What is Triple- Negative Breast Cancer?

Did you know that there are many types of breast cancer?  Breast cancer is a disease made up of several subtypes, one of which is called triple negative breast cancer.  Approximately 10% to 20% of breast cancers are triple-negative.

Dr. Lisa Newman, who directs the U-M Breast Care Center, speaks to colleagues and patients in Ghana, Africa. Her research focuses on triple negative breast cancer in African-American women. In Ghana, she treats women with breast cancer and collects information to bring back here. By better understanding the disease in African women, Dr. Newman hopes to be able to improve treatment options for all women with triple-negative breast cancer.

Triple-negative breast cancer cells do not express three markers that can play a role in breast cancer.

  • Estrogen receptor(ER)
  • Progesterone receptor(PR)
  • HER2(human epidermal growth factor receptor 2)

These negative results mean that the growth of the cancer is not supported by the hormones estrogen and progesterone, or by the presence of too many HER2 receptors. Therefore, triple-negative breast cancer does not respond to hormonal therapy (such as Tamoxifen or aromatase inhibitors) that target estrogen and progesterone, or therapies that target HER2 receptors, such as Herceptin.

Who gets triple -negative breast cancers?

  • Younger people – Triple-negative breast cancer is more likely to occur before age 40 or 50, whereas other breast cancer types are more common in women; 60 or older.
  • African-American and Hispanic women -Triple-negative breast cancer most commonly affects African-American women, followed by Hispanic women. Asian women and non-Hispanic white women are less likely to develop this type of cancer.
  • People with a BRCA1 mutation. – When people with an inherited BRCA1 gene mutation develop breast cancer, especially before age 50, it is often triple-negative.

Researchers do not yet understand why premenopausal women and women in some ethnic groups have higher rates of triple negative breast cancer–than other groups of women. Continue reading

New trends in breast reconstruction

Women making a decision about breast cancer surgery should include a plastic surgeon in that discussion. Several options for breast reconstruction give women choices, with each choice carrying its own risks and benefits.

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October is Breast Cancer Awareness Month.

“The decision tree is complicated. A plastic surgeon ultimately has to walk through the choices with patients and help them consider which option is best for their individual situation and preferences,” says Adeyiza Momoh, M.D., assistant professor of plastic surgery at the U-M Medical School.

As more younger women at high risk of breast cancer choose to have their breasts removed before cancer develops, a procedure called a DIEP (Deep Inferior Epigastric Perforator) flap has become increasingly popular. The technique involves transplanting tissue from the woman’s abdomen into her chest. But unlike traditional tissue reconstruction, called a pedicled TRAM flap, where the entire rectus muscle was included with the flap, a DIEP flap involves a complex approach to dissecting out the small blood vessels and leaving the muscle behind. The blood vessels are then reconnected to blood vessels in the chest.

The technique preserves the abdominal muscle function and typically has fewer abdominal complications. Continue reading

Clearing the confusion about mammograms

The bottom line: Mammography saves lives. Various organizations may not agree perfectly on screening recommendations, but don’t use that as an excuse to throw up your hands and do nothing.

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October is Breast Cancer Awareness Month. This year, an estimated 209,060 Americans will be diagnosed with breast cancer; more than 40,000 will die from the disease.

“Mammography is one of the few screening tools that has been proven to save lives. Every woman over 40 should at least begin a discussion about screening with her doctor,” says Mark Helvie, M.D., director of breast imaging at the U-M Comprehensive Cancer Center.

Here’s what everyone does agrees on:

  • All women 50-74 should receive regular mammograms.
  • Mammography may be the right choice for women in their 40s. While many groups, such as the American Cancer Society and the National Comprehensive Cancer Network, continue to recommend routine screening, others advocate a discussion between women and their health care providers.
  • Yearly or every other year? Many groups continue to recommend annual exams. The difference of opinion comes down to a balance between benefit and harm. Annual screening saves more lives but at a cost of more harms. Talk to your doctor about your options.
  • Women at very high risk for breast cancer may benefit from additional screening with MRI. Continue reading