Beating Triple Negative Breast Cancer
- Alicia Cutts, a school teacher from Utah, beat aggressive triple negative breast cancer after a routine mammogram revealed a small tumor at age 40. She celebrated by being a contestant on “The Price Is Right.”
- “Triple-negative” means the cancer is not fueled by any of the three main types of receptors: estrogen, progesterone, or the HER2 protein. Because of this, the cancer won’t respond to certain common therapies.
- In addition to surgery and radiation, chemotherapy is a mainstay of treatment for early-stage triple-negative breast cancer. Different chemotherapy combinations may be used to treat this aggressive form of cancer. In some cases, immunotherapy — which harnesses the body’s immune system to recognize and attack cancer cells — will be used for triple-negative breast cancer.
- A mammogram is a standard breast cancer screening that examines breast tissue for signs of cancer.
- While there is some disagreement about the exact age a woman should start getting mammograms, doctors generally agree it should happen in their 40s. The American Cancer Society (ACS) suggests women should begin annual mammogram screenings for breast cancer at age 45 if they are at average risk for breast cancer.
- However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) says that women should start getting mammograms every other year at the age of 40, suggesting that this lowered the age for breast cancer screening could save 19% more lives.
Cutts was diagnosed with breast cancer at just 40 years old following her first routine mammogram, an X-ray image of the breast used to screen for cancer, which led to the discovery of a “skittle”-sized tumor. When breast cancer is deemed triple negative, that means that on the outside of your cancer cells you don’t have the receptors that are commonly found in breast cancer. These are the estrogen, progesterone, and HER2 receptors.
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Cutts was seen on the show playing a game called Plinko, where the contestant has to drop a disc down a board, aiming to land on a spot at the bottom to win money, where she was found to be successful.
Recounting her cancer journey to KUTV, Cutts said her routine mammogram found a mass “the size of a skittle” that she could have never noticed without the screening test.
When she received her aggressive triple negative breast cancer diagnosis, Cutts recalled her doctor’s way of fighting the cancer was, “It’s like we’re going to have to throw everything at this because we want to make sure that we get it the first time.”
Now Cutts, who continued working as a teacher through her treatment, is urging anyone hearing her story, “Even if you’re in the middle of treatment, even if you just finished the worst year of your life…
“There’s still hope. There’s still really good, lots of life to live. I mean, you could be on ‘The Price is Right.'”
Cutts credits her mammogram for saving her life and hopes other women will make appointments for their routine checkups.
It’s important to note that the medical community has a consensus that women between 45 and 54 have annual mammograms. However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) is saying that women should start getting mammograms every other year at the age of 40, suggesting that this lowered the age for breast cancer screening could save 19% more lives.
Understanding Triple-Negative Breast Cancer
Triple-negative breast cancer is one of the most aggressive forms of the disease and makes up for approxiamately 20 percent of all breast cancers. The treatment approach varies from patient to patient and may include a combination of different treatments.
Early-stage triple-negative breast cancer (TNBC) treatments may use a combination of chemotherapy drugs.
Helping Patients Understand Treatment Options for Triple-Negative Breast Cancer
- ‘It’s A Game Changer’: FDA Approves Keytruda, Chemo Combo To Treat Aggressive Triple-Negative Breast Cancer
- Chemo Plus Immunotherapy for Metastatic Triple-Negative Breast Cancer
- Can Statin Use Improve Breast Cancer Survival? New Research Shows ‘Significant Association’ for Triple-Negative Breast Cancer Patients
- How to Treat Triple-Negative Breast Cancer: Keytruda Shows Promising Boost in Survival
- Metastatic Triple-Negative Breast Cancer Treatments To Consider
- New Hope for Patients with Metastatic Triple-Negative Breast Cancer: Antibody Drug Conjugate Doubles Survival Time for Some Patients
- More Than 80% of Women With Early-Stage Triple-Negative Breast Cancer Experienced a Prolonged Event-Free Survival With Keytruda Plus Chemotherapy Regimen
For example, a CMF regimen is an abbreviation for combining chemotherapy drugs cyclophosphamide, methotrexate, and fluorouracil. AC stands for doxorubicin (Adriamycin) with cyclophosphamide, and ACT just indicates that a taxane drug is added to the regimen. Likewise, TC is an abbreviation for a regimen of Taxotere and cyclophosphamide.
RELATED: In Triple Negative Breast Cancer, New Drug Trodelvy Extends Life
In 2021, the FDA approved the immunotherapy drug pembrolizumab for the treatment of early-stage triple-negative breast cancer (TNBC). Pembrolizumab (Keytruda) is already used to treat other cancers, including melanoma and non-small cell lung cancer. Doctors heralded the FDA’s approval of pembrolizumab as a potentially paradigm-shifting advancement in breast cancer treatment.
For patients with stage 2 or 3 TNBC, adding the immune-boosting medication pembrolizumab to combination chemotherapy before surgery increases chances of living free of breast cancer, explains oncologist Dr. Sylvia Adams, director of the Breast Cancer Center at NYU Langone’s Perlmutter Cancer Center.
She was one of several researchers involved with the pembrolizumab trials. “It changes the standard of care and should be discussed with all patients diagnosed with stage 2-3 TNBC,” she adds. “Yes, it’s a game-changer, though there is much more to be learned.”
