In March 2010 my mum, Lauretta Burton, passed away after losing a 5 year battle with breast cancer. Lauretta was diagnosed with a particularly aggressive and difficult to cure form of the disease: Triple Negative Breast Cancer (TNBC). 

 

What is TNBC?

Breast cancer is not just one single disease, and medical research continues to reveal its complexity, including many variations of how and where breast cancer cells originate and what stimulates them to grow.

Breast cancer cells are now commonly tested for receptors to see what is helping them grow:

·         Those known as ‘hormone receptor positive’ rely on oestrogen to grow and are treated with drugs such as tamoxifen and aromatase inhibitors. 

·         If oestrogen receptors are not present (ER negative) tests may be done to find out whether the breast cancer is sensitive to progesterone, another hormone. 

·         Another group, known as ‘HER2 positive’ rely on HER2 proteins to grow and are treated with Herceptin, widely recognised as an extremely effective targeted treatment.

However, around 15–20% of people with breast cancer test negative for all three of these receptors – and so have what is termed triple negative breast cancer. This means that the treatments mentioned above are of no benefit. Triple negative breast cancers are more commonly found in women who have not yet reached the menopause, people of African-American origin and those who carry a faulty BRCA1 gene (associated with hereditary breast cancer).

This type of breast cancer is typically responsive to chemotherapy. However, triple negative tumours generally do not respond to receptor targeted treatments. Depending on the stage of diagnosis, triple negative breast cancer can be particularly aggressive, and more likely to recur than other subtypes of breast cancer, particularly in the first 5 years.

 

What is currently being done for TNBC?

Until fairly recently little was known about TNBC.  However in recent years the level of research has increased considerably, especially in the US, and as a result we now have a much better understanding of the disease. Trials are currently comparing different chemotherapy drug combinations in people with triple negative secondary or locally advanced breast cancer but the results won’t be available for some years. There are also a number of new targeted treatment options currently being trialled, the most exciting of which being PARP inhibitors. As targeted therapies become available the outlook for TNBC patients should look more positive.

There are only a few charities who are currently dedicated to providing support for TNBC and most of these are based in the US, such as the TNBC Foundation.  However, a small number of UK based charities such as Breakthrough have have focused attention specifically on this form of the disease. In doing so they have made some important advances in understanding triple negative breast cancer and recently opened an entire unit focused on researching this form of the disease.

This research unit at Kings College London is dedicated to improving the treatment of triple negative breast cancer. By discovering more about these types of tumour, and the faulty molecules that cause their growth, Breakthrough hope to develop treatments that target cancer cells and leave healthy cells unharmed.

In 2008, along with Cancer Research UK, Breakthrough launched a clinical trial which aims to improve treatments for triple negative breast cancers that spread to other parts of the body.

The trial will compare two forms of chemotherapy: carboplatin, not normally used to treat breast cancer, and docetaxel, the standard treatment. If successful, the trial could lead to carboplatin becoming part of a new tailored treatment for this disease.

Breakthrough’s Professor Clare Isacke has also discovered that some triple negative breast cancers over-produce a molecule called Endo180, which may encourage the disease to spread to other parts of the body. She is now looking to see if Endo180 can be used as a target for new treatments to prevent this spread, thus improving the chances of successful treatment.

The Lauretta Burton TNBC Foundation

We are still someway off from an effective targeted treatment becoming available. Further, the UK lags behind the US and many other European countries in terms of the research being done and organisations like Breakthrough need all the help they can get!    

The aim of the foundation is to support all those who suffer from the disease and are affected by the disease (both now and in the future) by helping organisations like Breakthrough.

Dedicating Lauretta's memory and name to the fight against TNBC is one of the greatest tributes we can pay her and I'm certain that it would make her very happy.

 

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