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Approximately 3.5 million women in the U.S. are living with breast cancer, including more than 154,000 with disease that has spread beyond the breast to other parts of the body, known as metastatic breast cancer (stage IV). The outlook for non-metastatic breast cancer patients has overall improved, with an average five-year survival rate reaching close to 100 percent for people with stage 0 or I breast cancer, and 93 percent for people with stage II breast cancer.

The prognosis for those women diagnosed with metastatic breast cancer is not as promising. But, as research continues, progress is emerging. The percentage of women surviving five years with metastatic breast cancer (aged 15-49) doubled from 18 to 36 percent between 1994 and 2012.

“Sometimes metastatic breast cancer can be considered much more of a chronic disease,” said Denise A. Yardley, M.D., a senior investigator at the Sarah Cannon Research Institute in Nashville, TN. “I’ve seen a positive impact on patients who continue relatively normal lives despite their disease and treatment.”

DENISE A. YARDLEY, M.D.

DENISE A. YARDLEY, M.D., FROM THE SARAH CANNON RESEARCH INSTITUTE BELIEVES WE ARE SEEING PROGRESS IN THE TREATMENT AND PROGNOSIS OF METASTATIC BREAST CANCER.

Treatment Advances Are Constantly Occuring

There are many forms of metastatic breast cancer. Patients’ tumors can be either positive or negative for growth receptors, signaling the presence or absence of the known drivers of the disease. And they may or may not have disease driven by HER2 (human epidermal growth factor receptor 2) receptors. That complexity and the cross signaling from the HER2 receptor to other growth factor receptors, as well as the multitude of treatments available to treat metastatic breast cancer are part of the reason it has been a particularly difficult disease to treat. But translational researchers are making significant strides to further understand tumor biology and the genomics behind breast cancer subtypes.

The end result is a more tailored treatment approach based on a patient’s specific tumor biology and other clinical factors. With an expansion in targeted therapies, there is greater value in having patients’ tumors thoroughly examined so treatments are better selected. “We’re continuing to try to improve our precision medicine and really tailor treatments to what’s going on in that specific patient’s tumor,” Yardley said.

Doctors also have a better understanding of how to use the growing array of treatments. While combination therapy is used in early stages of breast cancer, recent studies have provided additional evidence on how to  sequence treatment options for their patients. We now also focus  on balancing symptom control with quality of life and partnering with our patients to make appropriate treatment selections at any given time.”

There’s every reason to be optimistic for patients facing the diagnosis and challenges of metastatic breast cancer today.

Preventing Metastasis from the Start

About 30 percent of women with early stage breast cancer eventually develop metastatic disease. So in addition to improving the treatment of metastatic breast cancer, researchers are trying to continue to improve the cure rate and thus prevent breast cancer from becoming metastatic in the first place.

Metastatic Breast Cancer TreatmentMost women with early stage breast cancer will have surgery during the course of their treatment. Now, many are also candidates for  a variety of systemic therapies, either before or after surgery, to reduce the number of potentially microscopic cancer cells left behind and prevent the disease from coming back. Chemotherapy  is usually reserved for patients at higher risk for a recurrence or metastasis.

“We want to make sure we’re appropriately recommending specific therapies but sparing patients who have a lower risk of disease recurring and becoming metastatic,” Yardley said.

By administering these medications earlier, when the disease is still operable, researchers aim to increase the cure rate and prevent—or at least delay—recurrence and metastasis in breast cancer patients.

More Work to Be Done

Admittedly, much work remains to be done, according to Yardley. Over the last 60 years, breast cancer survival rates have tripled, but metastatic survival rates have a long way to go before they reach that level.

Clinical trials play an essential role in exploring new treatments and approaches in metastatic breast cancer, and these trials continue to become more targeted as researchers learn more about the disease subtypes. For instance, while immunotherapies have not proven effective in studies for metastatic breast cancer in general, trials investigating immunotherapy in specific breast cancer subtypes such as triple negative breast cancer have shown promising activity. Thus, targeted treatments in combination with chemotherapy continue to demonstrate great promise.

