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Lumpectomy for Triple Negative Breast Cancer

Posted 5/8/2014

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  As you may know, triple negative breast cancer refers to those cancers that are Her2 negative, estrogen negative, and progesterone negative. Somewhere between 10%-20% of all cancers fit this description, and there is a lot of interest in developing treatments that may be especially helpful. Clearly, the valuable therapies of herceptin, tamoxifen, and the AIs are irrelevant for this population, and these cancers tend to be more aggressive than other types.

  Because of their worrisome characteristics, there has been some thought that mastectomy might be a safer option than lumpectomy/wide excision and radiation. A recent study published in JAMA Surgery suggests that this is not the case. Good news indeed.

  Here is the beginning of an excellent summary from and then a link to read more:

Triple-negative breast cancer is: estrogen-receptor-negative progesterone-receptor-negative
The hormones estrogen and progesterone don’t fuel the growth of triple-negative breast cancers. Triple-negative
disease also doesn’t have an abnormally high level of HER2 receptors. This means that triple-negative breast cancer doesn’t respond to hormonal therapy (such as tamoxifen or the aromatase inhibitors) or therapies that target HER2 receptors, such as Herceptin (chemical name: trastuzumab), Tykerb (chemical name: lapatinib), or Perjeta (chemical name: pertuzumab).
About 10-20% of breast cancers – more than one out of every 10 – are triple-negative. Triple-negative breast cancer tends to be more aggressive than other types of breast cancer.
Because triple-negative disease is considered more aggressive than breast cancers that are HER2-positive or
hormone-receptor-positive, many doctors believe that it should be removed with mastectomy rather than lumpectomy followed by radiation to reduce the risk of recurrence and improve survival chances. Still, not much research has been done on the type of surgery that’s best for early-stage, triple-negative breast cancer, so no standard recommendations have been developed.


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