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Is Her2 Negative Breast Cancer Aggressive

Hormone Receptor Status And Early Breast Cancer Prognosis

Health Tips – HER2-Positive Breast Cancer

Hormone receptor status is related to the risk of breast cancer recurrence.

Hormone receptor-positive tumors have a slightly lower risk of breast cancer recurrence than hormone receptor-negative tumors in the first 5 years after diagnosis .

After about 5 years, this difference begins to decrease and over time, goes away .

For a summary of research studies on hormone receptor status and survival, visit the Breast Cancer Research Studies section.

What Is The Prognosis For Triple

A good treatment result depends on several factors. Chemotherapy is what can really make a difference in the outcome. The size of the invasive part of the tumor, and the number of involved lymph nodes can also greatly influence your prognosis, Sun says, but adds that if the cancer has spread , the prognosis is less certain.

There is hope, even with this serious diagnosis, and staying optimistic is essential. It can be stressful and scary to go through chemo, but positive thinking can make a difference. You have to believe that its doing you good, and for most people, it does.

Breast Cancer Treatment at Johns Hopkins

The breast cancer program at Johns Hopkins is made up of a diverse group of nationally-recognized specialists in breast cancer research and treatment.

Inform Her2 Dual Ish Test

This test is also conducted for identifying the presence of excessive copies of the HER2 gene in the breast cancer cells. The test report of the Inform HER2 Dual ISH test can help to determine the HER2 gene amplification or no HER2 gene amplification .

All the above-mentioned tests are conducted for the purpose of identifying the HER2 gene amplification or HER2 protein over-expression which is indicated by HER2-positive in the pathology report. The finding of this assists in determining HER2-positive Breast cancer. The aggressive nature of the HER2-positive breast cancers have a faster growth tendency and also spread faster and tend to relapse, which are not similar in HER2-negative breast cancers.

Different research results showed that the test report is not always correct to determine the status of HER2 protein due to the variation of the laboratory markers to classify positive and negative HER2 status. The pathologist who study the test report also follows different criteria to fix on whether the results are positive or negative. Most of the time confusion is created when the test report showed borderline and that cannot provide strong HER2-positive or HER2-negative. This lacuna needs to keep in mind during treating a patient with breast cancer, as Inaccurate HER2 test results may cause ineffective treatment prognosis. Therefore, repetition of test or alternative test must be performed to get an accurate result.

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Understanding Your Pathology Report

The pathology report describes important characteristics of the breast cancer. This information will help you and your doctors choose the best treatments for you and your unique situation.

The term pathology report makes it sound like youll get just one report with all the information in it. But thats not what happens. There is more than one type of pathology report.

Youll receive a report of results each time a test is done. Because not all labs do all tests, youll likely receive several different reports. Some tests take longer than others, but most information comes one to two weeks after surgery or a blood draw.

Together, all these reports make up your pathology report. Its a good idea to keep allthe reports in one place so when you visit your doctors you can discuss any ofthe results.

Pathologists are doctors who specialize in making a diagnosis by looking at tissue and cells, usually with the help of a microscope. By examining breast tissue and cells, a breast pathologist will issue a report that describes the diagnosis. At this point you may receive a diagnosis of breast cancer. The pathologist may then do more tests on a sample of your blood or cancer tissue removed from your body to further describe the specific type of breast cancer.

There are two main types of pathology reports:

  • an excision pathology report with a synoptic summary

What Percentage Of Breast Cancers Are Her2

What is HER2?

Approximately 20% of breast cancers are HER2-positive. HER2-positive breast cancers more commonly occur in women younger than 40. It is not clear what causes HER2 gene mutations, however, studies show HER2 breast cancers are not inherited. HER2-positive breast tumors are more likely to be larger and ER-negative.


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Hormone Receptor Status And Prognosis

Hormone receptor status is related to the risk of breast cancer recurrence.

Hormone receptor-positive tumors have a slightly lower risk of breast cancer recurrence than hormone receptor-negative tumors in the first 5 years after diagnosis .

After 5 years, this difference begins to decrease and over time, goes away .

