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Wednesday, June 23, 2021

New findings could change treatment of breast cancer

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When Nadia Miller was diagnosed with triple negative breast cancer in 2007, she was already familiar with the disease. Two years earlier, the 26-year-old Indianapolis native lost her older sister to the same disease. According to the American Cancer Society, this deadly form of breast cancer is more likely to affect Black women, who have a 42% higher mortality rate than white women. 

After completing treatment, which included a double mastectomy, Miller became an advocate for her health and the health of other women. In 2008, she joined Pink-4-Ever, a breast cancer awareness foundation started by her brother, John, as board president. But, despite her successful fight against cancer and the work she was doing in the community, the fear of her cancer recurring was always in the back of Miller’s mind.

“The fear of recurrence is a big piece of one’s mind space,” Miller said. “The mental anguish that one puts themselves through or the ‘what if there’s a recurrence, what if I have to go through this again?’”

New findings from the Indiana University School of Medicine may help put Miller’s, and the nearly 100,000 women in the United States living with triple negative breast cancer, minds at ease.

Milan Radovich and Bryan Schneider of the Indiana University Medical School found the presence of circulating tumor DNA (ctDNA) can help predict whether or not this form of cancer will recur in patients. They presented their findings at the San Antonio Breast Cancer Symposium on Dec. 13. 

Triple negative breast cancer is unique. Unlike other types of breast cancer, which are fueled by estrogen receptors, progesterone receptors and excess HER2 protein, the cancer cells test negative for all three.

“If you are a woman with triple negative breast cancer, after surgery you are in a constant ‘watch and wait’ scenario, in fear of the cancer coming back,” Radovich said in a press release. “We know that a significant proportion of these women will have disease relapse after surgery. ctDNA is a powerful tool to be able to predict recurrence and could help us identify the best ways to manage care for women diagnosed with the disease.”

According to the study, women whose plasma contains specific genetic material from a tumor have a 56% chance of being cancer free in a two-year span after treatment. For women whose plasma does not contain the genetic material, their chance of being cancer free after a two-year period is 81%. These tests can not only help give cancer survivors peace of mind, but can also serve as a proactive approach to treatment in women for whom recurrence is more likely to occur.

“Just telling a patient they are at a high risk for reoccurrence isn’t overly helpful unless you can act on it,” Schneider said at the symposium. “What’s more important is the ability to act on that in a way to improve outcomes.”

While triple negative breast cancer has a higher mortality rate in later stages than other forms of breast cancer, this finding may pave the way for more aggressive treatments for the disease. 

“While we have made extraordinary progress in treating many types of breast cancer, triple negative disease remains a formidable challenge,” IU School of Medicine Dean Jay L. Hess said in a press release. “We are dedicating substantial expertise and resources to this disease, and this discovery is an important step forward. We will continue to press ahead until we have new therapies to offer women with this most aggressive form of breast cancer.”

Due to the prevalence of triple negative breast cancer in African American women, Miller argues the importance of taking charge of one’s own health. She finds a large barrier for women is the lack of understanding about health issues and the resources available, as well as a lack of representation in medical literature. 

 “When someone goes to the doctor and there isn’t an awareness or understanding coming from the patient, it impedes upon the medical treatment they get,” Miller said. “More often than not, when people in the African American community do not have even the fundamental foundations like knowledge after diagnosis, they’re sitting in the doctor’s office and go in waiting for the physician to tell them the next steps.”

Miller speaks from experience. Despite watching her sister die of the disease, she didn’t consider her own risk until she was faced with a diagnosis. 

While the findings from the Indiana University School of Medicine are a promising step forward for cancer treatment, Miller urges women, especially those who are high risk for triple negative breast cancer, to learn everything they can about the disease and to open themselves up to dialogue about the illness.

“Women need to get involved and be proactive about their health,” Miller said. “[Cancer] is taboo until it knocks on their door. One in eight women will be diagnosed with breast cancer … It shouldn’t take you being diagnosed in order for you to get involved.”

Contact staff writer Breanna Cooper at 317-762-7848. Follow her on Twitter @BreannaNCooper.

breast cancer

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