“The science has become astounding, allowing us to manipulate the biology of metastatic breast cancer through very tailored approaches,” Yardley added. “There’s every reason to be optimistic for patients facing the challenges of metastatic breast cancer today.”

To learn more about a patient’s experience with metastatic breast cancer, read “How This Metastatic Breast Cancer Survivor Told Her Family About Her Diagnosis.”

It wasn’t easy the first time. When Kimberly Jewett was 31, she found herself listening to a doctor explain what her breast cancer diagnosis meant and what her treatment options were. But at that moment, Kimberly was thinking less about herself and more about her daughter Kalli and her son Tyler, who were 6 and 4 at the time.

“I was in shock,” Kimberly recalled. “All I could think was, ‘How do I tell my children?’”

Answering that question wasn’t any easier the second time around. Four years after Kimberly survived her first battle with breast cancer, the disease came back as metastatic breast cancer that had spread to other parts of her body. Although she knew that three out of four women who are first diagnosed with an early-stage breast cancer eventually progress to metastatic breast cancer, it was still shocking news. Her outlook was significantly less hopeful: while 90 percent of women with breast cancer are alive five years after being diagnosed, only 36 percent of women with metastatic breast cancer survive that long.

Meanwhile, her children were also older. At 8 and 10, they had a better understanding of life and death, making the experience even scarier for them. They began asking difficult questions. When they asked if she was going to die, Kimberly didn’t know what to say.

Kimberly is one of the 266,000 women each year who have to come home from the doctor’s office and tell their families that they have breast cancer. These conversations are never easy. They can be even more difficult when young children are involved, which happens frequently; an estimated 30 percent of all breast cancer in women under the age of 45 is diagnosed within a few years after giving birth.

Now in remission once again, Kimberly is teaming up with her daughter Kalli to share their stories to help other families better navigate the difficult conversation and emotions that come with a breast cancer diagnosis.


WHEN KIMBERLY JEWETT (CENTER) WAS DIAGNOSED WITH BREAST CANCER, SHE HAD THE DIFFICULT TASK OF EXPLAINING HER DISEASE TO HER CHILDREN TYLER (LEFT) AND KALLI (RIGHT).

Honesty, the Best Policy

The fact that conversations may be difficult doesn’t mean they should be avoided, according to Kimberly. When she was diagnosed, her initial instinct was to protect her children from the news. But she quickly realized that keeping her disease a secret would damage her relationship with them and undermine the trust she wanted in her family.

Her kids would have eventually found out anyway, Kimberly figured, which might have distorted the truth and amplified their fears. So she believed that it was better that they heard the truth from her.

“It was also hard to shield my kids from my diagnosis because I was so emotional all the time,” Kimberly said. “My husband and I decided to tell them once my diagnosis was finalized and we knew my treatment plan.”

Looking back, Kimberly believes that one of the best things she did for her children was to be open and honest with them. By sharing her feelings with her kids, she opened the door for them to share their questions and fears with her.

“They came to me with a ton of questions, like, ‘Are you going to be okay?’ and ‘Am I going to get it?’” Kimberly said.

Sometimes, she admitted to them that she didn’t have all the answers, and that was ok. She told them that she wasn’t sure what would happen and what that meant for their future. But she assured them that whatever happened, they would find the answers together.

We continue to talk about what would happen if my breast cancer came back. All we can do is remain hopeful and continue to pay it forward by inspiring others and sharing our story.

Preparing for Difficult Conversations

Kimberly felt like she had no one to turn to for advice on breaking the news to her children. No friends or family members had gone through similar situations, and she wasn’t involved with any cancer support groups at the time.

So she started searching online for information. She found a comprehensive guide on BreastCancer.org on how to talk to children of all ages and bought children’s storybooks specifically dedicated to breast cancer. These resources were helpful in having those difficult conversations with her children.

