Treating Estrogen Receptor Positive Breast Cancer At Dignity Health North State
Compared to tumors that arent affected by hormones, hormone receptor-positive breast cancer grows more slowly. A common treatment for ER-positive breast cancer is hormonal therapy, which lowers the amount of estrogen in your body or completely blocks estrogen from attaching to the tumors cells. Hormone therapy is also an effective treatment for progesterone positive breast cancer.
In addition to hormone therapy, our full-fledged cancer centers offer other standard cancer treatments, including surgery, chemotherapy, and targeted drug therapy.
Correctly identifying the hormone receptor status is part of a quality diagnosis at Dignity Health North State. You can rely on our compassionate and experienced oncologists to explain your diagnosis and how it well affect your personalized treatment.
Triple Negative Breast Cancer
Triple negative breast cancers don’t have oestrogen receptors, progesterone receptors or HER2 receptors. Around 15 out of 100 women have this type . It is more common in younger women.
Hormone therapies and targeted cancer drugs do not work well for this type of breast cancer. So you are more likely to have chemotherapy.
Mean Gene Methylation And Receptor Status
We modeled using logistic regression analysis each of the 807 mean gene methylation values as a predictor of ER/PR status one at a time while adjusting for age and race/ethnicity . The resulting logistic coefficients for methylation variables and their corresponding P values were assembled. We then dichotomized coefficients into those representing a qualitatively inverse association and those representing a qualitatively positive association of higher methylation with ER/PR-positive breast cancer. The percentage of associations that were positive, along with the ratio of the number of positive divided by the number of negative associations, was estimated along with 95 % confidence intervals using bootstrapped bias-correction procedures based on 1000 replications. In addition, to assess whether or not difference between DNA methylation was significantly different between ER/PR-positive and ER/PR-negative groups, two-sided t tests were conducted using the β value of each gene across the samples in these two groups.
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What Is The Her2 Receptor What Does Her2/neu Mean
HER2/neu is the name of a growth-promoting protein that is found outside every breast cell. It is sometimes shortened in reference, as just HER2. If breast cancer cells contain higher-than-average levels of HER2, the cancer is called HER2-positive breast cancer. Such type of cancers have a tendency to grow and spread faster than other types of breast cancer.
It is advisable that all women who have recently been diagnosed with invasive forms of breast cancer, get tested for HER2 receptor status. Knowing HER2 status is important because because HER2-positive cancers can respond better to targeted therapies that have been tailored to identify and kill protein-active cancer cells, such as Trastuzumab .
Hormone Therapies And Targeted Therapies For Breast Cancer
Breast cancer treatments have been developed to specifically counteract ER+, PR+ and HER2 positive breast cancers.
For ER+ and PR+ a hormone therapy will most likely be included with other cancer treatments to block the receptors on the cancer cells from attracting the hormone. This slows the growth of the cancer.
The HER2 protein can also be blocked with a special category of drugs called targeted therapy. Clinical research has recently made available several targeted therapies for breast cancer patients that specifically block the growth of the HER2 protein, slowing the growth of the cancer.
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What Are Breast Cancer Hormone Receptors
Hormone receptors are the proteins, which are expressed on breast cancer cells. These hormone receptors can be detected by different molecular analysis techniques. These receptors are helpful in predicting the treatment and prognosis.
When estrogen and progesterone attach to such receptors, they can fuel the growth of cancer. Cancers are classified as either hormone receptor-positive or hormone receptor-negative based on whether or not the tissue samples reveal these receptors . Understanding ones breast cancer hormone receptor and HER2 status can help in navigating the treatment in the right direction.
What Do The Hormone Receptor Test Results Mean
Test results will give you your hormone receptor status. It will say a tumor is hormone receptor-positive if at least 1% of the cells tested have estrogen and/or progesterone receptors. Otherwise, the test will say the tumor is hormone receptor-negative.
Hormone receptor-positive breast cancer cells have either estrogen or progesterone receptors or both. These breast cancers can be treated with hormone therapy drugs that lower estrogen levels or block estrogen receptors. Hormone receptor-positive cancers tend to grow more slowly than those that are hormone receptor-negative. Women with hormone receptor-positive cancers tend to have a better outlook in the short-term, but these cancers can sometimes come back many years after treatment.
Hormone receptor-negative breast cancers have no estrogen or progesterone receptors. Treatment with hormone therapy drugs is not helpful for these cancers. These cancers tend to grow faster than hormone receptor-positive cancers. If they come back after treatment, its often in the first few years. Hormone receptor-negative cancers are more common in women who have not yet gone through menopause.
