Breast Cancer Info

My Diagnosis:
            Dx January 2011 at age 26
Invasive Ductal Carcinoma, Stage 2, Grade 3 (nottingham 9/9), Triple Negative
My Treatment Plan:
            Lumpectomy (December 2010)
            6 rounds of TAC chemotherapy (January through May 2011)
            Double Mastectomy with Reconstruction  (June 2011, October 2011, December 2011)

Although the malignant tumor has been removed, there are often tiny microscopic cancer cells that linger in the body afterwards.  I have chosen to have the most aggressive chemo treatment that is available for me.  TAC chemotherapy is composed of three drugs that are administered through IV, which attack all of the rapidly dividing cells in the body.  My hope is for the chemo to kill any and all cancer cells, while of course it's (unfortunately) also attacking my good cells. 

After I have completed chemotherapy, I plan to have surgery to remove both breasts and to have them cosmetically reconstructed.  Plastic surgery is not something that I have ever considered before, but in a situation like this, I am so thankful for it.  As a preventative measure, I will be having a prophylactic mastectomy on the breast that does not have any cancer.  Studies show that although prophylactic mastectomies do not benefit older women, they do increase survival rates for women under fifty who had stage 1 or 2 estrogen receptor negative breast cancer.  I'm in that group.  It is said to increase our survival rate by almost five percentage points over five years.  I am all for doing whatever it takes now to prevent the cancer from recurring in the future.

These are some posts that I wrote when I was newly diagnosed:

But This Can't Be Real

My Diagnosis

And here are the rest of my posts about breast cancer:

In the United States, breast cancer is associated with higher death rates of women than any other cancer, besides lung cancer.  Over the course of her lifetime, 1 in 8 women will develop breast cancer.
Specific types of breast cancer

Stage 0: Carcinoma in situ (pre breast cancer cells)
Stage 1: Early stage invasive breast cancer (tumor is less than 2cm and lymph nodes are clear)
Stage 2: Early stage invasive breast cancer (tumor is greater than 2cm and/or has spread to lymph nodes)
Stage 3: Invasive breast cancer (tumor has spread to lymph nodes, other breast tissue, skin, chest wall, ribs, or muscle)
Stage 4: Advanced metastatic breast cancer (cancer has spread to other organs or tissues, such as the liver, lungs, brain, skeletal system, etc)

(A more detailed description and breakdown of the stages can be found here).

The grade allows us to determine how fast the cells are dividing and how aggressive the tumor is.  The Nottingham histologic score is used to assess the grade, based on whether the tumor looks like the normal tissue from where it originated.  For example, 1/9 would be the slowest growing, least aggressive cancer, and 9/9 would be the fastest growing, most aggressive cancer.
Grade 1: looks very much like the normal surrounding breast tissue
Grade 2: looks less like the normal tissue
Grade 3: shows very little similarities to the normal breast tissue

Hormone Receptor Status
This information is important for understanding how the tumor acts and what kind of treatment may work the best.
-Hormone receptor (estrogen receptor positive, or progesterone receptor positive)
          -accounts for about 65 to 75% of breast cancers
          -these tumors grow in response to hormones
          -Tamoxifen and other hormone therapies can be used in treatments 
-HER2/neu positive (human epidermal growth factor)
          -accounts for 20 to 25% of breast cancers           
          -the cancer cells make too much of a protein called HER2/neu          
          -Herceptan is a drug that is very effective in treating this cancer
-Triple negative
          -accounts for 10 to 20% of breast cancers
          -not responsive to receptors for estrogen, progesterone, or HER2

Triple Negative Breast Cancer (TNBC)

This is a relatively rare type of breast cancer that tends to hit younger women, and is especially more prevalent among African American and Hispanic women.  TNBC is also the type of cancer that Susan G. Komen had.  It is associated with a larger tumor size, high grade (fast-growing and aggressive), pushing margins, and higher rate of recurrence and distant metastasis.  Compared to other types of breast cancer, TNBC has a worse prognosis when it comes to overall survival and disease-free intervals.  The greatest risk of recurrence is within the first three years after diagnosis.

TNBC is usually treated with chemotherapy, which is very effective for some women.  However, beyond that, there are limited treatment options available for triple negative tumors.  This is because in order to develop new medicines, we need to have an understanding of what makes a particular cancer grow.  TNBC is not fueled by any of the three factors that are known to promote tumor growth: estrogen, progesterone, and human epidermal growth factor (Her2/neu).  Nobody is exactly sure what makes these cancers grow.  All of the medical progress that has helped women with common types of breast cancer has not really been able to benefit women with TNBC.  The good news is that there has been a lot of recent studies and research looking into TNBC, and targeted therapies may (hopefully!) become available soon.

PARP Inhibitors

Current clinical trial studies are considering that triple negative breast cancers may have problems with DNA repair.  PARP inhibitors are drugs that can interfere with the DNA repair process in cancer cells, therefore making them more vulnerable to chemotherapy and less likely to grow back.  Iniparib, the first of the PARP inhibitors, showed very promising outcomes in phase 2 trials, but phase 3 trials have not proven to be successful yet.  More information on these clinical trials is expected to be released.

Breast Cancer Resources

Susan G. Komen for the Cure:
American Cancer Society:
Living Beyond Breast Cancer:
Triple Negative Breast Cancer Foundation:
Young Survival Coalition:
Be Bright Pink:
Facing Our Risk:

Quotes from Celebrities who Battled Breast Cancer

Related Posts Plugin for WordPress, Blogger...