Risk Factors for Triple-Negative Breast Cancer in Women Under the Age of 45 Years

Rationale. Breast cancer (BC) has been recognized to be the most common type of cancer in women all over the world. One of the most aggressive subtype of BC is the triple negative breast cancer (TNBC) which is defined by the absence of estrogen receptor (ER) and progesterone receptor (PR) as well as the lack of overexpression of the human epidermal growth factor 2 (HER 2). Aim. As the estrogen and progesterone receptors as well as the expression of HER2 are lacking, a targeted therapy with anti-hormone agents and anti-HER2 cannot be utilized, the therapeutic possibilities for TNBC women are limited. The aim of this review is to present the current scientific data as well as the latest research in TNBC with focus on the risk factors as well as the current role of platinum-based chemotherapeutic agents and their future implications in TNBC treatment. Method. Information about the risk factors associated to TNBC as well as the chemotherapeutic regimens was searched through Pubmed and Medline using controlled vocabulary (e.g. breast cancer) and key words (e.g. neoadjuvant, triple negative, platinum). Systematic reviews, randomized and controlled clinical trials were analyzed. No restrictions regarding date or language were used. Conclusions. TNBC is a complex and heterogeneous disease, divided into many subtypes and with an aggressive evolution. Premenopausal women and African American women are far more likely to develop TNBC. More research is required in order to confirm the association between obesity, BMI, parity, use of oral contraceptives, alcohol and cigarette smoking and TNBC. Randomized clinical trials presented at the San Antonio Symposium suggest that platinum chemotherapy play an important role in the treatment of TNBC, especially early stage TNBC. Tumor-based measures of genomic instability will help to clarify the optimal use and activity of platinum in TNBC. However, it is clear than more epidemiological studies as well as the discovery of novel therapeutic possibilities are mandatory in order to unravel the complexity of this BC subtype, hence offering a chance to women diagnosed with TNBC.

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Racial Disparities in Triple Negative Breast Cancer: A Review of the Role of Biologic and Non-biologic Factors

Frontiers in Public Health ◽

10.3389/fpubh.2020.576964 ◽

2020 ◽

Vol 8 ◽

Author(s):

Om Prakash ◽

Fokhrul Hossain ◽

Denise Danos ◽

Adam Lassak ◽

Richard Scribner ◽

...

Keyword(s):

Breast Cancer ◽

United States ◽

Risk Factors ◽

Racial Disparities ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

The United States ◽

Poor Survival ◽

Potential Interactions ◽

Biologic Factors

Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer that lacks expression of the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor (HER2). TNBC constitutes about 15–30 percent of all diagnosed invasive breast cancer cases in the United States. African-American (AA) women have high prevalence of TNBC with worse clinical outcomes than European-American (EA) women. The contributing factors underlying racial disparities have been divided into two major categories based on whether they are related to lifestyle (non-biologic) or unrelated to lifestyle (biologic). Our objective in the present review article was to understand the potential interactions by which these risk factors intersect to drive the initiation and development of the disparities resulting in the aggressive TNBC subtypes in AA women more likely than in EA women. To reach our goal, we conducted literature searches using MEDLINE/PubMed to identify relevant articles published from 2005 to 2019 addressing breast cancer disparities primarily among AA and EA women in the United States. We found that disparities in TNBC may be attributed to racial differences in biological factors, such as tumor heterogeneity, population genetics, somatic genomic mutations, and increased expression of genes in AA breast tumors which have direct link to breast cancer. In addition, a large number of non-biologic factors, including socioeconomic deprivation adversities associated with poverty, social stress, unsafe neighborhoods, lack of healthcare access and pattern of reproductive factors, can promote comorbid diseases such as obesity and diabetes which may adversely contribute to the aggression of TNBC biology in AA women. Further, the biological risk factors directly linked to TNBC in AA women may potentially interact with non-biologic factors to promote a higher prevalence of TNBC, more aggressive biology, and poor survival. The relative contributions of the biologic and non-biologic factors and their potential interactions is essential to our understanding of disproportionately high burden and poor survival rates of AA women with TNBC.

