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pattypoo54

Junior Member
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Posts: 47
Reply with quote  #1 
I have had genetic testing done, still awaiting the results.My mom had breast cancer at age 65, and I was 50, they said based on my family history, I have a 3% chance of it being hereditary.Being that I am triple negative, and have two daughters, I decided to have the test.
 (1)Do you find that most triple negative breast cancers are hereditary?
 I am not sure what I will do if I test positive, as I am already five years out from my diagnoses. 

(2)My bone density has gone down on my last dexa scan, my doctor wants me to start taking Actonel, is that a cox 2 inhibitor?
I have also read about zometa, and reclast, what is your opinion on this? Are there trials for zometa? How does one go about getting the zometa?This is all so confusing, thanks for all your help.
Patty
edge

Chief of Research
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Posts: 1,129
Reply with quote  #2 

Patty:
 
First as to the genetic testing, as I've noted it can benefit clinical therapy management to know BRCA status, given  provisional evidence that BRCA1-mutated tumors may be relatively chemoresistant to taxanes and relatively chemosensitive to anthracyclines, and of course it can also clarify risk within familial structures.  But as to your query, no, most triple negative breast cancers (TNBC) are not hereditary or familial.  Although most BRCA1(-mutated tumors) are TNBC, and most BRCA1 and TNBC are basal, most TNBC are not BRCA-mutated (neither BRCA1 nor BRCA2).

 

As to your second query, risedronate (Actonel) is a bisphosphonate, meaning a drug used preventively against osteoporosis, helping to build back lost bone mineral density (BMD), and the class of bisphosphonate drugs also includes alendronate (Fosamax), ibandronate (Boniva), and clodronate (Bonefos, available outside of the U.S.), all administered orally, plus two intravenous bisphosphonates,  zoledronic acid (Zometa) and pamidronate (Aredia). None of these are COX-2 inhibitors, which are anti-inflammatory - not anti-osteoporotic - agents often used for pain, like celecoxib (Celebrex), and they resemble the non-prescription NSAIDs like ibuprofen (Advil) among many others.

 

Where the injectable zoledronic acid (Zometa) bisphosphonate fits in is that, like all the other bisphosphonates including Actonel, it is anti-osteoporotic and aids building or restoring BMD, but it is the most heavily studied such agent which has also been found to both

 

  1. reduce risk of bone-metastatic disease and
  2. exhibit positive benefit against active bone-metastatic disease, and there is recent suggestive evidence that it may also
  3. benefit all, not just bone, metastatic disease. 

 

It can be prescribed therefore by your doctor for both its benefit in osteoporosis and BMD, and/or its anti-metastatic activity (against risk or active disease).  Reclast is also just zoledronic acid like Zometa, but the distinction is that the Reclast formulation is administered once yearly, while Zometa may be every six months, every quarter or monthly.  But although there are many clinical trials of Zometa, for various uses and in various combinations with other therapies, it typically isn't necessary to go the trial route, since an oncologist can prescribe it assuming insurance coverage. 

 

Finally, although my sense is that it may turn out that any bisphosphonate may exert anti-metastatic benefits, right now we have the most evidence of this with Zometa (or Reclast).    

 

Hope this clarifies matters.

 


Constantine Kaniklidis
Breast Cancer Watch
edge@evidencewatch.com  

pattypoo54

Junior Member
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Posts: 47
Reply with quote  #3 
Thank you Edge for all the information. I'll let you know what I end up doing.
Patty
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