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Triple-negative breast cancer (TNBC) is one of the aggressive subtypes of breast cancer that occurs in women. Unfortunately, the prognosis and management of TNBC pose great difficulty. However, a new study by the University of Texas M. D. Anderson Cancer Center reports an association between statin use and improved survival rates among TNBC affected individuals.
TNBC is a subtype of breast cancer that lacks any receptors generally found in breast cancer cells. The other types of breast cancers have receptors for any of these hormones:
*Note: Receptors are proteins that receive chemical signals by binding to specific molecules.
TNBC represents about 10-15 % of all breast cancers.
The presence of even one of the receptors makes treating breast cancer easier. Doctors can then treat cancer by targeting these receptors to get inside the cancerous cell and destroy it.
However, in TNBC, the lack of receptors limits the treatment options.
According to the American Cancer Society, based on diagnosis information between 2010-2016, the 5-year survival rate for TNBC affected individuals is 77%. However, these statistics are subject to variation depending on the cancer progression stage and grade of the tumor.
Know about your BRCA status and risk for breast cancer using Xcode Life’s BRCA and Breast Cancer Report.
Statins represent a class of drugs usually prescribed for heart attacks and stroke. Statins help in lowering blood cholesterol levels.
Statins can be broadly classified into lipophilic and hydrophilic statins. Lipophilic statins are fat-soluble, and hydrophilic are water-soluble.
Notably, lipophilic statins quickly enter the cells and communicate with cell membranes. In contrast, hydrophilic statins show more selectivity to liver cells.
Explore your body’s response to different types of statins with Xcode Life’s Personalized Medicine report.
The earliest research to report a link between statin and TNBC was a study in 2013. According to the study, statins activate the inhibition of TNBC through the PI3K pathway. They also suggested Simvastatin as a potent candidate for the treatment of TNBC, especially for wild-type (a form of the gene occurring naturally and predominating a population) expression of PTEN in the TNBC tumors.
Another study, done in 2017, to investigate the outcome of statin use on TNBC produced mixed results. The study observed no apparent association between statin use and overall survival (OS) in an unselected cohort of TNBC patients.
However, statin use significantly improved OS within a specific group of test subjects whose cholesterol and triglyceride levels were controlled. In addition, statin use showed a pronounced effect on survival rate even for another group of triple-negative patients who experienced metastatic failure.
*Note: 1. Overall survival: Length of time from the diagnosis date or start of treatment that a patient is still alive.
2. Metastasis: Stage of cancer where the cancerous cells start migrating from their origin site and infect other healthy parts of the body.
In 2019, a study found that the effect of statin use on breast cancer survival depended on the duration of statin use. In the test subject group, patients who had a medical history of statin use for more than five years experienced a conspicuous improvement in survival rate.
(NB: The findings of the study were irrespective of breast cancer type or receptor subtype)
In 2020, a statistical study on the clinical outcome of statin use on breast cancer diagnosis involving multiple research studies found a significant association between statin use and decreased recurrence rate and breast-cancer mortality in women.
| Year | Study | Outcome |
| 2013 | Statin induces inhibition of triple negative breast cancer (TNBC) cells via PI3K pathway. | Statin activates inhibition of TNBC through the PI3K pathway |
| 2017 | Impact of Statin Use on Outcomes in Triple Negative Breast Cancer. | Statin use improved survival rates in TNBC patients who:Had their cholesterol and triglyceride levels controlledExperienced metastatic failure |
| 2019 | Impact of long-term lipid-lowering therapy on clinical outcomes in breast cancer. | Long-term (>5 years) use of statin improved survival rates in TNBC patients |
| 2020 | Association Between Statin Use and Prognosis of Breast Cancer: A Meta-Analysis of Cohort Studies. | Significant link between statin use and decrease in the recurrence rate of TNBC and disease-specific mortality in women. |
A study led by Kevin Nead of the University of Texas M. D. Anderson Cancer Center explored the outcomes of statin use in breast cancer patients. This study was the first to investigate the effect of statin use on all subtypes of cancer, focusing mainly on TNBC.
According to Nead, “Previous research has looked at breast cancer as only one disease, but we know there are many subtypes of breast cancer, and we wanted to focus our research on this particularly aggressive form of breast cancer that has limited effective treatment options.”