Triple-positive cancers are ER-positive, PR-positive, and HER2-positive. These cancers can be treated with hormone drugs as well as drugs that target HER2.
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Dna Methylation At Disease Predictor Genes In The Validation Dataset
We examined whether the 25 predictive gene methylation markers identified through the BCCC study would predict hormone receptor status in data from The Cancer Genome Atlas . Methylation data from TCGA represent a much larger platform, with 27,578 probes corresponding to 14,475 genes in total . An ER/PR-specific DNA methylation pattern was apparent in these data from TCGA . The prevalence of ER/PR-positive disease in the TCGA validation dataset was similar to that in our training dataset . We performed analysis of the TCGA data similar to the BCCC data . In the validation dataset, 2088 DNA methylation probes were strongly associated with ER/PR status. Multiple probes for IGFBP3 or PTGS2 showed similar DNA methylation pattern . Other predictor genes such as RASSF1, however, had a subset of probes that did not distinguish between ER/PR-positive and ER/PR-negative disease. The number of genes exhibiting hypermethylation in ER/PR-positive tumors was five times larger than the number of genes exhibiting hypermethylation in ER/PR-negative tumors.
What Are Estrogen Receptor/progesterone Receptor Tests
Estrogen receptor/progesterone receptor tests are used to help guide breast cancer treatment. Receptors are proteins that attach to certain substances. ER/PR tests look for receptors that attach to the hormones estrogen and progesterone in a sample of breast cancer tissue. Estrogen and progesterone play key roles in a woman’s sexual development and reproductive functions. Men also have these hormones, but in much smaller amounts.
About 70 percent of all breast cancers in women have receptors that attach to estrogen and/or progesterone. About 80 percent to 90 percent of breast cancers in men have these receptors. Breast cancers with estrogen and/or progesterone receptors include the following types:
- ER-positive : Cancers that have estrogen receptors
- PR-positive : Cancers that have progesterone receptors
- Hormone receptor-positive : Cancers that have one or both types of these receptors.
Breast cancers without ER or PR receptors are known as HR-negative .
ER/PR tests will show whether there are ER and/or PR receptors on your breast cancer cells. Test results are frequently referred to as the hormone receptor status. If your hormone receptor status shows you have one or both of these receptors on your cancer cells, you may respond well to certain types of treatments.
Other names: ER/PR IHC testing, hormone receptor status
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Testing For Hormone Receptor
After a breast cancer , the removed sample of breast is sent to a lab for testing. If the tissue is confirmed to have cancer cells, the tests help your care team learn more about the cancer and how to treat it. Your doctor will share the test results with you in a document called a pathology report.
One test performed on breast cancer cells is called an immunohistochemical staining , or IHC test. This test checks the hormone receptor status of the cancer cells. IHC tests show whether the cancer cells have estrogen receptors, progesterone receptors, or both.
What Is Triple Negative Breast Cancer
Triple negative breast cancer is estrogen receptor-negative, progesterone receptor-negative, and HER2-negative. Using hormone therapies or HER2 drugs will not slow these aggressive cancers. Triple negative breast cancer is more common among Hispanic and African American women, as well as younger women.
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Treatment For Breast Cancer
While there are many different types of breast cancer, its important to know that there are a wide range of treatments available. Your doctor will help you to understand what type of breast cancer you have and discuss your treatment options with you. These will depend on the subtype and stage of your breast cancer as well as your own health and personal situation.
Breast cancer treatment includes local treatment to the breast and lymph node regions. If your breast cancer can be removed with a clear margin, a lumpectomy and radiation therapy is as effective as a mastectomy. Breast cancer treatment also commonly includes drug therapy, such as hormone therapy and chemotherapy.
When These Receptors Attach To The Hormones Estrogen And Progesterone And Grow It Can Leave You With One Of Four Results:
- Estrogen-receptor positive or negative : This means the breast cancer cells may or may not have receptors for the hormone estrogen. ER+ results suggest that the cancer cells may receive signals from estrogen that could promote their growth.
- Progesterone-receptor positive or negative : This means the breast cancer cells may or may not have receptors for the hormone progesterone. PR+ results indicate that the cancer cells may receive signals from progesterone that could promote their growth.
- HER2 positive or negative: Treatment can also be affected by the presence of HER2 , which is a protein that appears on the surface of some breast cancer cells and plays a role in how a healthy breast cell grows, divides, and repairs itself. Knowing whether they are present will affect the treatment thats chosen.
