Recap of TNBC Teleconference

I enjoyed the Triple-Negative Breast Cancer Teleconference yesterday through Living Beyond Breast Cancer. Below are some quick notes from that discussion. Check the LBBC site for a podcast and transcript. Neither is available yet.

From Dr. Rebecca Dent, MSc, MD FRCP(C). Assistant Professor, University of Toronto

• We used to talk about stages in breast cancer; now we look at the biology of the disease and tailor our treatment. Research on TNBC and Her2 have “fundamentally changed the way we see breast cancer.”

• TNBC is not one disease, but many. Some tumors are basal-like—in the basal layer of the breast. Some are connected to the BRCA gene. Some have neither of these connections.

• Basal-like tumors are likely to spread to the nodes even when they are small.

• Women with HR- tumors benefit more from chemotherapy than those with HR+.

• “We’re trying to come up with triple-negative treatments. We are making a lot of headway.”

• TNBC and HR2+ cancers benefit the most from the addition of taxanes to chemotherapy.

• Platinum-based chemotherapy has long been used for lung cancer might be more effective against TNBC and Her2+. These include Cisplatin and carboplatin.

• Avastin has shown success with metastatic breast cancer.

• If you have a pathologically complete response—no sign of cancer after treatment—your chances of surviving TNBC are as good as with non-TNBC.

• A lot of our data come from older treatments—CMF, sometimes AC. We might be seeing better responses with new treatment—AC, plus taxanes.

From Dr. Lisa Newman, Professor of Surgery and Director of the Breast Care Center for the University of Michigan in Ann Arbor, Michigan,

• We don’t know what causes TNBC or why some women get it. We do know that it is many different types of diseases.

• Risk factors associated with TNBC include being younger at age and African-American. TNBC tumors are also larger at diagnosis than non-TNBC—an average of 3 cm. as opposed to 2 cm.

• At present, we define this disease according to what it does not have—it does not have markers for estrogen, progesterone or Her2. We need to find what markers are present.

• Because African ancestry is a consistent feature in this disease, we might be able to identify TNBC better by studying people in their environments.

• African-Americans are less likely to be diagnosed with breast cancer at all. If they are, they are more likely to be younger at diagnosis, have larger tumors, and a higher likelihood of dying from the disease. There is also a higher incidence of male breast cancer among African-Americans.