basal like or basaloid
A dear friend of mine has been diagnosed with triple negative and they tested it to see if it was a basal subtype. Does anyone have information on this? aren't mose TN's basal?
Comments
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Most triple negative breast cancers are basal subtype, but not all - I think it is around 70% that are basal. Mine was tested for basal markers - 5/6 cytokeratins and EGRF. The presence of either marker would have classified mine as basal - in my case, the 5/6 cytokeratins was elevated, but the EGRF was only "focally positive." I was never told why they did this- some studies show a poorer outcome for basal versus non-basal but not all studies do. I think there may be some research on target therapies for the EGRF.
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Mine is triple neg and non-basal and I've asked a lot of oncologists about prognosis and treatment, and none of them will commit to answering as to whether or not this type has a better or worse prognosis, nor if the "standard" dose dense chemo regiment I'm on (AC every 2 weeks for 8 weeks, Taxol every week for 12 weeks) is the right one for non basal??? help anyone have info???
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Marina,
Some research shows worse outcome for true basal, some show worse outcome for basal with elevated EGRF (one of 2 basal markers they test for) - but I don't believe it is 100% conclusive either way. I am not educated enough to read between the lines and differentiate between a great study and a good study, so I have to take what I learn with a big grain of salt. More than once I have threatened to break out my old statistics textbooks! When asked, my oncologist said basal is a little bit worse in terms of prognosis than non basal. He is a general oncologist, not a TNBC specialist.
I wish I had had dose dense. I consulted with 2 different oncologists here in my hometown that were considered the best oncologist available and both of them wanted to do chemo every 3 weeks. I had neoadjuvant chemo with only a partial response - and the biggest kick from the chemo seemed to be from the first two doses when it felt much smaller and softer. Hindsight is 20/20 but I really feel I would have gotten a much better response with dose dense. Maybe it would have knocked the sucker out!! Instead I had a partial response based on what they found at mastectomy, then headed for radiation, and now because I was told I had a higher chance of recurrence because of my partial response, I have been doing another four months of chemo in a clinical trial setting.
Studies seem to show more PCR (pathological complete response) with dose dense chemo. I have a local friend who was TN, had 5 positive nodes, a lumpectomy/rads, and is over 5 years out with no recurrence.
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Christina, thanks for responding, I am so sorry to hear that you had only a partial response to the chemo and you are now facing another 4 months!! TNBC is so confusing, I have a background in research (LOL and statistics), but trying to figure out all the research on the different subtypes of triple negative and the different markers etc. is a nightmare! Oncologists do differ re the dose dense vs the every 3 weeks, I was probably wrong in saying that dose dense is "standard'. Happy about your friend, it's always so encouraging to hear about women who are TN and 5 years out with no recurrence!
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