The study analyzed 23,192 female patient data included in the Surveillance, Epidemiology, and End Results (SEER)-Medicare registry and the Texas Cancer Registry (TCR)-Medicare databases between 2008-2015. Patients were at least 66 years of age and diagnosed with stage I-III breast cancer.
2281 patients out of 23,192 were individuals who commenced statin use within 12 months of a breast cancer diagnosis. Out of these 2281 patients, 78.1% were white, 8.9% were black, 8.4% were Hispanic, and 4.5% belonged to other races.
The study also assessed the type-specific effect of statin on breast cancer outcomes.
Breast cancer is one of the most common types of cancer affecting American women. On average, 13% of American women will develop this invasive condition.
Many genetic and environmental factors can increase or decrease a person’s risk of developing breast cancer.
One such factor is the amount of fat you consume.
Dietary fat is a macronutrient needed in the right amounts to keep the body healthy and nourished.
The fat you consume is usually stored as a reserve in the adipose tissue and used as an energy source when you consume fewer calories than what the body needs.
Fat also helps absorb fat-soluble vitamins like vitamin A, D, E, and K.
Fats play a role in protecting your internal organs, keeping you warm, and controlling the action of different hormones.
High levels of dietary fat may increase the sex hormones in a woman’s body (estrogen and progesterone). Some researchers assume that this may be why fats increase the risk of breast cancer, especially hormone-receptor-positive breast cancers.
High dietary fat intake also increases the risk of obesity. Obesity, in turn, increases postmenopausal ER-positive breast cancer risk by increasing estrogen production in the body.
A 2003 study assessed the risk of breast cancer in 90,655 premenopausal women between the ages of 26 and 46. This 8-year study identified 714 cases of breast cancer during the follow-up.
According to the study, women who had consumed high animal dietary fats had a slightly increased risk for breast cancer. The study identified that red meat, animal fat, and dairy products specifically increased cancer risk.
Does The Type of Fat Matter?
There are four major types of dietary fatty acids.
Saturated and trans fat are considered unhealthy fats as they increase blood cholesterol levels and lead to heart conditions.
Unsaturated fats are healthy as they bring down cholesterol levels and also boost heart health.
When it comes to breast cancer risk, the type of fat you consume definitely matters. Many studies relate saturated fats and trans fats to an increased risk for breast cancer. Conversely, some unsaturated fats seem to be protective against breast cancer.
A 2003 meta analysis studies the risk of breast cancer in people who consumed excess dietary fats.
According to the meta-analysis, short-term and long-term studies found that people who consumed excessive saturated fats and meat had a 13% higher risk of breast cancer.
Another combined analysis study that included data from 12 case-controlled studies found a positive relationship between saturated fat intake and breast cancer.
This study also reports that with changes in the diet, up to 24% of postmenopausal women and 16% of premenopausal women in North America decreased their risk of developing breast cancer.
Industrial Trans Fatty Acids (ITFAs) are trans fats produced in industries and added to various dairy products, snacks, and pastries. Ruminant Trans Fatty Acids (RTFAs) are made in the bodies of cows, goats, sheep, and other animals as a result of bacterial action. RTFAs are present in most animal fats, and consuming these fats increase RTFA levels in the body.
The European Prospective Investigation into Cancer and Nutrition (EPIC) found a positive relationship between ITFA and RTFA consumption and the risk of breast cancer in 318,607 women.
A 2005 study analyzed the effects of unsaturated fatty acids on breast cancer risk. The study reported that omega-3 fatty acids, a type of polyunsaturated fatty acid, brought down the risk of breast cancer.
In contrast, omega-6 fatty acids, a different kind of polyunsaturated fatty acid, increased the risk of breast cancer.
A 2015 article observed the interaction of omega-3 fatty acids and omega-6 fatty acids in the development of breast cancer in 1463 breast cancer patients and 1500 controls. The study suggests that American women can reduce their risk of breast cancer by increasing their omega-3 fatty acid intake (omega-3 has anti-inflammatory properties) and decreasing the consumption of omega-6 fatty acids (Omega-6 induces inflammation).
When it comes to MUFAs, the type of food plays a role in increasing or decreasing cancer risk.
A 1993 meta-analysis study reported that MUFAs also increase a woman’s risk of developing breast cancer.
Another study reported that oleic acid and palmitic acid, types of monounsaturated fatty acids, increased the risk of breast cancer in women.
Olive oil, which is rich in MUFA, seems to protect against cancers, though. People who chose olive oil over other lipids like butter had high levels of protection against all cancers, including breast cancer.
