New data helps doctors zero in on breast cancer risks, treatments
At Ricki Fairley's annual check-up in 2012, doctors found a tiny lump. She was diagnosed with triple negative breast cancer, a less common and more aggressive form of the disease that has very few treatment options. Approximately 15 percent of all breast cancer cases are categorized as triple negative.
Triple negative breast cancer can be effectively treated if the disease is caught early, and Fairley, now 58 years old, is living proof. She underwent a long course of aggressive chemotherapy and radiation and is now doing well.
Triple negative is one of four subtypes of breast cancer, and a new report emphasizes how important it is for doctors to identify the risks and treatments for each. For example, triple negative cancers do not respond to certain hormonal therapies that can help other women.
The nationwide data -- published in the Journal of the National Cancer Institute and co-authored by the American Association of Central Cancer Registries, the American Cancer Society, the Centers for Disease Control and Prevention, and the National Cancer Institute at the National Institutes of Health -- may help doctors identify which patients are at most risk for each type of breast cancer and which treatments may be most effective.
The authors of the paper looked at the impact of a number of genetic, environmental and social factors including ethnicity, race, age and poverty level that may contribute to breast cancer risk.
"This is just such a complex disease. We used to think of breast cancer as, you were before or after menopause," Dr. Joanne Mortimer, an oncologist at City of Hope in Duarte, California, told CBS News. "It really is more about the biology of the cancer."
When a woman is diagnosed with breast cancer, her doctor must identify the subtype in order to provide the best and most effective treatment to help her beat the disease. The four subtypes are classified by their hormone receptor (HR) status and expression of the HER2 gene. They are known as Luminal A (HR+/HER2-), Luminal B (HR+/HER2+), HER2-enriched (HR-/HER2+) or triple negative (HR-/HER2-) breast cancer.
Doctors are now reporting their patients' breast cancer subtypes to cancer registries nationwide, which could help develop further investigations about why certain demographics of women are more likely to develop one subtype or another.
In the study, the researchers found that non-Hispanic black women had a higher rate of triple negative breast cancer and tended to be diagnosed at a later stage of the disease compared with women in other racial groups.
The data also also confirmed the previous finding that non-Hispanic white women are more likely to develop HR+/HER2- breast cancer, the least aggressive subtype, than women of other races and ethnicities. The study found that rates of HR+/HER2- breast cancer increased with increasing levels of poverty for every racial and ethnic group.
A broad analysis, "The Annual Report to the Nation on the Status of Cancer, 1975-2011," also looks at other cancers and found lung, colorectal and prostate cancer rates are declining. On the other end, incidences of thyroid, kidney and liver cancers are on the rise for both men and women. Additionally, the report identified a rise in oral cancers related to HPV among white men, as well as an increase in rates of uterine cancer, especially among black women.