TNBC is different. Treatment is different. Thriving is different.
And each TNBC story is different.
Project Goal: By weaving together the medical history and scientific developments with the experiences and stories of the women receiving treatment, I aim to investigate the changes in TNBC over the past 30+ years and explore how medicine can further support women with TNBC in the future.
The Ask: Share your story. Any story. Survivors, thrivers, caregivers, practitioners, researchers. All interviews will be anonymous and conducted at your convenience.
The Final Outcome: The initial goal is a better understanding of how the medicine and treatment options improve women’s lives. This in itself is a success. Beyond that, I intend to publish a mixed methods account of TNBC over the past several decades.
Breast cancer was first noted in ancient Egyptian medical texts in 3500 BCE, with an acknowledgment that the disease was incurable and that the mass must be removed in its entirety. Fortunately, since then, we have continuously made improvements- from diagnosis to treatment protocols to biologics and genetic therapies- in treating breast cancer.
The art and science of medicine allow professionals to provide care based on what is available at the moment. ER/PR receptors were identified in the mid-1970s; the HER2 gene was identified in the mid-1980s; and not until 1990 was the BRCA-1 gene identified. With each of these discoveries, new research initiatives and treatment options were subsequently investigated and developed. However, a small percentage (10-15%) of women whose breast cancer did not fit into any other category were still facing poor prognosis and a lack of progress in treatment options.
In 2005, the term Triple Negative Breast Cancer (TNBC) was used for the first time. It is called “Triple Negative” because of the absence of ER/PR receptors and the absence of HER2. According to women who have shared their stories with me already, the treatment of TNBC in the 1990’s and 2000’s was dark and dismal. The message was consistently to expect a recurrence, to expect complications, to prepare for the worse.
In 2021, Keynote 522, which included Ketruda, an immune checkpoint inhibitor, as part of the protocol for the first time, was released as the first advancement in the treatment of TNBC in decades. This treatment protocol offered higher survival rates across the board, decreased recurrences and was a huge step in treating TNBC. Yet many women faced different, at times unexpected, challenges with new protocols.
The medical and technological advances in the past few years have increased exponentially. In looking back, we can see Cardio-Oncology was born out of heart-related problems related to Adriamycin; immunotherapies are intended to utilize the body's immune system to help attack the disease; understanding genetics has offered insight for screening and preventative care, and potentially a new means for delivering existing therapies.
We must understand where we have been- the medical and personal journey to date- to help determine where we must move forward.