For a summary of research studies on hormone receptor status and survival, visit the Breast Cancer Research Studies section.

Her2 Negative Breast Cancer Treatment Guidelines

Her2 negative breast cancer treatment guidelinesHER2-Positive vs. HER2-Negative Whats the Difference?ASCO issues evidenced-based information for management of patients with HER2-negative or HER2 status unknown advanced breast cancerHER2-positive breast cancer is one form of breast the FDA approved Herceptin as a single agent for the adjuvant treatment of HER2-positive node-negativeAdjuvant systemic therapy for HER2-positive trastuzumab for node-negative, HER2-positive breast cancer. systemic therapy for HER2-positive breast

In HER2-positive breast cancer, a gene called HER2 is expressed that promotes an aggressive form of the disease.

Researchers Jean-François Côté and Marie-Anne Goyette explain how a new therapeutic target works to fight a very aggressive form of breast cancer.

Jean-François Côté

Better treatments of HER2-positive breast cancer are closer at hand, thanks to new research by a team led by Université de Montréal professor Jean-François Côté at the cytoskeleton organization and cell-migration research unit of the UdeM-affiliated Institut de recherches cliniques de Montréal .

In HER2-positive breast cancer, a gene called HER2 is expressed that promotes an aggressive form of the disease. Affecting 20 per cent of women suffering from breast cancer in Canada, the HER2-positive subtype is associated with a poor prognosis.

We asked Côté and Goyette to tell us more.

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How Her2 Affects Staging

Your HER2 status helps determine the pathology of your specific breast cancer. Your HER2 status can also help determine how aggressive the cancer is. Your doctor will use this information to evaluate your treatment options.

As of 2018, the breast cancer staging system that the American Joint Committee on Cancer uses now incorporates HER2 status.

Staging is complex and must take various other factors into account, such as:

  • the size of the tumors
  • the cancers hormone status
  • whether the cancer has spread to nearby lymph nodes
  • whether the cancer has spread beyond the breast
  • whether the cancer cells look abnormal

For example, these two cancers are both classified as stage 1B:


Current Classification Of Breast Cancer

HER2/neu Breast Cancer Treatment For Shamenas Treatment from Memorial

Intertumoral heterogeneity of BC is initially illustrated with a clinical staging of the disease. The TNM staging system by the American Joint Committee on Cancer and Union for International Cancer Control adds information about tumor features such as size, regional lymph-node involvement or the presence of distant metastases . After the clinical diagnosis, the first step is the assessment of histological criteria on the primary tumor obtained by surgery and/or a core biopsy, encompassing morphology-base and immunohistochemical analyses for testing the biomarker profile. This is a classical and non-molecular classification of BC, and sets the standard in the usual clinical practice. Classic pathological criteria, such as histological type, tumor size, grade and axillary lymph node status, are relevant for the initial prognostic evaluation . The expression of hormone receptors by IHC and the overexpression and/or amplification of HER2 by IHC and/or ISH gives additional predictive value, being elementary for guiding algorithms of treatment , as will be discussed in the following two sections.

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The Effect Of Young Age In Hormone Receptor Positive Breast Cancer

Helena R. Chang

1University of California, Los Angeles, Los Angeles, CA 90095, USA

2Department of Surgery, David Geffen School of Medicine, Los Angeles, CA 90095, USA

3Revlon/UCLA Breast Center, Los Angeles, CA 90095, USA

4Department of Biomathematics, David Geffen School of Medicine, Los Angeles, CA 90095, USA

5Department of Pathology, David Geffen School of Medicine, Los Angeles, CA 90095, USA


1. Introduction

Although the incidence of breast cancer in young women is low, it is the leading cancer-related death in women younger than 45 years of age. Young women in this age group account for approximately 11% of new breast cancer cases and approximately 6% of breast cancer-related deaths . The question of whether young age alone is an independent prognosticator in breast cancer patients has been in debate. Several studies have reported that breast cancer in young women is associated with worse outcomes including higher mortality and recurrence rates compared to older women . However, many others have shown that young age is not an independent predictor of poor survival when controlling for other confounding factors .