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Microarray-based SNP genotyping to identify genetic risk factors of triple-negative breast cancer (TNBC) in South Indian population

Molecular and Cellular Biochemistry ◽

10.1007/s11010-017-3187-6 ◽

2017 ◽

Vol 442 (1-2) ◽

pp. 1-10 ◽

Cited By ~ 4

Author(s):

M. Aravind Kumar ◽

Vineeta Singh ◽

Shaik Mohammad Naushad ◽

Uday Shanker ◽

M. Lakshmi Narasu

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Triple Negative Breast Cancer ◽

Genetic Risk ◽

Indian Population ◽

Triple Negative ◽

Genetic Risk Factors ◽

Snp Genotyping ◽

South Indian Population ◽

South Indian

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Reproductive and hormonal risk factors for postmenopausal luminal, HER-2-overexpressing, and triple-negative breast cancer

Cancer ◽

10.1002/cncr.24187 ◽

2009 ◽

Vol 115 (8) ◽

pp. 1802-1802

Author(s):

Omer Dizdar ◽

Sercan Aksoy ◽

Kadri Altundag

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Her 2

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Obesity and race as risk factors in triple-negative breast cancer

Gynecologic Oncology ◽

10.1016/j.ygyno.2016.04.491 ◽

2016 ◽

Vol 141 ◽

pp. 190

Author(s):

T. Picerno ◽

A. Damewood ◽

J. Sims-Mourtada

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Triple Negative Breast Cancer ◽

Triple Negative

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Racial Disparities in Triple Negative Breast Cancer: Toward a Causal Architecture Approach

10.21203/rs.3.rs-1177963/v1 ◽

2021 ◽

Author(s):

Scott D. Siegel ◽

Madeline M. Brooks ◽

Shannon M. Lynch ◽

Jennifer Sims-Mourtada ◽

Zachary T. Schug ◽

...

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Alcohol Use ◽

Racial Disparities ◽

Triple Negative Breast Cancer ◽

Invasive Breast Cancer ◽

Neighborhood Effects ◽

Triple Negative ◽

Unhealthy Alcohol Use ◽

Unhealthy Alcohol

Abstract Background: Triple negative breast cancer (TNBC) is an aggressive subtype of invasive breast cancer that disproportionately affects Black women and contributes to racial disparities in breast cancer mortality. Prior research has suggested that neighborhood effects may contribute to this disparity beyond individual risk factors.Methods: The sample included a cohort of 3,316 breast cancer cases diagnosed between 2012 and 2020 in New Castle County, Delaware, a geographic region of the US with elevated rates of TNBC. Multilevel methods and geospatial mapping evaluated whether the race, income, and race/income versions of the neighborhood Index of Concentration at the Extremes (ICE) metric could efficiently identify census tracts (CT) with higher odds of TNBC relative to other forms of invasive breast cancer. Odds ratios (OR) and 95% confidence intervals (CI) were reported; p-values <0.05 were significant. Additional analyses examined area-level differences in exposure to metabolic risk factors, including unhealthy alcohol use and obesity.Results: The ICE-Race, -Income-, and Race/Income metrics were each associated with greater census tract odds of TNBC on a bivariate basis. However, only ICE-Race was significantly associated with higher odds of TNBC after adjustment for patient-level age and race (most disadvantaged CT: OR= 2.09; 95%CI=1.40-3.13), providing support for neighborhood effects. Higher counts of alcohol and fast-food retailers, and correspondingly higher rates of unhealthy alcohol use and obesity, were observed in CTs that were classified into the most disadvantaged ICE-Race quintile and had the highest odds of TNBC. Conclusion: The use of ICE can facilitate the monitoring of cancer inequities and advance the study of racial disparities in breast cancer.

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