GUEST COMMENTARY: How to save your mother's life

2013-05-12T00:00:00Z GUEST COMMENTARY: How to save your mother's lifeBy Tranece Artis nwitimes.com
May 12, 2013 12:00 am  • 

Sadly, hundreds of thousands of young women ignore a ticking time bomb called triple negative breast cancer, and they don't even know it.

Carol Johnson, a 28-year-old working mother of three, first noticed a small lump in her left breast in 2005. Because she had a busy work schedule and felt healthy, she delayed seeking medical attention. She assumed it was a cyst similar to the small lumps that plagued her mother over the years -- a nuisance but not deadly. Just two months later, the small "cyst" had grown from the size of a quarter to the size of a golf ball, and she began to feel pain under her left armpit.

Not long after, she was diagnosed with TNBC, an aggressive breast cancer tumor that grows rapidly, has few treatment options, and results in relatively low survival rates.

The pain in her armpit was a sign that the cancer had spread to her lymph nodes -- the gateway to other parts of her body. This diagnosis marked the beginning of a three-year battle with breast cancer Carol eventually lost, leaving her husband to care for her three children alone.

Carol's story is sad but not unique. Nearly 40,000 women are diagnosed with TNBC annually. Even with early detection, women diagnosed with TNBC have only a 77 percent survival rate.

Unfortunately, early detection is rare for the women most likely to be diagnosed with TNBC because they are too young (under age 40) to qualify for coverage of mammograms under most insurance programs. Therefore, these young women usually don't seek medical treatment until large lumps appear in the later stages of the disease.

The survival rate for women diagnosed with stage four TNBC (the last stage) is less than 20 percent. This is in stark contrast to the overall breast cancer survival rate which has improved to nearly 93 percent with early detection.

The use of hormone therapies that attack the estrogen, progesterone or protein receptors in breast cancer cells and stop them from growing and multiplying has contributed greatly to the improved overall survival rate. Unfortunately, TNBC tumors do not respond positively to the three classes of hormone therapies currently available, hence the name Triple Negative Breast Cancer.

Because only 10 to 15 percent of all breast cancers are classified as TNBC, most research dollars are directed to more common forms of the disease. As a result, improvements in TNBC survival rates have been negligible.

Some researchers contend TNBC incidence can be reduced dramatically by conducting genetic testing on women under age 40 to assess their risk and by providing special preventive care, if needed, to prevent the onset of the disease -- thereby saving lives.

Implementing these specialized treatment plans before the disease develops is akin to expertly diffusing the ticking time bomb.

Under the Affordable Care Act, insurance companies are required to cover women's preventive health services including mammograms for breast cancer screening and to cover pre-existing conditions.

With these protections in place, now is the time to encourage the Department of Health and Human Services to consider adding TNBC genetic testing to the list of its covered preventive health services under the ACA. Had a similar measure been in place before 2005, it is possible Carol would be celebrating this Mother's Day with her now teenage children.

Tranece Artis is executive director of a breast cancer charity called Laini Fluellen Charities and a graduate student at University of Chicago's Harris School of Public Policy. The opinions are the writer's.

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