breast cancer recurrence. A large retrospective study of aspirin use also showed that routine use may be linked to lower breast cancer recurrence and, if already on it for cardiovascular health, it is very reasonable to continue. The data for metformin is somewhat mixed, but some retrospective studies have shown a protective effect of metformin on breast cancer risk.

Question: I was diagnosed with triple-negative breast cancer in 2009 and my doctor told me it has a tendency to recur after treatment. What percentage of TNBCs, would you say, actually recur? My doctor's statement has caused me to live in fear, even though I took chemotherapy at that time and have been clear for 4 years now.

Dr. Anders: Studies have shown that women with TNBC have twice the rate of distant recurrence as compared with other types of breast cancer. In contrast to other subtypes of breast cancer, the risk of TNBC recurrence peaked within 3 years of diagnosis and declined rapidly thereafter. These studies are somewhat limited by their retrospective nature and use of older, possibly outdated, chemotherapy regimens.

http://www.lbbc.org/Learning-From-Others/Ask-the-Expert/2013-08-Triple-Negative-Breast-Cancer-Highlights/(language)/eng-US

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