Having now had these conversations twice with her kids, other mothers are turning to Kimberly for advice. She highly recommends an app called The Magic Tree for Breast Cancer, developed by Celgene, as a starting place. The app explains the disease in a kid-friendly way so mothers don’t have to navigate the conversation alone, according to Kimberly. It incorporates videos and games that help to answer difficult questions such as, “What is cancer?”, “Did I cause this?”, and “Can you catch it?”

“I remember reading my kids a book about a booboo on a mom’s breast, but the app does this in a video that is much more engaging for them,” Kimberly said.

Kalli—now 16—agrees. “We were so young, we didn’t understand what was truly happening. An app like this would have definitely been helpful for us.”


THE MAGIC TREE IS AN APP CREATED BY CELGENE SPECIFICALLY FOR CHILDREN AGES 5-8 WHO HAVE A LOVED ONE WITH BREAST CANCER. THROUGH ANIMATED VIDEOS, GAMES AND DISCUSSION GUIDES, THE APP EXPLAINS WHAT CANCER IS, HOW IT AFFECTS THE BODY, AND OFFERS TIPS ON HOW TO DISCUSS TREATMENT.

Silver Linings

Kimberly said that because her kids understood what she was going through, they felt like they were part of her support system. They wanted to help her and, in the process, formed a deeper bond with their mother. Kimberly’s battle with breast cancer became a shared experience in their family.

“I wanted to take care of my mom as best as I could,” Kalli said. “She was always sitting in the same chair, tired and exhausted from her treatments. I would ask if she needed anything. I remember bringing her ice cream or whatever she asked.”

Her experience as one of her mother’s caregivers and witnessing cancer’s devastating toll firsthand certainly made a lasting impact on Kalli, who is now considering a career in oncology.

Having those difficult conversations helped to put everything into perspective for the Jewett family. Kimberly found incredible joy in sharing little moments with her children—such as watching Tyler pitch a 60-mph fast ball in a baseball game and taking Kalli to her first high school dance.

While the Jewett family are enjoying their busy lives together, they know that there’s a chance that Kimberly’s breast cancer could come back one day. “We continue to talk about what would happen if my breast cancer came back,” Kimberly said. “All we can do is remain hopeful and continue to pay it forward by inspiring others and sharing our story.”

HAVING THOSE DIFFICULT CONVERSATIONS HAS HELPED THE JEWETT FAMILY RECOGNIZE THE IMPORTANCE OF ENJOYING THE LITTLE MOMENTS IN LIFE SUCH AS TYLER’S BASEBALL GAMES.

To help facilitate conversations about breast cancer such as the ones that Kimberly had with her children, Celgene has launched The Magic Tree mobile app with input from patient advocacy groups and clinical experts. The Magic Tree is an educational interactive app with videos and activities designed to help families and their children (ages 5 to 8) to have meaningful and open discussions about a breast cancer diagnosis. The app is available for download in the United States on both Apple and Android devices.

When she was diagnosed with metastatic breast cancer in 2006, Margaret Zuccotti had just given birth a month prior and was also caring for her other two children who were aged three and six at the time. With the stress of caring for her children and researching her treatment options at the same time, much of that time in her life remains a blur. But she does recall trying hard not to tell her kids about her breast cancer diagnosis until after the treatment plan was determined.

“If I had a chance to do it again, I’m not sure I would have done it that way,” Zuccotti said. “All children, even little ones like my three-year-old, pick up on stress and emotional changes in the family. They know something is going on. I think it’s important for a mother to share her breast cancer diagnosis with her kids.”

Being diagnosed with metastatic breast cancer while parenting young children is becoming more common; the number of women aged 25 to 39 diagnosed with metastatic breast cancer has increased 2.1 percent each year on average between 1976 and 2009. Zuccotti reflects on how she approached the difficult discussion with her children about her breast cancer diagnosis, so that other mothers can learn from her experience.

