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How Siteman approaches triple-negative breast cancer treatment

Washington University School of Medicine

According to the American Cancer Society (ACS), triple-negative breast cancer (TNBC) accounts for 10-15 percent of all breast cancers. It develops more quickly, is more likely to spread and is harder to treat than other breast cancers. Because it’s such an aggressive cancer, TNBC has a poorer prognosis than other invasive breast cancers.

What is triple-negative breast cancer?

Triple-negative breast cancer is a type of breast cancer whose cells have tested negative for estrogen receptors (ER), progesterone receptors (PR) and human epidermal growth factor 2 (HER2). Unlike other invasive breast cancers, TNBC does not respond to hormone therapy or therapies that target HER2.

Afraid of your triple-negative breast cancer diagnosis? You’re not alone

If you have recently received a TNBC diagnosis, you likely feel a great deal of fear. Common fears that TNBC patients have include:

  • Lack of targeted drug treatments
  • Treatment not working
  • Cancer recurrence
  • Dying

While a TNBC diagnosis can be terribly scary, remember that it is not a death sentence. There are effective treatments for this cancer and many women go on to beat TNBC and live full lives, cancer-free. The earlier the cancer is caught, the easier it is to treat. This is why mammograms and early detection are so important.

Survival rates for triple-negative breast cancer

Survival rates for TNBC depend on how far the disease has progressed. According to the ACS, 5-year survival rates are as follows:

  • Localized (contained to the breast): 91 percent
  • Regional (spread outside the breast to nearby structures or lymph nodes): 65 percent
  • Distant (spread to distant parts of the body such as lungs, liver or bones): 12 percent
  • All stages combined: 77 percent

It’s important to keep in mind that survival rate statistics for TNBC are an estimate. Your experience as a TNBC patient is unique, and statistics reflect outcomes of previous patients and past treatments. Speak with your doctor about your specific situation and what your prognosis looks like.

The Siteman approach

With expert physicians, skilled support staff and the latest technology, we give our TNBC patients the comprehensive care they need to fight their cancer. In addition to clinical care, our researchers are making strides in developing ways to use the body’s immune system to fight breast cancer, including vaccines.

TNBC treatment options at Siteman

As a TNBC patient, making treatment decisions can be stressful. At Siteman, our exceptional providers offer a variety of triple-negative breast cancer treatment options:

  • Surgery: oftentimes, patients first need to have either the lump removed (lumpectomy) or the entire breast removed (mastectomy). Then, they will receive chemotherapy to target any remaining cancer cells.
  • Chemotherapy: because hormone therapy and HER2 drugs aren’t effective treatment options for women with TNBC, chemotherapy is the main systemic treatment option. Patients may receive chemo prior to surgery (neoadjuvant chemo), either by itself or with pembrolizumab to shrink a large tumor. Patients may also receive chemo after surgery (adjuvant chemo) to reduce the chances of recurrence.
  • Targeted drugs: for women with TNBC who have a BRCA mutation and whose cancer no longer responds to more common breast cancer chemo drugs, their treatment teams may turn to other chemo drugs (such as carboplatin) or targeted drugs (called PARP inhibitors).
  • Radiation therapy: radiation usually comes after lumpectomies or mastectomies. High-energy radiation targets the breast to kill any remaining cancer cells. The process takes about 20 minutes. Most women receive radiation four to five days a week for about six weeks.

Populations at increased risk for TNBC

There are certain risk factors that put a woman at greater risk for TNBC. You may be at increased risk if:

There are many factors that contribute to these racial disparities that are still unknown. However, Black and Hispanic patients are more likely to have unsatisfying communication with their doctors, experience discrimination in health-care settings and have a harder time getting to and from their appointments.

Clinical trials for TNBC

Clinical trials are often used for triple-negative breast cancer treatment. Prior to taking part in a clinical trial, patients will first undergo standard treatments. However, if those treatments haven’t been successful, patients may choose to take part in a clinical trial in the hopes of a better outcome. If you are a TNBC patient interested in participating in a specific clinical trial, please speak with your physician about the trial.

The choice to participate in a clinical trial is highly personal, and one you should make after speaking with your provider about potential benefits and risks. While most health insurance plans cover clinical trials, make sure to first verify your coverage with your insurance carrier.

Our breast cancer specialists

The breast cancer specialist team at Siteman comprises outstanding Washington University medical oncologists, radiation oncologists, surgeons, radiologists, geneticists and psychologists. The diverse expertise of our specialists is what allows them to create individualized treatment plans for all triple-negative breast cancer patients.

Success among Siteman triple-negative breast cancer patients

In 2016, when Celina Campbell found a quarter-sized lump in her breast, she assumed it was just a swollen area due to a minor injury. However, breast cancer runs in Celina’s family and her cousin had just received a TNBC diagnosis. Because of this, she began to suspect the lump could be cancer. After following up with a breast surgeon, it was indeed confirmed that Celina, too, had TNBC.

While triple-negative breast cancer treatment was very emotionally and physically draining, Celina remained determined to overcome her diagnosis. And, after eight sessions of chemotherapy, no more lump could be found. Now, six years later, Celina lives a full life and her cancer is considered fully cured.

Throughout her cancer journey, Celina received the most exceptional care and support from Siteman’s breast cancer specialist team. Former Washington University medical oncologist William Popovic, MD, laid out a thorough and personalized treatment plan for Celina, putting her at ease with his warm demeanor and genuine concern. All of the staff dedicated themselves fully to Celina’s journey, always working to help her understand her cancer and her treatment. The expertise, commitment and compassion of Washington University breast cancer specialists at Siteman allowed Celina to take charge of her life and to become an incredible inspiration to other TNBC patients.

Patient support

In addition to providing unmatched clinical care, Siteman provides compassionate support to help each and every patient cope with the emotional and physical tolls of cancer treatment.

  • Nurses: specially trained to help breast cancer patients cope with symptoms, treatment and side effects.
  • Nurse navigators: clinically trained to provide guidance and answer questions at any point.
  • Registered dietitians: provide guidance about nutrition and meals or snacks that will be good for you as you move through treatment.
  • Psychologists: provide free mental health care for you and your family members.
  • Palliative care specialists: provide support to help you manage pain and other side effects of your treatments.

You’ve been diagnosed with triple-negative breast cancer. Now what?

If you’ve received a TNBC diagnosis, you may be experiencing a range of emotions including fear, anger and sadness. Siteman providers are here to support you every step of the way throughout your cancer journey. With our exceptional physicians, psychology services and survivorship care, we are committed to caring for your body, mind and wellness, even after treatment ends.

If you are experiencing symptoms that may point to breast cancer, or if you have received a TNBC diagnosis and would like a second opinion from a breast cancer specialist at Siteman, please call 800-600-3606.