How to Unpack the NCCN Guidelines for mTNBC


Two oncologists explain how patients can better understand the NCCN Clinical Practice Guidelines.


0:08 | Dr. Moroose with that, why is it key that this should really be a shared decision making process?

0:14 | So, every individual deserves to guide their own destiny and the clinician should understand the patient's goals and desires in terms of what they're looking toward what, what they hope to achieve, and it's really critical and we as oncologist probably spend more time talking about the side effects of treatment. Then we do the success of treatment, but it is, you know, a balance. It's definitely a risk-benefit balance. A patient's need to understand as much as they can. This whole era of molecular testing of breast cancers. As was mentioned, not all breast cancers are alike. And I think we're just on the verge of understanding more and more potential targeted therapies for metastatic triple negative breast cancer at all, metastatic cancer.

1:08 | Absolutely. And so, Dr. Kaklamani, how can patients learn more about dancing NCCN guidelines? Should they be asking their doctors? Are there resources to kind of better understand this information for them?

1:22 | I think both there are resources, so the NCCN guidelines also have a section for patients but it's not just the NCCN guidelines. ASCO, the American Society of Clinical Oncology puts up a webpage for patients so they can go and be informed. And I've looked at that website and it's, it's very nice. It's very nicely patient oriented. And then it's going to be a discussion like Dr. Moroose said that we really need to a lot of times we focus on what our goals are. Our goals for metastatic breast cancer is help patients live better and live longer, which is great. But patients may have very specific goals. They may want to feel well for their kids’ graduation, which happens on a specific day or somebody's getting married and they need to be out of town. To attend that wedding. And a lot of times this interferes with our treatment, and he doesn't have to, we just have to adjust things to make sure that we can get them to what they're at least short-term goal is, but it's very important that we have that discussion. And sometimes I guess loss.

2:22 | Absolutely. Dr. Moroose, [do you have] any information on how patients can learn more as well?

2:27 | Right. I think the sites that Dr. Kaklamani spoke about are excellent. American Cancer Society often also has fairly solid education. Just be aware though sometimes the scientific guidelines are more quickly emanated than patient guidelines. So always rely on your oncologist to help you. The other thing I do want to mention is that not only are treatment guidelines evolving here, but for example, recently anybody with triple negative breast cancer should have germline testing for BRCA1 and BRCA2 and other mutations, regardless of the age so the also the considerations for patients and their families are equally evolving.

3:16 | So, to kind of just to bring it all together. Do you have any final thoughts for our metastatic triple-negative breast cancer patients on maybe how they can just be a better educated patient?

3:30 | First of all, my hat's off to all of these brave men and women primarily women who are facing this, who have participated in research trials who have been brave enough to undergo therapy. And having practiced for 35 years as a breast oncologist, it warms my heart to see some successes now that we didn't enjoy in the past. Dr Kaklamani’s a lot younger, so she'll see a lot of this going forward in her career. But just continue to ask questions. If your oncologist doesn't want you to ask questions, think about whether that's the right oncologist for you and stay as informed as you can, not about just about your therapy, but about your options.

4:18 | And I think the only thing I would add and Dr. Moroose already mentioned it previously, is how important clinical trials are. We are where we are today because brave men and women before us were able to participate in clinical trials to define what the standard of care is. If we want to improve on that standard of care. We have to do clinical trial research to get to our next better medication, better medication eventually get to the cure, even of metastatic disease even as difficult as triple-negative breast cancer is we will get to the cure, but we will only get to the cure if we are able to participate in clinical trials.

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