2. Patients and Methods

2.1. Pathology
2.2. Statistical Analysis

3. Results


4. Discussion

5. Conclusions

Conflict of Interests

The authors declare that there is no conflict of interests regarding the publication of this paper.




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How Her2+ Breast Cancer Is Diagnosed

There are many steps in the process of diagnosing breast cancer.

If a person has a symptom that is concerning to them, such as a lump in their breast, they should discuss it with their healthcare provider. The healthcare provider will likely start by taking a medical history and performing a physical exam. This can help them determine what is causing the symptoms. The next step in the process is imaging.

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Clinicopathologic Characteristics Of Single Hormone Receptor

The median follow-up duration for the 6,980 patients included in this analysis was 45 months . In this study, 4,651 cases were double HR+ tumors, 1,758 were double HR- tumors, and 571 cases were single hormone-receptor positive tumors, of which 90 cases were ER-PR+ tumors and 481 were ER + PR- tumors. The clinicopathological characteristics of the four subtypes are summarized in Table . Overall, ER+/PR- tumors were found more frequently in postmenopausal women than other subtypes . Compared with ER + PR+ tumor, ER + PR- tumors were not significantly different in staging , but ER+PR- tumors exhibited higher nuclear grade , higher Ki-67 level , and higher EGFR and HER2 expression . However, compared with ER-PR- tumors, ER + PR- tumors showed lower stage , lower NG , lower Ki-67 level , lower p53 expression and lower EGFR expression , but there was no difference in HER2 overexpression .

Table 1 Clinicopathologic characteristics of patients with ER + PR+, ER + PR-, ER-PR+ and ER-PR- tumors

ER-PR+ tumors had higher NG , higher Ki-67 level , and higher expression of p53 and EGFR than ER + PR+ tumors. However, compared with ER-PR- tumors, there was no difference in stage or NG . Also, there was no difference in expression of Ki-67 , p53 , EGFR or HER2 .

Survival Rates For Triple


Triple-negative breast cancer is considered an aggressive cancer because it grows quickly, is more likely to have spread at the time its found, and is more likely to come back after treatment than other types of breast cancer. The outlook is generally not as good as it is for other types of breast cancer.

Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time after they were diagnosed. They cant tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful.

Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. These statistics can be confusing and may lead you to have more questions. Talk with your doctor about how these numbers may apply to you, as he or she is familiar with your situation.

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Risk Of Recurrence: Early And Late

Research has shown the HER2-positive early breast cancers are two to five times more likely to recur than HER2-negative tumors. Even very small HER2-positive tumors with negative lymph nodes have a much higher risk of recurrence relative to tumors that are HER2-negative. Treatment with Herceptin can cut this risk by half.

The pattern of breast cancer recurrence may also differ. Small tumors are also more likely to have a metastatic recurrence if they are HER2-positive.

Despite the fact that HER2-positive and estrogen receptor-negative tuors are more likely to recur early on than estrogen receptor-positive and HER2-negative cancers, late recurrences are much less common.

With estrogen receptor positive breast cancers, the cancer is more likely to recur after five years than in the first five years, and the risk of recurrence remains steady each year for at least 20 years following the diagnosis. In contrast, those who have HER2 positive tumors and reach their five-year mark are much more likely to be “in the clear” and remain recurrence free.

Is Her2 Breast Cancer Curable

The chances of successfully treating HER2 breast cancer is high if the cancer is detected in early stages. HER2 cancers, however, are often high grade tumors in stage III at the time of diagnosis. If HER2 cancer has metastasized at the time of diagnosis, it is treatable but not curable in most individuals.

With the development of medications that specifically target HER2 proteins, HER2-positive breast cancers now have a much better outlook than in the past. HER2-positive cancers that have been in remission for five years are less likely to recur.

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Determining Your Her2 Status

A breast biopsy is used to determine HER2 status. The biopsy can be sent for laboratory testing with an immunohistochemistry test. The fluorescence in situ hybridization test looks for the HER2 gene in breast cancer cells.

