Triple negative breast cancer: from symptoms to new treatments
The triple negative breast cancer It’s a fairly aggressive type of breast cancer. According to the report, it is responsible for 15% of the 55,000 cases of breast cancer “Cancer numbers in Italy 2021”every year they register in Italy 8,000 new cases.
What is triple negative breast cancer?
It’s about one of the more aggressive forms and difficult to heal. This means that it has a greater tendency than others to spread rapidly (and thus metastasize) and reappear after treatments have ended. The term “triple negative” means that the cells are cancerous Three receptors are missing: that of estrogen (ER), that of progesterone (PR) and that for human epidermal growth factor (HER2). And since all three are molecular targets for which there are targeted treatments, It is a tumor in which an application is not possible this Therapies, very effective and minimally invasivewhich are instead used to treat other types of breast cancer.
Bad lifestyle habits such as lack of exercise, alcohol, smoking, obesity, a high-fat and low-vegetable diet are risk factors that increase the risk of developing breast cancer. However, you can counteract this by making healthier lifestyle changes. Between risk factors not changeableInstead there is:
- Old under 50;
- familiarity with breast cancer (private or family);
- To be available genetic mutationsespecially BRCA1.
Triple negative breast cancer: symptoms
Similar to other forms of breast cancer, triple negative can also present with some of these symptoms:
- occur from palpable nodules or visible on the udder;
- Change in the shape of the nipple (in out or in);
- change in the appearance of Breast (asymmetries) and the breast skin (in places orange peel);
- secretions of a nipple (If the loss occurs on both nipples, the cause could be hormonal instead);
- Magnification of lymph nodes armpits.
There are two types of prevention: primary and secondary. There primary prevention refers to modifiable risk factors. Means that live a healthy lifeAdopting healthy behaviors and habits reduces the risk of developing breast cancer. Some examples: Eat lots of fruits and vegetables, fiber, good fats, stop or don’t start smoking, drink alcohol as recommended, get physical activity, keep your weight under control by avoiding overweight or obesity avoid. There secondary preventionhas something to do with that exams From screening and those it targets early diagnosis.
There is a nationwide screening program to detect all types of breast cancer at an early stage. This program offers the opportunity to to all women between the ages of 50 and 69carry out every two years A free mammogram. In some Italian regions, screening has been extended to two additional age groups: between 45 and 49 on an annual basis; and every two years between the ages of 70 and 74. Mammography is an examination in which the breast is pressed between two plates to take an X-ray. It allows you to detect the presence of any tumor formations. In general, before the age of 50, women with a familiarity or with special characteristics of the breast are prescribed mammography by their doctor or gynecologist (in this case, however, it is not a screening but diagnostic tests prescribed ad hoc). .
If you experience lumps or any of the symptoms described aboveBreast cancer can be detected early with aUltrasonic. It is a useful test, especially for examining young breasts. It must be prescribed by your doctor.
If the personal history reveals information that puts a woman at an increased risk of breast cancer, such as the possible presence of inherited genetic mutations, the doctor may consider performing it genetic testing for analysis of the BRCA 1 and 2 genes. If this verification is successful, the prior checking measures can be strengthened, for example by carrying out a MRI able to detect the tumor very early, or – and it does Famous case of actress Angelina Jolie – fall back on mastectomy preventivethen for surgical removal of the breast.
How do you treat triple negative breast cancer?
As with many other types of breast cancer, triple negative breast cancer is also affected the operation it is undoubtedly a mainstay of treatment. There are two types: conservative and invasive. The first is called quadrantectomyconsists in the removal of only the area of the breast where the tumor is located and its spread since the eighties is due to the intuition of Umberto Veronesi.
The second that mastectomypredicts instead the removal of the whole gland Breast. In the case of triple-negative tumors, however, the procedure is often also performed Removal of axillary lymph nodesif signs of the disease have been detected by analyzing the sentinel lymph nodes (the first to be reached by cancer cells).
Until recently, the only treatment option for patients with triple-negative cancer was Chemotherapy. Today, after an operation, it still plays an extremely important role, but presents itself important therapeutic limitations. Indeed, in many cases it is not possible to eliminate potentially remaining tumor cells after the operation, and the occurrence of recurrences or metastases can only be partially prevented.
«After the surgical phase, chemotherapy remains a priority in triple-negative breast cancer,” he explains Alessandra Fabi, Head of UOSD Precision Medicine in Senology, Agostino Gemelli IRCCS University Hospital Foundation in Rome. “But about that Today they can be associated with immunotherapy And targeted drug treatments based on the genetic mutations that characterize the different forms».
Immunotherapy and targeted drugs
Among the new therapeutic weapons available to physicians to treat triple negative breast cancer are immunotherapy She Parp Inhibitors. The first case involves drugs, i.e. molecules that can trigger a reaction of the immune system against tumor cells.
Recently in the scientific journal New England Journal of Medicineone was released Study on the efficacy of an immunotherapeutic moleculefrom the name pembrolizumab. The study, which aimed to evaluate the use of pembrolizumab in addition to standard therapy with chemotherapy, produced excellent results. In fact, the combination has been shown to be extremely effective in prolonging overall survival after the disease compared to chemotherapy alone.
In the second case, however, we are talking about targeted drugs capable of selectively attacking tumor cells. They are used in the presence of mutations in the BRCA 1 and 2 genes. For several years, the Italian Medicines Agency (Aifa) has authorized its use in clinical practice olaparib, a molecule belonging to this category. In the studies conducted, its use led to a significant improvement in survival.
A new medicine
Additional treatment options for patients with advanced triple-negative breast cancer may arise from another class of drugs: Drug Conjugated Antibodies. In particular, as presented at the recent American Society of Clinical Oncology (ASCO) Congress, dal sacituzumab govitecan, recently approved by US and European regulators.
It’s a drug that combines the potential of chemotherapy those of monoclonal antibodies. In fact, it is able to deposit the chemotherapy molecule directly into the diseased cell and kill it. Today the molecule is sacituzumab govitecan Approved in over 40 countries for the treatment of adult patients with inoperable, locally advanced or metastatic triple-negative breast cancer who have received two or more prior systemic therapies, at least one of which was for metastatic disease.
Life expectancy in triple negative breast cancer
Triple negative is a particularly aggressive form of breast cancer. And for that it presents a average survival from the diagnosis lower than the other forms. However, the expert from the Polyclinic of Rome recalls: “le Resources made available through research Science has made this possible in recent times and will continue to do so in the future significantly improve survival after the diagnosis”.