The DOCK1 gene (Dedicator of cytokinesis gene) helps create the DOCK180 protein that plays a role in signaling between cells.
rs113847670 is a single nucleotide polymorphism or SNP in the DOCK1 gene. It is associated with breast cancer risk. The T allele of this SNP results in 5 times higher risk of developing breast cancer on excess intake of saturated fats.
| Allele | Implications |
| T | 5-times higher risk of developing breast cancer on excess intake of saturated fats |
| C | Normal risk of breast cancer on excess intake of saturated fats |
Obesity is one of the factors that can contribute to increased breast cancer risk. Excess intake of fats can lead to weight gain and obesity too. As a result, the combination of obesity and excess fat intake can aggravate breast cancer risk.
This is true, especially in post-menopausal women. Such women can bring down their risk of breast cancer by limiting saturated and trans-fat intake.
Other than cutting back on fats, the following dietary changes can help lower breast cancer risk:
Genetic testing will tell how harmful fat consumption is for your body. If you are at higher risk of developing breast cancer because of fat intake, talk to a nutritionist to control the risk.
Did you know that a person’s chance of developing breast cancer could be genetic? Here’s how it happens.
We inherit DNA from our parents. Our DNA is present within each of the trillions of cells in our body. DNA contains the instruction manual that determines how our bodies function.
Within the DNA, there are thousands of genes that produce all the proteins required by the body. You have two copies of every gene: one from your mum and one from your dad. The mix of your genes is different from that of another person’s. In fact, only identical twins share the same genes.
Sometimes these genes contain faults, called mutations. In most cases, these faults do not have any dangerous effects. But certain mutations alter the proteins that play vital roles in the body. It can disrupt normal development and may lead to medical conditions.
Two genes, BRCA1 and BRCA2, are associated with breast cancer. Contrary to popular belief, these genes don’t cause breast cancer. In fact, they have a protective role against cancers! In some cases, BRCA1 and BRCA2 genes have mutations that interfere with their protective role. Though these mutations may not definitely cause breast cancer, they do increase the chance for it to develop.
A faulty BRCA1 or BRCA2 gene can be passed down from one generation to the next. If either your mum or dad carries a faulty version, then the chance of you having the faulty gene is 50%. Similarly, if you inherit one faulty gene, the chance of you passing it on to each child is 50%. Breast cancer genes cannot skip generations. People who have a family history are estimated to have at least a one-in-ten chance of carrying a faulty gene.
Genetic tests analyze the BRCA gene and help family members find out whether or not they are at increased risk for breast cancer. More than 1,000 mutations in the BRCA1 and BRCA2 genes are known to increase cancer risk.
Xcode Life’s BRCA genetic analysis includes 18 breast cancer-related traits.
Most genetic ancestry companies like 23andMe, provide your DNA information in the form of a text file. This file is called the DNA raw data. Your 23andMe raw data contains several of the BRCA gene markers, which can be analyzed to find out your breast cancer risk. This data looks like a bunch of letters and numbers, which may not make much sense to you.
But, Xcode Life can interpret all this information for you!
All you need to do is upload your raw data and order the BRCA and breast cancer report. Xcode Life then analyzes your raw data in detail to provide you with a comprehensive Breast Cancer Risk analysis.
Even as we inherit our genes from our parents, we also inherit some of the gene mutations that can cause significant changes in our body. Mutations are variations in the genetic code of a gene that can alter or affect its functions. These inherited mutations, however small they are, can increase our risk to certain diseases.
Research studies have established that BRCA1 (Breast Cancer Susceptibility Gene 1) and BRCA2 (Breast Cancer Susceptibility Gene 2) genes are linked to breast cancer. Mutations of these genes that belong to a class of genes known as tumour suppressors are linked to hereditary breast and ovarian cancers. While it is true that not all genetic changes or mutations are harmful, a woman who inherits this faulty or harmful genetic mutation in BRCA1 or BRCA2 is prone to the risk of developing breast or ovarian cancer before menopause. It is also very likely that breast and ovarian cancers run in the family with some of her close family members being diagnosed with the diseases. Apart from breast and ovarian cancers, harmful BRCA1 mutations are also likely to increase a woman’s risk of developing cervical, uterine, pancreatic and colon cancer and harmful BRCA2 mutations may increase risk of pancreatic, stomach, gall bladder, bile duct cancers and melanoma. However researchers add that not all women who hail from families with a history of breast or ovarian cancer are carriers of harmful mutation and further not every woman who has inherited this deleterious mutation will develop breast or ovarian cancer.
