Despite the fact that the number of new breast cancer diagnoses have stabilized over the past few years, the incidence rate among African American women continues to rise. 
Eva Joseph hopes by sharing her breast cancer story she can encourage women to seek knowledge and learn the facts about this serious disease.
Originally diagnosed in 2002 with stage 3 triple-negative breast cancer (TNBC) during a routine mammogram, Eva didn’t understand everything that was happening with her body. Unfortunately, Eva’s situation is far too common.
TNBC is twice as likely to occur in African American women compared to white women,  but many Black women aren’t receiving the necessary information about this disease.
Breast cancer is not a one-size-fits-all disease. Rather, “breast cancer” is an umbrella term for a number of different diseases that impact every woman differently.
Eva’s breast cancer type, TNBC, is defined by what it lacks; in this case, estrogen receptors, progesterone receptors and excess HER2 protein. The absence of these biological components make TNBC notoriously harder to treat. Some targeted therapies that are standard treatment in other types of breast cancer don’t work in TNBC. TNBC also typically grows and spreads faster and is more likely to come back after treatment than other types of breast cancer. These characteristics make the outlook for TNBC generally not as good as other types. 
Starting the Conversation
Eva’s daughter, Andrea Joseph, wants to know why more women aren’t talking about TNBC. Andrea has been by her mom’s side through this journey, as a daughter and caregiver. She is inspired by her mom’s resilience and positive attitude, but also worries that Black women aren’t being effectively reached when it comes to breast cancer education and awareness.
“It makes me angry that Black women don’t have this information,” says Andrea.
Andrea isn’t alone in feeling this way. Ricki Fairley, vice president of strategic partnerships & national programs at Sisters Network, Inc., an African American breast cancer advocacy group, wants to make sure she is doing her part to spread the word about this disease. An eight-year survivor herself, Ricki knows the hardships of TNBC firsthand.
“Though all breast cancer is bad, my TNBC sisters and I have had to fight a different fight, particularly Black women,” shares Ricki. “We’re not only more likely to get this type of breast cancer, but we’re more than twice as likely to die from the disease compared to white women. ”
A Brave Decision
Since Eva’s 2002 diagnosis of stage 3 TNBC, scientists have come a long way in understanding how to treat this complex type of breast cancer in part due to scientific observations in clinical trials. So, when Eva’s TNBC came back as stage 4 after years of remission, she didn’t hesitate to enroll in a study that was researching her specific type of breast cancer.
“I learned about the outcomes of TNBC and learned that this disease was aggressive,” shares Eva. “When my doctor told me my breast cancer had returned [and spread], I was afraid. But I had a family to think about and immediately started developing a treatment plan with my doctor.”
Eva enrolled in a clinical trial and received chemotherapy and a cancer immunotherapy called Tecentriq® (atezolizumab). Unlike targeted therapies that target different receptors or proteins on the cell, cancer immunotherapies like Tecentriq are designed to work differently. These medicines help reactivate the body’s own immune system to help fight cancer.  Tecentriq may also affect normal cells. Tecentriq was approved by the Food and Drug Administration as the first immunotherapy for TNBC. Tecentriq plus nab-pac*, a type of chemotherapy, is approved for the treatment of adults with metastatic TNBC whose tumors express PD-L1 – a protein expressed on some tumor and immune cells. The approval of Tecentriq in these patients is based on a study that measured the amount of time until patients’ disease worsened. Continued approval for this use may depend on the results of an ongoing study to confirm clinical benefit. Possible serious side effects include, but are not limited to, lung problems, liver problems, intestinal problems, hormone gland problems, problems in other organs, severe infections and severe infusion reactions. More important safety information can be found below in this article.
Fighting for Hope
Eva and Ricki are determined to raise awareness and educate their communities about TNBC – Black women who are currently impacted by breast cancer, and the caregivers – like Andrea – who support them.
“People should be screaming about TNBC and its impact from the mountaintops,” proclaims Andrea.
Eva, Ricki and Andrea want women to know there is progress being made to treat this aggressive, difficult-to-treat disease and that new advancements, such as cancer immunotherapies, may help.
Eva urges, “Learn more about the disease you have, ask questions. Knowing more information can lead to hope. And, that’s what this is really all about, it’s about hope.”
To learn more about advances in breast cancer treatment and other diseases, visit Genentech’s breast cancer hub.
*Abraxane® (nab-paclitaxel; paclitaxel protein-bound particles for injectable suspension [albumin- bound])
Tecentriq U.S. Indications
Tecentriq is a prescription medicine used to treat adults with:
A type of breast cancer called triple-negative breast cancer (TNBC).
Tecentriq may be used with the medicine paclitaxel protein-bound in patients when their breast cancer:
- has spread or cannot be removed by surgery and
- their cancer tests positive for “PD-L1”
The approval of TECENTRIQ in these patients is based on a study that measured the amount of time until patients’ disease worsened. Continued approval for this use may depend on the results of an ongoing study to confirm benefit.
