Triple Negative Breast Cancer

With update below

Upon the request of Desiree Jimenez-Razo (36), we traveled to Donsol, Sorsogon to address her breast cancer as well as conduct a symposium for teachers in this far-flung tourist destination.

She had undergone breast surgery two months ago and had been diagnosed with invasive ductal carcinoma at the Bicol Reguional Training and Teaching Hospital in Legazpi City. Though the pathology report was negative for residual tumor, all surgical margins of resection and all ten axillary lymph nodes, the immunohistochemical report showed triple negative breast cancer: Estrogen receptor negative (ER-); Progesterone receptor negative (PR-) and HER2/neu negative (HER2-). 

It is said that from 10 to 20% of medically diagnosed breast cancer cases are triple negative, occurring more often in younger women and are considered often to be aggressive with a poorer prognosis than other types of breast cancer. At this time, however, there is no standard medical recommendation that women with triple-negative breast cancer should have more treatment than the usual.

Ongoing studies have been looking at whether giving chemotherapy before surgery is better than after surgery. However, doctors are still developing their understanding of triple-negative breast cancer and vary in their treatment recommendations because triple negative breast cancer does not respond to hormone drugs and becomes resistant to chemotherapy. To this very day, medical science does not yet know the cause of triple negative breast cancer or the factors that initiate the process.

In my opinion, triple breast cancer is medically considered aggressive precisely because there is no drug doctors can use to address it. As if all the surgery, chemotherapy and radiation aren't aggressive in themselves! 

A school teacher since after college, Desiree (a mother of two sons, 12 & 8) had none of the known medical risk factors. She has been residing since birth at a relatively clean environment as evidenced by the "butandings" (whale sharks) in Donsol, the main tourist attraction of their less than 50,000 inhabitant community. What could have most likely caused her breast cancer - a triple negative at that?

During the symposium we conducted for teachers the day before leaving Donsol, there was another teacher who had also just recently undergone breast surgery and undergoing chemotherapy despite not having any hormone assay. Another one had multiple lumps on both breasts upon our physical examination. Two others had thyroid problems while another was already sensing breast lumps. The only common risk exposure to these teachers was the annually required chest x-rays which were done by a mobile unit from Legazpi City.   

To my knowledge, the Philippine is the only country in the world that requires annual chest x-rays on all its public school teachers regardless of their health condition, no matter that majority have no history of lung illnesses. Worst of all, even young girls entering college are unnecessarily exposed to the dangers of radiation during their vulnerable period - at a time when their breasts are undergoing formation. History taking is foremost in medical screening but both government and medical authorities in the Philippines continue to expose women to the high risks of radiation especially in the rural areas where out-dated and terribly unsafe mobile machines are being used!

Prior to coming to Donsol, we had a 50 year old patient whose latest mammogram showed a BIRADS 4 (suspicions of malignancy). This particular woman had been submitting herself to annual mammography since age 38 in the hope of early detection only to get a suspicious malignancy from the continuous exposures to radiation from mammography. No, it was not early detection but eventual affliction from mammography!  In the case of Desiree, she had underwent chest x-ray more than once within a year in two occasions for use of a relative's work application. 

Instead of looking at possible receptors to find a drug (because tamoxifen and herceptin are not for triple negative breast cancer), looking into environmental factors such as radiation exposures would be more like it! Government and health authorities must stop the practice of requiring annual chest x-rays on all female employees as well as female students entering high school and college. As for mammography, women must not submit to this high risk exposure to radiation!

The PBCN re-affirms its position that whatever type of breast cancer (triple negative or not), a non-toxic and non-invasive approach will be safe and beneficial for the patient! 

Updated 28 September 2014

Exactly two years ago, we travelled all the way to Donsol, Sorsogon for a public school teacher who underwent a mastectomy with 0/10 lymph nodes negative and diagnosed with triple negative breast cancer. While we were there, we visited another co-teacher breast cancer patient but she and her policeman husband preferred to follow their doctor. She passed away six months later - most surely because of the toxic chemo she submitted to.

The PBCN is proud and happy because Desiree is a living testimony of how an empowered woman can live with breast cancer without chemotherapy. Last April, she gave normal birth to a heath baby boy and her seaman husband has jumped ship to be with her and their three sons in their simple but peaceful and beautiful town of Donsol. Keeping well and staying happy together!