The First Immunotherapy Approved For Breast Cancer Hope For Triple Negative Breast Cancer
Is Your Cancer Really Triple-Negative?
Dr. Heather McArthur, Clinical Director of the Breast Cancer Program at Simmons Cancer Center at UT Southwestern Medical Center, has spoken with SurvivorNet on this relevant topic.
You might be told you have triple-negative breast cancer, that means that your cancer is not being fueled by any of the three main types of receptors: estrogen, progesterone nor the HER2 protein. But now you could be categorized as HER2 low instead of HER2 negative.
RELATED: Vegas Showgirl Dances Her Way Through Treatment for Triple Negative Breast Cancer
Breast cancer cells with higher-than-normal levels of HER2 are called HER2-positive, those with low levels of HER2 are (or were) called HER2 negative. Recently, however, researchers have looked to further expand this definition to include patients that have a minimal amount of HER2 expression but do not meet the classic definition for HER2-positive tumors. This group has been called HER2 “low” and is very important as it represents almost 50% of all patients with breast cancer.
This excitement stems from the fact that HER2-low breast cancers are targetable with a recently new FDA-approved Enhertu (Fam-trastuzumab deruxtecan-nxki). It appears that Enhertu is extremely effective for appropriate patients and can greatly improve their quality of life and help them live longer.
Therefore, it is exceedingly important to discuss with your physician about your HER2 status.
What to Know About Screening For Breast Cancer
The medical community has a consensus that women between 45 and 54 have annual mammograms. However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) is saying that women should start getting mammograms every other year at the age of 40, suggesting that this lowered the age for breast cancer screening could save 19% more lives.
WATCH: Screening for Breast Cancer
For women aged 55 and older, the American Cancer Society recommends getting a mammogram every other year. However, women in this age group who want added reassurance can still get annual mammograms.
Women who have a strong family history of breast cancer, have dense breasts, have a genetic mutation known to increase the risk of breast cancer, such as a BRCA gene mutation, or a medical history, including chest radiation therapy before age 30, are considered at higher risk for breast cancer.
Understanding the BRCA Gene Mutation
Experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk for developing breast cancer, you should begin screening earlier.
Breast density is determined through mammograms. However, women with dense breasts are at a higher risk for developing breast cancer because dense breast tissue can mask potential cancer during screening. 3D mammograms, breast ultrasound, breast MRI, and molecular breast imaging are options for women with dense breasts for a more precise screening. It is important to ask your doctor about your breast density and cancer risk.
Although breast cancer can happen to anyone, certain factors can increase a person’s risk of getting the disease. The known risk factors for breast cancer include:
- Older age
- Having a gene mutation such as the BRCA1 or BRCA2
- Added exposure to estrogen
- Having children after the age of 30
- Exposure to radiation early in life
- Family history of the disease
RELATED: Is Genetic Testing Right for You?
Different types of genetic testing can help people with a family history of cancer better ascertain their cancer risks. Your doctor will discuss your family history of cancer with you in the context of your type of tumor and your age at diagnosis. Hereditary genetic testing is usually done with a blood or saliva test.
The second test involves the genetic sequencing of your tumor if you’ve been diagnosed with cancer by this point. These genetic changes can be inherited, but most arise during a person’s lifetime. This process usually involves examining a biopsy or surgical specimen of your tumor. This testing can lead to decisions on drugs that might work against your cancer
About ten percent of breast cancers are hereditary, says Dr. Ophira Ginsburg, Director of the High-Risk Cancer Program at NYU Langone’s Perlmutter Cancer Center.
“We encourage only those who have a family history to really get [genetic testing],” Dr. Ginsburg previously told SurvivorNet.
“I would say that if you have anyone in your family who was diagnosed with a very rare cancer. Or if you have a strong family history of one or two kinds of cancer, particularly breast and ovarian, but also colon, rectal, uterine, and ovarian cancer, that goes together in another cancer syndrome called the Lynch Syndrome,” Dr. Ginsburg adds.
When You’re Called Back After a Mammogram: Breaking Down the Numbers
Staying Positive Despite Adversity
We love how Cutts remained positive and hopeful throughout her cancer journey, which is why we’d like to point out how SurvivorNet specializes in covering the lives of people who overcome seemingly insurmountable obstacles. Often, seeing the positive helps them maintain their resilience.
WATCH: Defining and Building Resilience
Dr. Zuri Murrell, an oncologist at Cedars-Sinai Medical Center, previously SurvivorNet about the role of a positive outlook on survival rates, saying, “I’m pretty good at telling what kind of patient are going to still have this attitude and probably going to live the longest, even with bad, bad disease. And those are patients who, they have gratitude in life.”
Resilience is an important trait, but not the easiest to build. The ultimate goal is not to avoid tough times, but to be able to bounce back from them. And yet, when they are faced with an overwhelming, life-changing situation, how do people shift their view? How do they learn to see the problem as temporary, rather than permanent, and figure out a solution?
It’s complicated, because building resilience is more about your mental and emotional fortitude than anything else. According to the American Psychological Association, “the resources and skills associated with more positive adaptation (i.e., greater resilience) can be cultivated and practiced.” In other words, resilience is not something you’re born with, which should be encouraging. Instead, after every challenge in your life, you build more and more resilience to those hard times.
Contributing: SurvivorNet Staff
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