Monday, November 11, 2013

Triple Negative Breast Cancer: Old Lady Style

It is been known for years that breast cancer is more deadly for younger women. The main reasons given is that it is more likely to be hormone negative than that in older women and that it is discovered at a later stage due to lack of effective screening.(dense breasts that hide tumors, screening not started to 40 etc)

But older women do get TNBC (15% of over 50 BC patients). What about them? Do they have the same scary prognoses as the younger women? I looked and looked for such studies and found nada. Meanwhile I noticed on blogs that I followed that the older TNBC women seemed to be all surviving and the young ones.....not so much. Could this mean that older women should not be so scared?

Yeah I know. Anecdotal evidence should count for squat. I once saw a Tshirt that said I make gross generalizations from an N of one. But finally various groups have decided to study this question that I had. Unfortunately each group defined older differently. One had under 40s and over 70s (leaving a huge number out). Another defined old/young as above  or below 53 as that is the median age of breast cancer. But the bottom line was that yes, though difficult to quantify, things were better for the older ladies no matter how you defined them even when they were under treated compared to the younger (The Red Devil isn't given to women who fail the heart screen).

Why do older women do better even when matched for tumor size? Not all TNBC is the same. Perhaps the various tumor factors are more deadly in the younger tumors. Now there is a company that is studying all  these various factors (quite a few of them) and coming up with a useful test to determine whether chemo would do any good. There has been a test for many years (oncotype) for estrogen positive ladies that considers their tumors various growth factors and places them is various categories of risk so they can make a decision whether chemo will do any good. It had been automatically assumed that all TNBC needed to be treated with chemo but now they are determining that maybe not.

Recently some uninformed reported in a national publication no less stated that TNBC was almost uniformly fatal. Fun to read for the newly diagnosed. She was set straight. The truth is that most people do survive TNBC. For more information about the promising potential test to see the likelihood of your tumor spreading see http://hormonenegative.blogspot.com/2013/11/test-may-determine-which-cases-of-tnbc.html

And the question of who is old? Recently a friend of mine in her 80s was greeted by a minister who said, It is so nice to see you Young Lady. She responded It's so nice to see you too, you Devil-Worshipper.
He was puzzled but she explained that she was not young just as he probably didn't worship the devil.

A quiet weekend. We did have Josh and his family come yesterday. Allie remains adorable. I was permitted to hold her despite my even lower raspy voice.

The days get colder and shorter. Yesterday I awoke to strong winds and cold aborting my planned bike ride.
But very late in the day, the winds died down and it was almost 50 so off I went as the sun was setting. Beautiful, cellar door light. Readers might note this is the same pond I pictured from my morning run last Friday but this is photographed late in the day..better for lighting. I went by the apple tree too but it is best observed in the very early light.





1 comment:

Anonymous said...

Beautiful photo!
Kris

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