Peter Attia· MD
and that's collectively about 15% of all breast cancer split half and half between those that are ER positive her two positive and E are negative and her two positive so again that includes all of your triple positives
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The evidence is convergent. Multiple independent sources reach the same conclusion, the underlying mechanism is well-characterized, and even the field's most cautious voices treat it as worth doing.
and that's collectively about 15% of all breast cancer split half and half between those that are ER positive her two positive and E are negative and her two positive so again that includes all of your triple positives
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those tumors were classically described in younger women and uh again there's the the epidemiology of herto positive breast cancer as opposed to ER positive breast cancer is not really well described so in general older women are more likely to have better prognosis breast cancer a diagnosis because of the subset that arises in them and younger women uh tend to have more aggressive flavors of breast cancer again in in Broad Strokes
so there is a both a biological difference there is a specific region of the chromosome 17 that's Amplified giving overexpression of the heru new enogen that's presumably a driver for a fraction of these breast cancers um but it's also important because it allows us to bring a specific targeted therapy to play
and similarly herto positive breast cancers which were tumors that have an amplification of the herto New enco Gen and account for about 10 to 15% of all breast cancers those tumors were classically described in younger women and uh again there's the the epidemiology of herto positive breast cancer as opposed to ER positive breast cancer is not really well described so in general older women are more likely to have better prognosis breast cancers a diagnosis because of the subset that arises in them and younger women uh tend to have more aggressive flavors of breast cancer again in in Broad Strokes Hal I want to go over that again because I think that's just a fantastic overview of basically the three subtypes I also want to point out that you did not talk about uh proest receptor except in the negative when you talked about the triple negative case let's go back case one is I'm assuming it's ER positive PR agnostic her two new her two negative correct that's correct though the vast vast majority of those tumors also Express progesterone receptor got it you made the case again these are the ones that are showing up more likely on mamography they're also showing up in older women median age I think you said about 65 yeah you re across the whole age Spectrum but the peak is at 65 and um that's correct yep obviously we're going to dive into the therapeutic options prognosis exam Etc you then talked about triple negative though you didn't give a uh distribution or a number on that I'm just doing the math in my head that seems to be about 10 to 15% of the population correct yep okay so 10 to 15% or triple negative again that's ER negative PR negative her two new negative these skew younger these skew more they skew younger they again you can see them anywhere uh I see 80-year olds who have triple negative breast cancer but um they tend skew younger um there is an interesting relationship between race and triple negative breast cancer and there's been a lot of really excellent studies to suggest that there may be some um real demographic genetic differences that predispose we tend to see triple negative breast cancers also in brca1 mutation carrier so there's a clear link between specific genetic syndromes such as brca and triple negative disease but they also tend to be more virulent so they're more likely to present as a lump in the breast or a physical exam finding as opposed to readily being identified on a screening mammogram you mentioned a higher prevalence in African-American where do Asian women fit into this did they skew to anymore any any more than others they they don't have any enrichment in general over the normal distribution or not the normal the last one you talked about was all the her two new positives which includes your triple positives and frankly agnostic of erpr but her two new positive correct and that's collectively about 15% of all breast cancer split half and half between those that are ER are positive her two positive and E are negative and her two positive so again that includes all of your triple positives and there's the distinction there a biologic One Hal or are you making that distinction more because of herceptin I guess I should just clarify for The Listener because that because there's a targeted therapy for the herun new receptor positive cancer yeah so you you're exactly right so trusum Abra herceptin is the target of therapy and that has been sort of the Revolutionary treatment in the uh management of her two positive tumors so there is a both biological difference there is a specific region of the chromosome 17 that's Amplified giving overexpression of the heru new enco Gene that's presumably a driver for a fraction of these breast cancers um but it's also very important because it allows us to bring a specific targeted therapy to [Music] play
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