There are many different types of BC but as far as I can understand, their growth is generally driven by one of three different things; Estrogen, Progesterone and Her2. This means that the tumour has receptors present on it and its growth is being driven by one of these three hormones/protein. In the case of Triple Negative, there are no receptors present on the tumour, therefore the factor causing the tumour growth is unknown.
Triple Negative BC is rare and accounts for only 10-20% of BC. It generally affects young women, African-American women and women with a genetic mutation. One of the things the Breast Care Nurse warned me not to do (and of course I did it!) was to google information surrounding Triple Negative. Triple Negative gets a very bad rep if you google it, with words such as 'most aggressive form of Breast Cancer." But for me, knowing everything I could know about it was more important than trying to save myself from reading these scary statements.
So what makes Triple Negative Breast Cancer so 'scary'?
Triple Negative is I guess less predictable than hormone/protein receptor BC as the growth factor fueling the tumour growth is unknown. It tends to be a very fast growing cancer and recurrence rates are higher for Triple Negative than they are for Hormone/Protein Positive BC. The five year survival rate for Hormone/Protein Positive BC is 93%, whereas for Triple Negative, it is 77%. The other worrying aspect of Triple Negative is that it currently has no targeted therapies available for treatment. Many Hormone/Protein Positive BC patients have another form of treatment available to them; Hormonal Therapy such as Tamoxifen and Herceptin. Hormonal Therapy can almost be like a safeguard to protect patients from recurrence as in some cases it can be taken up to 10 years after other treatments have ceased and it will in most cases inhibit any further Hormone/Protein Positive tumours from growing.
The most effective treatment available for Triple Negative is Chemotherapy. Chemotherapy may be the first part of treatment followed by surgery and radiation; Neoadjuvant treatment. Or treatment may consist of Surgery followed by Chemotherapy and Radiation; Adjuvant treatment. My treatment plan was Neoadjuvant, due to the large size of the tumour and the hope that Chemotherapy would shrink the tumour before surgery.
How do I feel about being Triple Negative?
- When I was initially diagnosed, I was terrified by the information I found online about Triple Negative BC, now not so much.
- I think all cancers are scary, nevermind the technicalities of the type of cancer but I wanted to be informed as much as possible about my own illness and I did that, I read and read and read until I had an understanding.
- I see myself as somewhat lucky that I don't have a hormone positive BC, as if I had I wouldn't have been able to attempt fertility treatments and the hormonal therapies I would have had to take after treatment may have affected my ability to have children even further.
- Somedays I am scared about recurrence rates, but mostly I don't think about it too much. Why? Because I could step out infront of a bus tomorrow and it'd all be irrelevant!
I'm currently waiting on the results of a genetic screening which I had done a few months ago. The genetic screening is just a blood test, which is sent to the UK to be analysed and takes 5 months to come back! The result of this test will be very important in determining the type of surgery I have done so I'm hoping the results come back in time!
The results of this screening will answer some questions for me but regardless of this I refuse to spend my time scared because I have an 'aggressive' form of cancer which has a 23% chance of recurring over the next 5 years. All you can do is hope you will be one of the lucky 77%.
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