Genetic testing plays a key role in detecting BRCA1 and BRCA2 mutations. Genetic testing gives the woman the chance to learn if her family history of breast cancer is due to an inherited gene mutation.
BRCA gene test is conducted to identify the harmful changes in the DNA of the two breast cancer susceptibility genes. Genetic counselling by qualified professionals in the field of cancer genetics is usually recommended before and after the test to discuss with the candidate about the importance of the test, its benefits, and implications of its outcome, psychological impact and the inherent risk of passing on the mutations to one’s kids.
A woman who tests positive now understands that she has a high lifetime risk of developing breast or ovarian cancer. However she should also understand that just because she is a carrier of the faulty gene, it does not mean that she would certainly develop the disease.
The woman who has the harmful BRCA1 or BRCA2 mutation will be placed under the radar of surveillance that includes periodical mammography and clinical breast examinations in the case of breast cancer and for ovarian cancer, surveillance methods include transvaginal ultrasound, blood tests and clinical exams. Screening will go a long way in detecting breast cancers early enough to be successfully treated with minimal damage to the quality of life of the individual.
The option of resorting to surgery as a pre-emptive step to reduce the risk of developing cancer is also explored by some women. Prophylactic surgery involving removal of tissues that are more exposed to risk i.e., prophylactic mastectomy (removal of healthy breasts) and prophylactic salpingo-oophorectomy (removal of healthy fallopian tubes and ovaries) might offer some degree of protection against the development of breast and ovarian cancers. However, this does not offer any guarantee against development of the diseases.
Prescription of drugs like tamoxifen has shown to reduce the risk of developing breast cancer in women, who are at premenopausal stage and who are at increased risk of developing the disease. Clinical studies have also proved that the drug also serves to reduce the risk of recurrence of breast cancer in women who are already undergoing treatment for a breast tumour diagnosed earlier. Similarly, raloxifene is another drug that has shown to reduce the risk of developing invasive breast cancer in postmenopausal women.
It is imperative that women who seek risk avoidance measures like surgery or intake of drugs should discuss their options in detail with their physicians before implementing them.
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Genetic testing for breast cancer will help in taking the fight against cancer to the next level. For those women who have known reasons like strong family history of the disease, it is essential to consider being tested for a genetic mutation. However, the risk for developing the disease in women with the faulty genes varies from individual to individual.
Though genetic testing for cancer can cause a lot anxiety, stress, anger, guilt and even chronic depression in some individuals, it can have its own benefits irrespective of the outcome of the test. While it gives a sense of direction by way of adoption of preventive measures to those who test positive for a faulty gene, those who test negative experience a great sense of relief which helps in motivating them to increase their awareness.
Apart from inheritance of harmful genetic mutations it is common wisdom that women empower themselves with the knowledge of the factors that increase or decrease their chances of developing breast or ovarian cancer. The following factors have a significant impact on the onset of the diseases:
Women who have a first degree or second degree relative with breast or ovarian cancer is at increased risk for developing the diseases. Besides, women who have already had breast cancer are at an increased risk of recurrence or developing ovarian cancer.
Age is a crucial factor. The risk of developing breast or ovarian cancer increases with age. Genetic mutations can lead to early onset of the disease.
The greater the exposure of a woman’s body to oestrogen, a hormone that stimulates breast tissue, the greater is her risk for developing the disease. Women whose menstrual periods commenced early or whose menopause set in late (after 55) and women who delivered their first child at 30 or beyond are said to be prone to breast cancer as these events in their lives indicate increased exposure of their bodies to oestrogen.
Women who undergo hormone replacement therapy for symptoms of menopause are at an increased risk of breast cancer, besides heart attack, stroke and blood clots.
Medical and hereditary risks apart, there are certain lifestyle factors like obesity, lack of physical activity, alcohol consumption and increased intake high-fat diet that contribute to the risk of developing breast cancer.
The fight against breast cancer calls for a proactive approach by empowering oneself with the knowledge about the disease and through intelligent use of the support system that has been put in place by scientists in the field of genetic research. As a woman if you have valid reasons to worry about your chances of developing the disease, it is time you explored the option of genetic testing as a preventive strategy that could embolden your spirit, imbibe confidence and direct you on the path of preventive self- care.