BREAST CANCER SURVIVOR MARGARET ZUCCOTTI BELIEVES THAT IT’S IMPORTANT FOR MOTHERS WHO ARE DIAGNOSED WITH BREAST CANCER TO LET THEIR KIDS KNOW WHAT IS HAPPENING THROUGHOUT THE JOURNEY.

BREAST CANCER SURVIVOR MARGARET ZUCCOTTI BELIEVES THAT IT’S IMPORTANT FOR MOTHERS WHO ARE DIAGNOSED WITH BREAST CANCER TO LET THEIR KIDS KNOW WHAT IS HAPPENING THROUGHOUT THE JOURNEY.

Finding the Right Words

When her treatment plan was confirmed, Zuccotti decided to tell her kids that she was sick and would have to take a lot of medicine to get better. She wanted to make sure that they knew to come to her and her husband for information and with any questions. That way they could address their concerns and find the answers to their questions together.

As a former school teacher, Zuccotti understood that books could help her children with this stressful situation and feel more at ease with any feelings of anger and sadness. Furthermore, she wanted to create a safe environment for them to share their concerns by holding them in her lap while reading together.

She found several cancer-related books. One book with a picture of a woman sitting in an infusion chair with an intravenous line helped her explain to her children what her treatment would look like.

Above all else, Zuccotti believed it was crucial to reassure her children that she loved them very much and that they were going to be okay. “It was important for me to say that ‘Mommy has cancer, but you’re not going to catch it,’” she said. “If kids know others who have died or suffered from cancer, you can tell them that everyone’s disease is different and explain more about yours.”

I think it’s important for a mother to share her breast cancer diagnosis with her kids.

An Ongoing Story

When Zuccotti told her six-year-old about her breast cancer, he said, “I understand. I don’t feel great today either,” and hopped off his bed and began to play again.

“Kids most likely won’t get it the first time around,” Zuccotti said. “It can’t be a one-and-done conversation. It’s essential you talk about what’s going on throughout the process and prepare them for anything that might change, especially things that may change regarding physical appearance.”

She told her kids her hair would begin to fall out because of the medicine and that she would shave her head when they were at school. Her three-year-old asked if she could touch her bald head, but her six-year-old just wanted her to put her scarf back on.

Before her mastectomy, Zuccotti warned her kids that she wouldn’t be able to hug them for two weeks. Together, they created a new ritual to share their love: the pinkie hug.

While she kept the conversation going throughout her treatment, Zuccotti didn’t share everything. She tried to focus on what she thought was appropriate based on their ages.

AS HER KIDS HAVE GROWN, THEY BETTER UNDERSTAND WHAT THEIR MOTHER HAS GONE THROUGH. THEY JOIN HER IN VOLUNTEER WORK WITH LIVING BEYOND BREAST CANCER, PARTICIPATING IN EVENTS SUCH AS THE ANNUAL YOGA FUNDRAISER.

AS HER KIDS HAVE GROWN, THEY BETTER UNDERSTAND WHAT THEIR MOTHER HAS GONE THROUGH. THEY JOIN HER IN VOLUNTEER WORK WITH LIVING BEYOND BREAST CANCER, PARTICIPATING IN EVENTS SUCH AS THE ANNUAL YOGA FUNDRAISER. 

Tell the Other Adults in the Room

Beyond sitting down and explaining her breast cancer diagnosis with her children, Zuccotti also told a few teachers and counselors at her children’s school and summer camp. She told her children whom she spoke to and encouraged them to reach out to those adults if they needed to talk with someone about what was going on at home.

“You don’t have to tell everything to people, but you may want to let the school know,” Zuccotti said. “If your wonderful child turns into the most disruptive one in the class, it’s pretty easy to figure out why.”

When sharing details with other adults, she made sure to tell them what her kids did and didn’t know, so they never inadvertently brought up something she might not have been ready to discuss.

