Triple-Negative Breast Cancer: Q&A with Kevin Kalinsky, MD

By Kevin Kalinsky, MD, director of breast medical oncology at Emory University’s Winship Cancer Institute, as told to Alexandra Benisek

In the WebMD webinar “Triple Negative Breast Cancer: How We Learn to Treat It More Effectively,” Kevin Kalinsky, MD, director of breast medical oncology at Emory University’s Winship Cancer Institute, answered questions from viewers about TNBC and its treatments.

We don’t have clear data from any of the tumor subtypes on stress and how it affects cancer development. There is some preclinical data, that is, data in the lab, that is being looked at stress hormones and cancer risk coming back. But again, that’s preclinical data. And that’s not necessarily translated into how we can care for people with TNBC.

When I talk to people about stress management, it’s important for us to think about the impact stress can have, period – on our overall well-being and mindfulness.

There is data that suggests this connection between the mind-body connection and the outcomes of someone with TNBC. However, there is no clear data on relationships between stress hormones and recurrence risk — and whether that can help reduce the risk of cancer recurrence.

When we treat people who have triple-negative breast cancer, and when we give them systemic therapy, it’s to reduce the chances of the cancer coming back. This includes lowering their risk of metastatic recurrence of triple-negative breast cancer (when the cancer has spread to other parts of your body).

We think more about the risk of other cancers if someone has a genetic predisposition, such as the BRCA gene. With BRCA there is a risk of breast cancer, also with BRCA1 and the link with triple-negative breast cancer and, for example, ovarian cancer.

So if people have a genetic predisposition, whichever that is, there may be a risk for other cancers as well.

There is data that looked at people taking supplements during chemotherapy. We saw that the more supplements people take, the worse their results. And it could be that these interfere with some of the treatments we give.

This is the most common question we get with breast cancer. There are ongoing studies looking at power supply And excercise and whether this can help with better outcomes, including in triple-negative breast cancer.

We are waiting for the results to help us answer this question.

I’d say it’s always helpful to talk to your nutritionist, even outside of breast cancer recurrence, just to have a healthy lifestyle. And I would say, in general, everything in moderation.

Yes, it’s an excellent question and something that’s important for us to continue to evaluate.

I think it’s been a consistent finding over the years, and also just emphasizes the importance that people — especially young women who non-Hispanic black — continue to get their screening mammograms and keep up to date with those images. Especially if they have a strong family history.

I don’t know if inequality is related to prevalence. But for outcome differences, this remains an important question in terms of social determinants of health.

That’s not just for triple-negative breast cancer, and it’s not just for non-Hispanic blacks versus non-Hispanic whites. The differences can also be seen between urban versus rural communities.

This is an extremely important question in terms of access to care. And even if someone has care, whether there is a difference in their level of care. We know that there can also be differences between communities in the extent of mammographic screening.

Watch an online replay of “Triple Negative Breast Cancer: How We Learn to Treat It More Effectively.”

Look different free WebMD webinars by leading experts on various health topics.