CASE SELECTION 3: Long-Term Survival with Advanced Triple-Negative Breast Cancer

“Case Selection” is a new format designed to highlight inspiring patient cases focused on challenging situations such as multiple recurrences, extensive metastases, rare subtypes, no longer response to standard treatments. Each case is derived exclusively from peer-reviewed medical journal case reports, rewritten by Patient Savvy in clear, easy-to-understand language without altering any critical information.

This collection highlights real stories of triple-negative breast cancer patients who achieved long-term survival through multiple lines of treatment—options often not fully detailed in standard guidelines (You can download FREE HERE). Their experiences show the power of self-advocacy and the importance of speaking with your doctor about personalized treatment paths.

Kati’s 6+ years with stage 4 TNBC

Invasive ductal carcinoma of the right breast, diagnosed at age 60 with lymph node involvement; recurrence in 2012 with metastases to bone and lymph nodes
Mastectomy, chemotherapy, radiation therapy, multiple systemic chemotherapy regimens, and bone-strengthening therapy

In June 2011, a 60-year-old woman, who had worked as a recruiter and had a history of type 2 diabetes, noticed nodules in her right breast. She underwent a mammogram, followed by a PET/CT scan, which confirmed a right breast mass with possible lymph node involvement. A biopsy revealed triple-negative invasive ductal carcinoma, a form of breast cancer that does not express hormone receptors or HER2. She underwent a right modified radical mastectomy later that month. Pathology confirmed that 19 lymph nodes were positive for metastatic disease. She proceeded with six cycles of adjuvant chemotherapy, completing treatment in November 2011, followed by radiation therapy, which she completed in January 2012. A PET/CT scan in February 2012 showed no signs of residual cancer.

Just months later, in June 2012, she discovered an enlarged left supraclavicular lymph node. A biopsy confirmed that her cancer had returned and metastasized to her bone and lymph nodes. Facing recurrent metastatic triple-negative breast cancer (TNBC), she started palliative chemoradiation but discontinued it shortly after. 

Seeking another opinion, she opted for systemic chemotherapy, receiving seven different regimens between July 2012 and June 2014. To help prevent complications from bone metastases, she also received monthly zoledronic acid and supportive medications to boost her immune system. Over time, her treatment was adjusted based on tolerance and response. A PET/CT scan in July 2013 revealed no metabolic activity in her previously affected bone lesion, indicating a strong response to treatment. After completing chemotherapy in June 2014, follow-up scans showed no evidence of metastatic disease.

Now 68 years old, she remains in remission and has not needed chemotherapy since 2014. While she discontinued zoledronic acid in 2015 due to mild osteonecrosis of the jaw, routine scans continue to show no signs of recurrence. Her journey demonstrates the importance of persistence, innovative treatment approaches, and expert medical care in overcoming metastatic TNBC. Today, she enjoys a good quality of life, inspiring others with her incredible resilience.

Source: Chue, B. M. F., & La Course, B. D. (2019). Can we cure stage IV triple-negative breast carcinoma?: Another case report of long-term survival (7 years). Medicine, 98(38), e17251.

Over 15 years with metastatic TNBC thanks to chemotherapy

High-grade invasive ductal carcinoma (2001), later recurrent triple-negative breast cancer (2003) with metastases
Initial surgery without adjuvant therapy; later chemotherapy, and bone-protecting agents led to remission

In March 2001, a 56-year-old homemaker discovered a nodule in her left breast. With a family history of prostate and uterine cancer, she underwent a biopsy in April 2001, which confirmed high-grade infiltrating ductal carcinoma. The tumor tested positive for estrogen receptor (ER) but negative for progesterone receptor (PR) and HER2 overexpression. She underwent a lumpectomy and lymph node dissection, which confirmed no lymphatic spread. However, she declined chemotherapy and radiation.

Two years later, in 2003, she noticed another mass in her left breast. A biopsy confirmed a recurrence, leading her to undergo bilateral mastectomies. This time, the cancer had evolved into a triple-negative subtype. Again, she declined additional treatment. Unfortunately, by September 2003, the disease had metastasized to her lungs, liver, bones, and lymph nodes.

Realizing the severity, she opted for chemotherapy, receiving multiple regimens alongside bone-protecting medication. Her treatment led to significant tumor shrinkage and normalization of cancer markers. By 2005, scans showed no evidence of disease. In mid-2005, minor skin recurrences were treated with an immune-stimulating cream, resolving by early 2006. Over the following years, her treatment was gradually reduced.

Now 73, she remains cancer-free for over 15 years, defying the odds of metastatic triple-negative breast cancer. Her journey highlights the importance of persistence, evolving treatments, and personalized care.

Source: Chue, B. M. F., & La Course, B. D. (2019). Case report of long-term survival with metastatic triple-negative breast carcinoma: Treatment possibilities for metastatic disease. Medicine, 98(16), e15302..

A journey from TNBC at age 24 to cancer-free

Invasive ductal carcinoma, TNBC, stage III, discovered at age 24
Chemotherapy (22 of 28 rounds), mastectomy with 34 lymph nodes removed, 33 rounds of radiation, and subsequent preventive mastectomy with reconstruction

A 24-year-old patient noticed a mass in her left breast during the summer of 2017 but did not initially suspect cancer. Because her gynecologist also presumed it might be a fibroid, they arranged additional tests at MD Anderson’s Undiagnosed Breast Clinic. A mammogram, ultrasound, and biopsy soon revealed invasive ductal carcinoma. Surprisingly, the cancer was triple-negative, meaning it lacked specific genetic markers for targeted therapy, and it had already reached stage III.

Given its aggressive nature, chemotherapy became the first line of defense. The patient started treatment on September 21, 2017, completing 22 of the prescribed 28 rounds before scans suggested the tumor was growing. Under the guidance of Dr. David Ramirez, surgery became the next essential step. On February 8, 2018, she underwent a complete mastectomy on the left side and removal of 34 lymph nodes. Fortunately, pathology reports showed 95% of the tumor was actually dead tissue; what appeared as growth on scans turned out to be swelling and scar tissue, indicating the chemotherapy had been effective after all.

With that encouraging news, 33 rounds of radiation therapy started in March 2018 under Dr. Eric Strom. On May 8, 2018, she rang the bell marking the end of radiation and learned she had no evidence of disease since surgery. However, triple-negative breast cancer carries a higher risk of recurrence, so she opted for preventive surgery in November to remove the other breast. Dr. Sarah DeSnyder and Dr. Summer Hanson performed a double mastectomy and subsequent breast reconstruction.

Though there was no genetic component to her cancer, the patient emphasizes the importance of regular self-exams and vigilance for those under 40. Early detection can make all the difference, especially when mammograms are not routinely recommended at younger ages. Her story highlights not only the significance of paying attention to any unusual changes, but also the hope and resilience that can come from timely medical intervention and unwavering determination.

Source:  MD Anderson Cancer Center (Published in January 2019)

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