As her kids have grown, they better understand what their mother has gone through. They join her in volunteer work with Living Beyond Breast Cancer, participating in events such as the organization’s annual yoga fundraiser. “The yoga on the steps of the Philadelphia Museum of Art event has been a cool way to fold my kids into what’s going on,” Zuccotti said.

To help facilitate conversations about living with breast cancer such as the ones that Zuccotti had with her children, Celgene has launched the Magic Tree mobile app with input from patient advocacy groups and clinical experts.They have also become pillars of support for their friends when a family member has been diagnosed with cancer. Her oldest child, now 17, has provided comfort to three classmates during the difficult times when their mothers were diagnosed with breast cancer. “It made him feel helpful,” she said. “They really helped keep me going when I was being treated, and it’s nice to see them do the same for others as well.”

To help facilitate conversations about living with breast cancer such as the ones that Zuccotti had with her children, Celgene has launched the Magic Tree mobile app with input from patient advocacy groups and clinical experts. The Magic Tree is an educational interactive app with videos and activities designed to help families and their children (ages 5 to 8) to have meaningful and open discussions about a breast cancer diagnosis. The app is available for download in the United States on both Apple and Android devices.

 

People who are diagnosed with triple-negative breast cancer can sometimes feel scared and pessimistic, especially considering the five-year survival rate is 17 percent lower for this disease than for all other breast cancers. But for Ricki Fairley, a 60-year-old triple-negative breast cancer survivor, it was an opportunity to reinvent herself. She divorced her husband, sold her home and bought a one-bedroom beachfront condo on the Chesapeake Bay where she now paddleboards on most days.

As we recognize and celebrate the strength of those living with triple-negative breast cancer on Triple-negative Breast Cancer Awareness Day (March 3) and throughout the entire month of March, Fairley wants to help others understand what makes this form of breast cancer different from the others by sharing her journey with the disease.

Why is Triple-Negative Breast Cancer Awareness Day important to you?

We know that Breast Cancer Awareness Month happens each October, but triple-negative breast cancer is special and different. Triple-negative breast cancer is harder to treat than other breast cancers because no targeted therapies can effectively treat it and prevent recurrence. I am African American and know that triple-negative breast cancer disproportionately affects young African-American women. We need to raise awareness of the facts about triple-negative breast cancer and invest in more research.

There’s always something new to keep looking forward to in my life. I feel very blessed to be alive today.

Do you believe that there are misconceptions about triple-negative breast cancer?

People don’t understand it until they are in it. I see helping people understand triple-negative breast cancer better as my purpose, especially in the African American community. I have worked in the Washington D.C. area to help bring in women off the street to get their breasts checked. We call it “Makeovers and Mammograms.” Women just don’t understand the necessity of it until it’s too late and they’re diagnosed with the disease.

How did you learn that you had triple-negative breast cancer?

In 2012, my doctor found a lump under my nipple and performed a biopsy. That led to my diagnosis. When I started Googling triple-negative breast cancer, everything that I found was pretty morbid and negative as well. It was pretty scary at the time. But I believed that God had other plans for me. So I got the best medical care I could and sought out second opinions. I got a double mastectomy, six rounds of chemotherapy, radiation and then more chemotherapy. It sucked.

How did you remain positive during your treatment?

At the time, my youngest daughter was a sophomore at Dartmouth College. I was determined to see her graduate in 2014. I graduated from Dartmouth, as did my father and my older daughter. My oncologist told me that his other patients with triple-negative breast cancer did not live more than two years after being diagnosed. I just said that I was a survivor, and I was going to beat this. I lived to see not only my youngest daughter graduate college but also my older daughter get married in 2015. And now my oldest daughter is pregnant, so there’s always something new to keep looking forward to in my life. I feel very blessed to be alive today.

