Question: My daughter was diagnosed w/trip neg breast cancer two years ago…She was 58, Caucasian, postmenapausal, no family history, on statins and an anti-depressant…Her only known risk factor was being extremely overweight (200+lb)…She had a lumpectomy…Her tumor was large but nodes were clear…she was treated with max chemo and radiation…her case is singular compared to the usual trip neg patient, I think…would her case indicate any potential differenece in cancer recurring percentage or for any new, additional treatment?

Answer: You are correct in saying that your daughter doesn’t fit the more common triple negative patient profile because they tend to occur in younger women and are more prominent in African-American women, but this is a heterogenous type of cancer and I have seem them in all age groups and in patients without a family history of breast cancer or BRCA1/BRCA2 mutations.  

It is good news her nodes were clear but you didn’t mention the size of the tumor so it is difficult for me to determine her stage.  Stage and grade of the tumor (most are high grade) are important in determining prognosis, not just the triple negative status. Also, I assume her surgical margins were clear before continuing with radiation therapy.  It was appropriate to then get chemotherapy and radiation therapy (since it was a lumpectomy).  It is good news she is two years out without a recurrence and now it is important that she continues to follow-up with her medical oncologist and try to maintain a healthy lifestyle.

As you are probably aware there has been a lot of research on triple negative breast cancer and the so-called “basal phenotype” breast cancer.  Many studies are looking at the “platinum” family of chemotherapy agents to see if they are more efficacious in triple negative tumors. If you would like any references to studies or ongoing clinical trials please feel free to contact me and I can email you directly.