Triple negative is one of several subtypes of breast cancer.
“There’s no longer a medical model of one size fits all,” said Dr. April L. Speed, a breast surgeon and expert on breast cancer.
Triple negative is more challenging to treat than many forms of breast cancer because the tumor lacks the three known receptors that fuel most kinds of the disease, rendering some treatments ineffective.
Smith said triple negative represents about 15 percent to 20 percent of breast cancer cases.
The incidence of triple negative disease in African-American women with breast cancer ranges from 26 percent to 46 percent; the incidence in non-African-American women is between 13 percent and 16 percent.
“Certainly some of the disparity is due to poorer access to health care,” meaning many black women do not seek treatment until the disease has progressed to later stages, said Dr. Ruth O’Regan, a professor and vice chairwoman of educational affairs, hematology and oncology at Emory’s School of Medicine. Research, however, has shown a disparity in the subtypes of breast cancers that black women develop compared with white women. “Triple negative breast cancers have the worst outcome of all breast cancer subtypes, with a high risk of recurrence within five years of diagnosis. “
Smith said the outcomes for black women with triple negative breast cancer tend to be worse than those for white women. She thinks the key may be a molecular and environmental basis for these differences. And generally, when there is a recurrence of triple negative disease, the cancer returns much more aggressively.
Smith doesn’t know how many of her husband Duane’s relatives in New Orleans had triple negative breast cancer. She suspects several did, but she doesn’t know for sure because some medical records were lost in the flooding after Hurricane Katrina slammed the city in 2005 or because some cases were too old.
The two met while she was a student at Dillard University in New Orleans. She planned to become a physician, a dream she had nurtured since her childhood in Mobile, Ala. As the relationship deepened, Smith got closer to her husband’s family, especially his older sister Terri.
In 2001, a diagnosis showed Terri had breast cancer. She started peppering Smith with phone calls and questions.
What is the survival rate?
What are my treatment options?
Later, it became how long do I have to live?
Terri died in 2005 at age 47.
Each call sent Smith, who now lives in Lawrenceville, back to her textbooks and further research.
The calls continued after other members of her husband’s family received diagnoses of breast cancer. Among those stricken were four paternal aunts, both grandmothers and his sister.
“It flipped everything,” said Duane Smith, whose a customer service manager for ICS parking at Emory. His wife once wanted to be a neonatal physician. She changed her career to focus on breast cancer.
“She not only wanted to have the answers for my sister but black women in general,” he said. “How can you not love somebody who changes everything because they see you hurting? I hate cancer with a passion, and we have to make sure we’re in front of it.”
LaTonia Smith calls her work “a very personal mission.”
“I don’t consider this a job.”