DESPITE HER DIAGNOSIS OF TRIPLE-NEGATIVE BREAST CANCER, RICKI FAIRLEY (LEFT) WAS DETERMINED TO SEE HER OLDEST DAUGHTER AMANDA’S (CENTER) WEDDING DAY. HER YOUNGER DAUGHTER HAYLEY (RIGHT) WAS A BRIDESMAID AT HER SISTER’S WEDDING.

DESPITE HER DIAGNOSIS OF TRIPLE-NEGATIVE BREAST CANCER, RICKI FAIRLEY (LEFT) WAS DETERMINED TO SEE HER OLDEST DAUGHTER AMANDA’S (CENTER) WEDDING DAY. HER YOUNGER DAUGHTER HAYLEY (RIGHT) WAS A BRIDESMAID AT HER SISTER’S WEDDING.

How do you feel about the progress being made in triple-negative breast cancer research?

I know the hard work that is being done, and we have the momentum to find preventative treatment. But too many young women are still dying from this disease. My friend was diagnosed with triple-negative breast cancer at the age of 26 and passed away just before she turned 29. That can’t keep happening. If we can raise awareness with women and doctors, maybe we can change the outcomes for patients.

What are your plans for this year’s Triple-Negative Breast Cancer Awareness Day?

I’m the Board Chair of the Triple Negative Breast Cancer Foundation, and we have an aggressive schedule of outreach and fundraisers. The coolest thing that I’ve done so far was getting to ring the Nasdaq stock market closing bell a couple of weeks ago.

BY WEARING PINK SHOES, RICKI FAIRLEY HELPS TO RAISE AWARENESS OF TRIPLE-NEGATIVE BREAST CANCER.

BY WEARING PINK SHOES, TRIPLE-NEGATIVE BREAST CANCER SURVIVOR RICKI FAIRLEY HELPS TO RAISE AWARENESS OF TRIPLE-NEGATIVE BREAST CANCER.

I’ll also be planning to wear pink shoes for Triple-Negative Breast Cancer Awareness Day. I was wearing pink cowboy boots when I was diagnosed and wore them until my mastectomy. It makes a statement and helps me talk about it with people that I meet. There’s not a day that goes by that I don’t talk with someone new about triple-negative breast cancer. We need to keep that conversation going on Triple-Negative Breast Cancer Day and throughout the year.

To learn more about what makes triple-negative breast cancer different from other breast cancers, read “3 Things You Should Know about Triple-Negative Breast Cancer.” 

At this year’s San Antonio Breast Cancer Symposium, which takes place this week, researchers will discuss how the treatment of breast cancer prior to surgery—known as neoadjuvant therapy—may extend survival or help women live without their cancer longer, especially those with aggressive or difficult-to-treat subtypes.

“It’s a hot topic among breast cancer researchers,” said George Somlo, principal investigator at the City of Hope Comprehensive Cancer Center, who studies the topic. “What we’re trying to figure out now is exactly what neoadjuvant treatment means for patients in the long-term.”

Surgery remains the primary treatment option for breast cancer, but some women have tumors so large that breast preservation or even a mastectomy could not be performed with clear margins or an acceptable aesthetic outcome. Pretreating these patients with chemotherapy has been an effective way to shrink these tumors, making surgery a viable option. In other cases, shrinking the tumor may mean it can be excised without removing the entire breast.

What we’re trying to figure out now is exactly what neoadjuvant treatment means for patients in the long-term.

Occasionally, this pre-treatment can even shrink the tumor so well that the surgery no longer identifies any trace of cancer. Such success is known as a pathological complete response (pCR).

Several recent meta-analyses have shown that achieving pCR improves outcomes for some patients. In one study, researchers found that patients who achieved pCR had a 36 percent increase in overall survival. For patients with difficult-to-treat subtypes, including HER2 over-expressive (particularly hormone receptor negative) and triple-negative breast cancers, pre-treatment offered a 75 percent decrease in cancer recurrence.