Important Safety Information
The most important information about Tecentriq is: Tecentriq can cause the immune system to attack normal organs and tissues and can affect the way they work. These problems can sometimes become serious or life-threatening and can lead to death.
Patients should call or see their healthcare provider right away if they get any symptoms of the following problems or these symptoms get worse.
Tecentriq can cause serious side effects, including:
- Lung problems (pneumonitis)–signs and symptoms of pneumonitis may include new or worsening cough, shortness of breath and chest pain
- Liver problems (hepatitis)–signs and symptoms of hepatitis may include yellowing of the skin or the whites of the eyes, severe nausea or vomiting, pain on the right side of the stomach area (abdomen), drowsiness, dark urine (tea colored), bleeding or bruising more easily than normal and feeling less hungry than usual
- Intestinal problems (colitis)–signs and symptoms of colitis may include diarrhea (loose stools) or more bowel movements than usual, blood or mucus in stools or dark, tarry, sticky stools, and severe stomach area (abdomen) pain or tenderness
- Hormone gland problems (especially the thyroid, adrenal glands, pancreas, and pituitary) –signs and symptoms that the hormone glands are not working properly may include headaches that will not go away or unusual headaches, extreme tiredness, weight gain or weight loss, dizziness or fainting, feeling more hungry or thirsty than usual, hair loss, changes in mood or behavior (such as decreased sex drive, irritability, or forgetfulness), feeling cold, constipation, the voice gets deeper, urinating more often than usual, nausea or vomiting, and stomach area (abdomen) pain
- Problems in other organs–signs and symptoms may include severe muscle weakness, numbness or tingling in hands or feet, confusion, blurry vision, double vision, or other vision problems, changes in mood or behavior, extreme sensitivity to light, neck stiffness, eye pain or redness, skin blisters or peeling, chest pain, irregular heartbeat, shortness of breath or swelling of the ankles
- Severe infections–signs and symptoms of infection may include fever, cough, flu-like symptoms, pain when urinating and frequent urination or back pain
- Severe infusion reactions–signs and symptoms of infusion reactions may include chills or shaking, itching or rash, flushing, shortness of breath or wheezing, swelling of the face or lips, dizziness, fever, feeling like passing out, and back or neck pain
Getting medical treatment right away may help keep these problems from becoming more serious. A healthcare provider may treat patients with corticosteroid or hormone replacement medicines. A healthcare provider may delay or completely stop treatment with Tecentriq if patients have severe side effects.
Before receiving Tecentriq, patients should tell their healthcare provider about all of their medical conditions, including if they:
- have immune system problems (such as Crohn’s disease, ulcerative colitis, or lupus); have had an organ transplant; have lung or breathing problems; have liver problems; have a condition that affects the nervous system (such as myasthenia gravis or Guillain-Barre syndrome); or are being treated for an infection
- are pregnant or plan to become pregnant. Tecentriq can harm an unborn baby. Patients should tell their healthcare provider right away if they become pregnant or think they may be pregnant during treatment with Tecentriq. Females who are able to become pregnant:
- should have a healthcare provider do a pregnancy test before they start treatment with Tecentriq
- should use an effective method of birth control during their treatment and for at least 5 months after the last dose of Tecentriq
- are breastfeeding or plan to breastfeed. It is not known if Tecentriq passes into breast milk. Patients should not breastfeed during treatment and for at least 5 months after the last dose of Tecentriq
Patients should tell their healthcare provider about all the medicines they take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
The most common side effects of Tecentriq when used with paclitaxel protein-bound include:
- hair loss
- tingling or numbness in hands or feet
- feeling tired
- low red blood cells (anemia)
- low white blood cells
- decreased appetite
Tecentriq may cause fertility problems in females, which may affect their ability to have children. Patients should talk to their healthcare provider if they have concerns about fertility.
These are not all the possible side effects of Tecentriq. Patients should ask their healthcare provider or pharmacist for more information about the benefits and side effects of Tecentriq.
Report side effects to the FDA at 1-800-FDA-1088 or http://www.fda.gov/medwatch. Report side effects to Genentech at 1-888-835-2555.
Please visit the full Prescribing Information for additional Important Safety Information.
 Cancer Action Network, American Cancer Society. Disparities in Breast Cancer: African American Women. https://www.fightcancer.org/sites/default/files/FINAL%20-%20Disparities%20AABreastCancer%2002.14.17%20.pdf
 Bauer KR, et al. Descriptive Analysis of Estrogen Receptor (ER)-Negative, Progesterone Receptor (PR)-Negative, and HER2-Negative Invasive Breast Cancer, the So-called Triple-Negative Phenotype. Cancer 2007 March ;10.1002/cncr.22618
 American Cancer Society. Triple-negative Breast Cancer. http://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/types-of-breast-cancer/triple-negative.html
 American Cancer Society. Immunotherapy for Breast Cancer. http://www.cancer.org/cancer/breast-cancer/treatment/immunotherapy.html