The aggressive cancer that targets young African women

By Nancy Nzalambi

Triple negative breast cancer (TNBC) is an aggressive and harder to treat type of breast cancer. And it is common among young African women, African American women and Latinos. It is rarer among women of European descent. The triple negative breast cancer lacks any of the three common receptors found in breast cancer cells. The three receptors commonly found in breast cancer cells, but not in this specific kind of cancer are:

·         Oestrogen receptor; ER

·         Progesterone receptor; PR

·         Human epidermal growth factor protein; HER2

When a patient presents with breast cancer with any of these receptors, specific treatment options for the receptor(s) are used to possibly destroy the cancer cells.

However, when the cancer lacks any of the three receptors, it limits the treatment options. According to Pathologists Lancet Kenya, TNBC is much more aggressive than other forms of breast cancer. It has a higher chance of metastasis and reoccurrence within the first three years after treatment.

TNBC is likely to be fatal in the first five years. However, it is reassuring that once one passes these milestones, their odds of survival are the same as survivors of any other type of breast cancer.

Recent data from 10 provincial health facilities across the country shows that TNBC constitutes approximately 20.2 per cent of all breast cancer cases.

However, since ER/PR/HER2 receptors are not part of the routine assessment in Kenya and are only available in countable centres, there are inconsistencies in acquiring adequate data on TNBC.

There is overreliance of breast cancer incidence data from urban hospital-based studies, the actual incidence could be much higher than reported when rural breast cancer data is considered.

Treatment of TNBC

TNBC is diagnosed using imaging tests and biopsy. It does not respond to targeted therapies that are effective with the other types of breast cancer. Fortunately, there are chemotherapy options that can be effective in treating TNBC.

TNBC is treated by having the lump (lumpectomy) or the entire breast removed (mastectomy). Some patients choose to have breast reconstruction done. Radiotherapy and chemotherapy are also employed to kill any remaining cancer cells and limit regrowth of the same.

It important to note that treatment success or failure depends on how big the tumour is, its growth rate and whether it has spread to other body parts and lymph nodes.

Data from the American Cancer Institute shows that five-year survival rates are at 91 per cent for localised breast cancer and 11 per cent for cancer that has spread to distant parts of the body.

 Besides race, other risk factors include:

·         Having a BRCA gene mutation. BRCA genes ensure stability of DNA in the cells. A mutation in these genes mean that damaged DNA may cause genetic alterations that result in cancer.

·         Being under the age of 40.

A few facts

1. Breast cancer still remains the most common cancer among Kenyan women. It accounts for 23 per cent of all the cancers women in the country get.

2. Early screening and detection is the easiest way to beat the high death rate it causes (7.1 women for every 100,000). This is because the earlier it is caught, before it spreads to other body organs (metastasis), the greater the odds of beating it.

- Nancy Nzalambi is a research scientist with NHIF