Last year, the Food and Drug Administration (FDA) acknowledged the potential of pCR to measure the efficacy of possible new breast cancer therapies in an effort to accelerate new drug approvals. Using pCR as an endpoint allows researchers to examine a therapy’s effects on a shorter timescale, making clinical trials in early stage disease (for which patient survival times are long) more feasible. Typically, new therapies were only tested in late-stage disease, when survival times are shortest.

“The FDA’s allowance of the use of pCR as an endpoint has allowed patients’ access to novel and effective therapeutic agents before the disease metastasizes,” Somlo said. “This is a positive evolution in the thinking of how to develop drugs.”

Some physicians urge caution in using pCR to make clinical decisions until we know more about its correlation with long-term survival outcomes. Others note that trials examining treatment before surgery should be reserved for patient groups for whom a benefit is clearest, such as those with hormone receptor-negative cancer. Still others point to data suggesting that neoadjuvant therapy may cause the cancer to mutate, leading to new tumors.

Yet many like Somlo remain optimistic about the mounting evidence supporting the association between neoadjuvant treatment and improved survival. Perhaps one day, muses Somlo, the need for surgery may even be eliminated.

“That would be the ideal situation,” he said. “We’re not at that point today, but in the future, I wouldn’t be surprised if this was an acceptable approach.”

Although breast cancer survival rates are improving on the whole, those for women diagnosed with the triple-negative form remain significantly lower. In large part, that’s because triple-negative breast cancer (TNBC) doesn’t respond to many of the more modern, targeted treatments.

But results of trials of combination therapies, which attack different aspects of the disease, are showing promise. At Celgene, we are committed to  helping improve the lives of patients with TNBC.

About 10 percent of breast cancer cases are triple-negative. While 93 percent of women with other types of breast cancer survive five years after diagnosis, only 77 percent of those TNBC can say the same, according to a 2007 study of 50,000 women with breast cancer.

“With all the progress that’s been made in treating certain types of breast cancer, triple-negative metastatic breast cancer unfortunately remains especially challenging,” Denise Yardley, senior investigator at Sarah Cannon Research Institute Breast Cancer Research Program, said. “That’s due in part to the genetics of the tumors, in part to where the metastases tend to occur, and in part because the disease is so aggressive.”

Indeed, TNBC is one of the most aggressive types of cancer. Women diagnosed with TNBC are four times more likely to have that cancer spread, or metastasize, to other organs within five years than patients with other types of cancer. Most often, TNBC tends to spread to vital organs such as the brain and lungs.

In a study published in Clinical Cancer Research in 2007, researchers found that the median time to metastatic recurrences in TNBC patients was just 2.6 years, while the median time for patients with other breast cancers was 5.0 years. In addition, the survival time from diagnosis of distance metastatic TNBC was just 9 months compared with 22 months for other cancers.

Some of the most effective breast cancer treatments today target proteins on the surface of breast cancer cells, such as human epidermal growth factor receptor 2 (HER2), estrogen receptors and progesterone receptors. Because the growth of TNBC cells isn’t supported by the presence of too many HER2 receptors, or by progesterone or estrogen hormones, these therapies are less effective.

Clearly, different approaches to treating this particularly aggressive form of breast cancer are required. One strategy that has received significant attention lately is a combination of therapies.

At the 2013 San Antonio Breast Cancer Symposium, researchers from Northwestern University presented promising data from a clinical trial of a combination of chemotherapies that showed improved outcomes for women with TNBC. After being treated with the combination therapy, 43 percent of women in the study were tumor-free. Historically, only 30 percent of women with TNBC are tumor-free after treatment.

“Triple-negative breast cancer tends to be very aggressive, and because it is aggressive it metastasizes very fast,” said Virginia Kaklamani, director of translational breast cancer research at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University and lead researcher of the study, said in a statement. “We don’t have many good treatments for it, which is why the results of our study is such good news.”

The results of combination therapy trials for TNBC are promising, although more effective treatments are still needed. Trials of different combination therapies are ongoing, so patients with TNBC should consider enrolling in trials and should always discuss all their treatment options with their doctors.