• Taking on Triple Negative Breast Cancer

    Personal Stories, Research

     

    The thought that it might be breast cancer never crossed Kathy’s mind when she felt an excruciating pain in her chest last November. After working as a nurse and then hospital president with the Franciscan Health System in the Seattle area for 26 years, Kathy Bressler had just accepted an exciting promotion with the same company, and was planning a move to Omaha, Nebraska.

    She thought the sudden and burning pain she felt may have been a ruptured muscle – after all, her pain ultimately went away, and it’s a common thought that “if it hurts, it’s probably not breast cancer.” But after encouragement from her husband, she went to get a mammogram. It came back clean, and Kathy was ready to move on with the next chapter of her life. But the results of a breast ultrasound, which revealed a 1.7 cm tumor near the surface of her skin, set her life on a new path.

    “It was black and ugly, with arms and legs. It looked evil, the way you would think cancer looks,” Kathy remembers. 

    Kathy is no stranger to breast cancer, losing both her mom and grandmother to this terrible disease. She had been actively involved with Komen Puget Sound: racing, walking, serving on their Board of Directors and as Board President– doing anything she could to help end this disease.

    Now faced with her own diagnosis, Kathy knew she wanted to put breast cancer as far behind her as possible, opting for a bilateral mastectomy (despite being a candidate for less extensive surgery). The surgery revealed three more tumors that had gone undetected, and the pathology report came back: triple negative.

    Even though TNBC only accounts for approximately 15 percent of all breast cancers, Kathy was still surprised to learn that her recommended course of treatment would include the same chemotherapy her mother received… 25 years ago.

    Triple negative breast cancer (TNBC) is difficult to treat because of what it lacks: estrogen receptors (ER), progesterone receptors (PR), and human epidermal growth factor 2 (HER2). These three types of receptors drive the majority of breast cancers, and as a result, established therapies that target these receptors are ineffective against TNBC, making it especially difficult to treat.

    While great progress has been made in treating many forms of breast cancer, current treatments for TNBC often target all of the actively dividing cells in the body (including the healthy ones!) resulting in inadequate tumor responses and often severe side effects.

    This aggressive subtype of breast cancer also disproportionately affects women with a BRCA gene mutation, young women and African-American women. There is great urgency in the breast cancer community to better understand and treat this aggressive type of breast cancer – to offer women like Kathy and so many others better treatment options.

    Susan G. Komen has invested more than $111 million in over 150 research grants and 30 clinical trials focused on TNBC, covering everything from the basic biology of a TNBC breast cancer cell to promising treatments that are currently in clinical trials.* Here are five projects that we are particularly excited about:

    • Komen Scholar Dr. Jennifer Pietenpol of Vanderbilt University has discovered 6 different subtypes of triple negative breast cancer, each with unique genetic differences. These differences could be used to develop targeted therapies for TNBC, which are lacking as treatment options. Dr. Pietenpol is currently developing clinical trials to test these targeted therapies.
    • Dr. Giorgio Seano, a young investigator at Massachusetts General Hospital, is working to improve the effectiveness of traditional radio- and chemotherapy in TNBC by testing a newly identified drug that may reduce the overgrown network of blood vessels known to strengthen and support these breast tumors.
    • Another Komen-funded young investigator, Dr. Kareem Mohni of Vanderbilt, is using big data approaches to identify genetic characteristics of TNBC tumors that may be most responsive to a promising new drug combination.
    • Also at Vanderbilt, Dr. Justin Balko is tackling the question of how to best prevent recurrences of TNBC following neoadjuvant chemotherapy followed by surgery. Dr. Balko is studying TNBC cells that survived chemotherapy to identify potential drug targets that could be exploited to take down these highly resistant cells.
    • Finally, Dr. Max Wicha of the University of Michigan received a Komen Promise grant to study the role of breast cancer stem cells in TNBC, and whether the increased presence of these cells in women of African descent may contribute to the increased likelihood of developing TNBC in these women. Dr. Wicha is also testing several potential drugs that target breast cancer stem cells in early stage clinical trials.

    This groundbreaking research will bring new options and hope for the thousands of women and men facing TNBC around the globe. But until we get there, we think Kathy said it best:

    “TNBC is rare, so I understand why we don’t yet have all the answers. But it’s out there, it’s still happening and it’s really aggressive. It’s not the end of anything – it’s the beginning of a new journey. Yes it will change you forever, but it doesn’t have to be for the worse.

    “And to those who ask why I lost my hair, I say, because we don’t know enough yet, so pull out your pocketbook! Until it’s no longer 1 in 8, we must continue this fight, we must continue to raise awareness and dollars, and we must continue to walk until we’ve ended breast cancer once and for all.”

     

    *TNBC Research investment updated from time of original blog publication.

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