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Triple negative breast cancer and the quest for targeted therapies

TNBC.fwTriple negative breast cancer tends to be an aggressive form of breast cancer that disproportionately affects African American women. Among women with breast cancer, the triple negative subtype represents about 15% of diagnoses in white American women and is twice as common in African-American breast cancer patients. In Africa, this form of breast cancer represents more than half of all cases diagnosed.

We call this subtype triple negative because it doesn’t have, or is negative for, all three specific tumor markers currently used to decide treatment:

  • Estrogen receptor
  • Progesterone receptor
  • HER2/neu

The most successful treatment advances in breast cancer have targeted these three markers, but since triple negative breast cancer lacks each of the markers, none of these promising new therapies are effective for treating triple negative tumors. Fortunately, TNBC, as it is starting to be called, is typically responsive to chemotherapy. Early diagnosis is important because depending on its stage when diagnosed, TNBC can be particularly aggressive and more likely to recur than other subtypes of breast cancer. Early detection improves our likelihood of successful treatment.

Why does this disease disproportionately affect African American women? To understand the genetic basis for this disparity, I travel to Ghana to work with Ghanaian physicians in treating African breast cancer patients and collect samples of their tumors. By learning about the disease in African women, I hope to improve treatment options for all women with TNBC.

Triple negative and early-onset breast cancer are patterns that are well-documented as being more common among women with hereditary susceptibility for malignancy, as seen in families that carry mutations in the BRCA-1 gene. Observing these patterns in African American women has motivated speculation that African ancestry might also be associated with an inherited marker for high-risk breast cancer.

In another promising development in TNBC research, earlier this month, researchers from our cancer center and Georgia Regents University identified a protein that fuels an inflammatory pathway in TNBC. Future research may lead to a molecularly targeted therapy for this subtype of cancer.

There is hope for women who have or are at risk to develop triple-negative breast cancer and there is increased awareness for this little-understood disease. However there is much more to be done. Monday, March 3, 2014 is set aside as Triple Negative Breast Cancer Day to increase awareness and support for research into this aggressive form of breast cancer. I hope you will look for a way to participate.

Take the next step:

  • Learn more about triple negative breast cancer at a community presentation Dr. Newman is giving in Dearborn at noon on March 3 through the TNBC Foundation®. It’s free and open to the public; registration is required. If you can’t attend in person, you can dial in remotely from a computer, laptop or iPad.  Complete details including how to register can be found here.

Lisa NewmanLisa A. Newman, M.D., M.P.H., is director of the Breast Care Center at the U-M Comprehensive Cancer Center. Her research focuses on ethnicity-related variation in breast cancer risk and outcome, evaluation and management of high risk patients and applications for induction chemotherapy. Dr. Newman, professor of surgery at the U-M Medical School, frequently speaks about breast cancer awareness, particularly in the African-American community. She serves on the Advisory Board of the TNBC Foundation® which is devoted to finding targeted treatment for triple negative breast cancer.

 

University of Michigan Comprehensive Cancer CenterThe University of Michigan Comprehensive Cancer Center’s 1,000 doctors, nurses, care givers and researchers are united by one thought: to deliver the highest quality, compassionate care while working to conquer cancer through innovation and collaboration. The center is among the top-ranked national cancer programs, and #1 in Michigan for cancer patient care. Seventeen multidisciplinary clinics offer one-stop access to teams of specialists for personalized treatment plans, part of the ideal patient care experience. Patients also benefit through access to promising new cancer therapies.