The results of an immunohistochemistry test show different levels of HER2 positivity. For example, a tumor may be reported as 0, 1+, 2+, or 3+. Tumors with a higher number may be referred to as having an overexpression of HER2.

According to the American Cancer Society, immunohistochemistry test results should be considered as follows:

3+ HER2-positive

The impact of being HER2-positive on breast cancer survival is, of course, a top concern. Unfortunately, statistics can be misleading without considering other aspects of your diagnosis, including cancer stage at diagnosis and whether the tumor is also estrogen and/or progesterone receptor-positive.

With this in mind, you may also be tested for progesterone and estrogen receptors. Triple-negative breast cancers are negative for HER2, estrogen, and progesterone, while triple-positive breast cancers are positive for all three.

What Is My Estrogen Receptor And Progesterone Receptor Status

Effect of Trastuzumab-based Therapy on Survival in Small, Node-Negative HER2-positive Breast Cancer

Your bodys hormones such as estrogen and progesterone may play a role in how your breast cancer progresses.

Normal cells are equipped with receptors that allow them to receive information from circulating hormones, similar to the way your phone picks up satellite signals. Cancer cells may also have hormone receptors, letting them tap into your bodys normal cell growth-regulating system.

Your ER/PR status is determined by testing a sample of breast cancer cells removed during a biopsy. If your breast cancer cells have estrogen and progesterone receptors if theyre ER/PR-positive then theyre capable of detecting estrogens signal and using it to fuel growth. If the cancer cells lack these receptors meaning theyre ER-/PR-negative they cant hear the growth-signaling message.

About 70% of breast cancer patients have positive ER/PR hormone status.

While being ER/PR-positive sounds bad, theres actually a benefit. Doctors can take advantage of the receptors presence. They can use an anti-estrogen drug that blocks the receptors and blocks estrogens growth signal. Or they can use other drugs like aromatase inhibitors that lower your bodys estrogen levels to deprive the cancer cells of fuel.

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What Makes This Discovery Promising

J-F.C.: With the latest scientific advances in cancer, immunotherapy and personalized medicine have generated a lot of hope. However, for HER2-positive patients, the results to date have been inconclusive, and thats why its important to better understand the immune environment surrounding this type of tumour. Indeed, its fundamental that the mechanisms and factors involved be identified to help better target treatments and those most likely to respond to them.

This is exactly what we did. We have not only shed light on a central mechanism of the functioning of some of the most aggressive tumours, but in doing so we have also unveiled a way to create an environment conducive to more effective treatment. The therapeutic potential of this study is highly significant for future clinical management of these cancers.

Options For Luminal Breast Cancer

with luminal or other types of HR-positive breast cancer receive hormone therapy. Some people call this endocrine therapy.

Triple-negative breast cancer does not respond to hormone therapy because it is HR-negative.

Anti-estrogen therapy

Anti-estrogen therapy works by preventing estrogen from attaching to the estrogen receptors of breast cancer cells.

The four different types of anti-estrogen therapy are:

  • selective estrogen-receptor response modulators, such as tamoxifen
  • aromatase inhibitors
  • estrogen-receptor downregulators, such as fulvestrant
  • luteinizing hormone releasing agents, including goserelin and leuprolide , prevent the ovaries from producing estrogen

The type of anti-estrogen therapy a person receives depends on various factors, including:

  • the stage of the breast cancer
  • whether the person has any other medical conditions
  • whether the person has been through menopause

A person usually continues hormone therapy for at least .

Other hormone therapies

In some cases, HR-positive breast cancer may not respond to the above treatments. Consequently, a doctor may recommend one of the following hormone therapies for more advanced cancer:

  • progestin medications, such as megestrol
  • an anabolic steroid, such as fluoxymesterone

Targeted therapies

Targeted therapies focus on specific genetic mutations that play a role in a cancers growth and spread. These drugs are usually combined with hormone therapy.

Examples of CDK4/6 inhibitors include:

  • abemaciclib
  • palbociclib
  • ribociclib

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