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Triple Negative Breast Cancer

Posted 6/12/2013

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  As many of you know, "triple negative" is a relatively new term used to describe breast cancers that are estrogen receptor negative, progesterone receptor negative, and her2 negative. For treatments, this means that neither the hormonal/anti-estrogen treatments or herceptin are useful. Often, triple negative breast cancers are grade III and believed to be of an aggressive nature. The "good" news about this is that they are particularly sensitive to chemotherapy as all chemo drugs attack fast growing cells.

  There is a lot of interest and research going on regarding this particular subtype of breast cancer. As seems to be generally the case in cancer research, as we learn more, we are realizing that there are subtypes and subtypes, and that "triple negative" is really a descriptive term that encompasses several different cell types. Learning to identify these different cells will likely lead to better treatments that are targeted at their particular characteristics. This is an essay by Elizabeth Whittington from Cure Today that does a very nice job of explaining and summarizing current knowledge as well as likely directions of inquiry.

  Here is the beginning and then a link to read more:

Is "triple-negative breast cancer" merely a descriptive term?

As it happens with cancer research, we are finding that the subtype of
triple-negative breast cancer (TNBCs, essentially those cancers that cannot be
treated with HER2-targeted and hormone therapies), contain many subsets
This theory may explain why any one drug class or approach to treatment has not
been very successful--a topic that was addressed during the annual meeting of
the American Association for Cancer Research.
To date, TNBC has become a catch-all disease with any breast cancer that isn't
HER2-positive or ER-positive. Right now, the term triple-negative breast cancer is
merely a "descriptive and operational term," as William Foulkes, the director of the
cancer genetic program at Quebec's McGill University, put it. It doesn't have a
biological definition. And its importance has risen only in the past five years.
What happens when we begin to separate these subtypes out--one expert
mentioned there could be up to six (for the record: basal-like 1 and 2,
immunomodulatory, mesenchymal, mesenchymal stem-like and luminal androgen
receptor)? And how do we separate them? By gene expression, which gave us the
six subtypes? By histology? Biomarkers?


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