Not So Scary Anymore

CURE, Fall 2013, Volume 12, Issue 3

With more knowledge, triple-negative breast cancer doesn't seem so scary.

Journalist and retired college professor Patricia Prijatel received a diagnosis of triple-negative breast cancer (TNBC) at age 60 after discovering a lump in her breast. “I was completely confused,” Prijatel says of her 2006 TNBC diagnosis. “I’d never heard of breast cancer that wasn’t fueled by hormones.”

She was told by her doctors that this was a very aggressive and often deadly form of cancer. Luckily for Prijatel, her tumor was small and had not spread to her lymph nodes. She had a lumpectomy followed by chemotherapy and radiation, and her cancer has never reemerged.

Prijatel’s initial confusion about her diagnosis spurred her into action; she began her own research and has become a frequent blogger on TNBC. Looking back, she feels that there was too much focus on the frightening aspects of the disease, given that many women with TNBC respond well to chemotherapy.

“We normally think of TNBC as a more aggressive, faster growing disease,” says Kent Osborne, director of the Smith Breast Center at Baylor College of Medicine in Houston. “But the prognosis is improved by optimal chemotherapy, so it’s probably not as bad a diagnosis as people hold it out to be.”

This is particularly true for patients with early-stage disease. “People go online and Google TNBC, and they see all these scary stories,” says breast cancer specialist Lisa Carey. “But a half-inch, node-negative TNBC tumor is not high risk, no matter what.” Disease recurs in around 30 percent of patients with TNBC, however, and once the disease spreads, it is not as responsive to chemotherapy, leading to a disproportionate number of deaths among individuals with TNBC compared with other types of breast cancer.

“Another reason TNBC is thought to be a worse kind of breast cancer,” Osborne says, “is because we don’t have specific therapies based on the genetic profile of the tumor.” But studies are underway to stratify these tumors based on key growth pathways and to test existing drugs that inhibit these pathways. In the meantime, Prijatel, who still gets nervous around the time of her yearly mammogram, has dedicated herself to educating others about TNBC, with a focus on the positive.