F or Breast Cancer Awareness Month, we reached out to Houston Methodist Hospital doctors and staff to answer four questions surrounding breast cancer.
There are approximately 42,000 new cases of triple negative breast cancer diagnosed in the United States each year; about 20 percent of all breast cancer diagnoses. Triple negative breast cancer is distinguished from other cancers in that it does not express the genes for estrogen receptor, progesterone receptor, and HER2 negative. Meaning, your pathology report would come back saying you were negative for ER- (estrogen receptors), PR- (progesterone receptors), and HER2- (HER2). Testing negative for all three of these hormones means the cancer is triple-negative and will not respond to hormonal therapy or HER2 directed therapies, such as Herceptin.Triple negative breast cancer makes up 20% of all breast cancer diagnoses Click To Tweet
Triple negative breast cancer is treatable, but it has the highest rate of recurrence. We are taking what we know in the lab to provide patients with better options with less toxicity to treat this aggressive disease.
2. What is the BRCA gene and who is at risk?
Kate Dempsey, genetics counselor in the Houston Methodist Cancer Center
BRCA1 and BRCA2 are just two of the 25,000 genes in our bodies. Each gene has a specific job, ranging from telling us what our eye color should be to how we should grow. BRCA1 and BRCA2 are two genes that are responsible for protecting us from cancer. They help stop tumors from growing and developing. BRCA1 and BRCA2 are found in every cell in our body, but work mainly in breast and ovary tissue. They serve as one of the “spellchecks” for our genetic information. As our cells grow, divide, and age, there can be changes to the genetic information in that cell. BRCA1 and BRCA2 work with a number of other genes to catch these changes, and signal for their repair.
A mutation can cause BRCA1 or BRCA2 genes to no longer function properly. When this happens, any changed genetic information is not repaired as it should be, which can lead to a cancer.
Only 5-10 percent of breast cancer is hereditary. Of all of hereditary breast cancer, approximately 70 percent is caused by mutations in BRCA1 or BRCA2. Approximately 1/300-1/500 individuals carry a mutation in their BRCA1 or BRCA2 genes.5-10% of breast cancer is hereditary and 70% of hereditary cases are caused by BRCA mutations Click To Tweet
Individuals with a personal or family history of the one or more of the following may be at risk to have a BRCA1 or BRCA2 mutation:
- Breast cancer diagnosed at or under the age of 50
- Multiple breast cancers in one or both breasts
- Triple negative breast cancer
- Ovarian cancer
- Breast cancer at any age with one or more relative with breast or ovarian cancer
- Male breast cancer
- Ashkenazi Jewish ancestry (1 in 40 individuals of Ashkenazi Jewish ancestry carry a mutation in either BRCA1 or BRCA2)
We encourage you to speak to a high-risk breast cancer physician or a genetic counselor about your family history. They will help you determine if genetic testing is right for you or your family, as well as help you develop a personalized cancer screening recommendations.
3. What are some tips when going through chemotherapy?
Jennifer Berry, registered nurse and director of infusion services in the Houston Methodist Cancer Center
- Stay active and maintain your normal routine and schedule
- Wear a button down or loose fitting shirt to your infusion appointment to allow easy access to your port
- Having your labs done the day before chemotherapy will help decrease the wait time the day of your infusion
- Schedule downtime for yourself
- Be sure to drink lots of fluids
- Reward yourself for milestones by doing something special to celebrate
- Give your body at least six months before you start feeling back to normal
Radiation therapy shrinks the tumor and kills cancer cells. Radiation to the breast is often given after breast-conserving surgery to help lower the chance that cancer will come back in the breast or nearby lymph nodes. It may also be recommended after mastectomy in patients either with a cancer larger than 5 cm, or when cancer is found in the lymph nodes. It is also used to treat breast cancer that has spread to other areas, for example to the bones or brain.