Years ago, people thought about breast cancer as a single, monolithic, often life-threatening disease. The disease was subdivided into four stages: In Stage I, the tumor is small and has not spread beyond the original site; with Stage II and III cancers, the tumor is larger than in Stage I and may have spread to the lymph nodes; and in Stage IV, the cancer has spread, or metastasized, to other parts of the body.
Outside of their stages, these cancers were thought to be the same disease, and every patient was given the same treatment.
“But stage is really just the amount of cancer,” Dr. Winer says. And while the stage is still part of determining treatment, it’s more important to take into account the type of cancer, he adds.
To that end, the types of breast cancers are categorized by their hormone receptors (estrogen and progesterone) and what’s called “HER2” status.
Breast cancer cells that contain receptors for hormones like estrogen and/or progesterone (which can help the cancer cells grow) are said to be hormone receptor (HR)-positive. And cancer cells that have high levels of receptors are called human epidermal growth factor receptor 2 (HER2)-positive. (HER2 is a protein that helps HER2-positive cancer cells grow.)
Cancer cells that do not contain hormones or HER2 receptors are called hormone receptor (HR)-negative or HER2-negative, respectively.
And breast cancers that do not have receptors for estrogen, progesterone, and HER2 are known as triple-negative.
With this in mind, doctors now know that identifying the correct subtype of breast cancer helps in personalizing treatment to that specific cancer, which means a one-size-fits-all approach no longer applies.
“Even the smallest breast cancers, depending on their biology—or type—may need targeted therapies that can help reduce the risk of a recurrence,” says Dr. Lustberg. “Through advances in clinical trials, breast cancer specialists are now better able to select therapies that are beneficial for different subtypes of breast cancer, leading to better individual and overall outcomes.”
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October 05, 2022 at 03:06AM
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