- Triple-negative breast cancer: If you are told you have triple-negative cancer, your breast cancer cells test negative for estrogen receptors, progesterone receptors, and HER2. Triple-negative breast cancer will be treated differently from the other types of breast cancer since hormones are not playing a role in breast cancer growth.
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What Does Receptor Status Mean In Breast Cancer
Your breast cancer may be classified as hormone receptor positive or negative, depending on whether it has particular protein receptors on its surface or not. This is known as the hormone receptor status. Breast cancer cells with hormone receptors may be stimulated by your own natural hormones, or by the pill or hormone replacement therapy.
The hormone receptor status you receive may include:
- ER+ breast cancer has receptors for oestrogen
- PR+ breast cancer has receptors for progesterone
- ER- and PR- breast cancer has neither oestrogen or progesterone receptors
If your breast cancer is classified as hormone receptor positive, it may respond to treatments that adjust or block the hormones in the body. This is known as hormone or endocrine therapy.
If your breast cancer is classified as hormone receptor negative, hormone treatment will not be effective.
Breast Cancer Her2 Status
Some genes and the proteins they make can influence how the breast cancer behaves and also how it may respond to a specific cancer treatment. HER2 is a gene that can play a role in the development of breast cancer.
What does it mean to be HER2- negative or positive?
HER2-negative breast cancers do not have excess HER2. These tumors will not respond to therapies that specifically target HER2 receptors.
HER2-positive breast cancers have too much HER2 protein or extra copies of the HER2 gene. These breast cancers tend to be fast-growing. HER2-positive breast cancer treatment typically includes targeted therapy drugs that slow the growth and kill these cancer cells.
Your pathology report will typically include information about HER2 status and whether or not it is playing a role in your cancer so that your doctor can select a medication that addresses HER2-positive patients.
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Availability Of Supporting Data
The datasets supporting the results of this article are available at the Gene Expression Omnibus series }GSE72110.
The datasets supporting the results of this article are also included as its additional files. Additional file 1: Table S1 and Figures S1âS7. Additional file 2: Table S2 listing the PCC with associated P value for genes in the TCGA dataset to assess correlation between DNA methylation and mRNA expression.
What Is The Life Expectancy For Each Cancer Stage
Your outlook depends on the stage of your cancer when its discovered. Cancer is staged by number, starting with 0 and going to 4. Stage 0 is the very beginning and stage 4 is the last stage, also called the metastatic stage, because its when cancer has spread to other areas in the body.
Each number reflects different characteristics of your breast cancer. These characteristics include the size of the tumor and whether the cancer has moved into lymph nodes or distant organs, like the lungs, bones, or brain.
Research on survival statistics for people with breast cancer tends to separate participants into categories of women and men.
Survival statistics of women with the major subtypes of breast cancer such as ER-positive, HER2-positive, and triple-negative are grouped together. With treatment, most women with very early stage breast cancers of any subtype can expect a normal life span.
Survival rates are based on how many people are still alive years after they were first diagnosed. Five-year and 10-year survival are commonly reported.
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What Are Estrogen And Progesterone Receptors
Receptors are proteins in or on cells that can attach to certain substances in the blood. Normal breast cells and some breast cancer cells have receptors that attach to the hormones estrogen and progesterone, and need these hormones for the cells to grow.
Breast cancer cells may have one, both, or none of these receptors.
- ER-positive: Breast cancers that have estrogen receptors are called ER-positive cancers.
- PR-positive: Breast cancers with progesterone receptors are called PR-positive cancers.
- Hormone receptor-positive: If the cancer cell has one or both of the receptors above, the term hormone-receptive positive breast cancer may be used.
- Hormone receptor-negative: If the cancer cell does not have the estrogen or the progesterone receptor, it’s called hormone-receptor negative .
Keeping the hormones estrogen and progesterone from attaching to the receptors can help keep the cancer from growing and spreading. There are drugs that can be used to do this.
Hormone Receptor Status And Hormone Therapy
Hormone receptor-positive breast cancers can be treated with hormone therapies.
Hormone therapy drugs include tamoxifen and the aromatase inhibitors, anastrozole , letrozole and exemestane . Ovarian suppression, with surgery or drug therapy, is also a hormone therapy.
Hormone receptor-negative breast cancers are not treated with hormone therapies because they dont have hormone receptors.
Learn about hormone therapy for the treatment of metastatic breast cancers.
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A Hormone Receptor Status Is Either Hormone Receptor Positive Or Hormone Receptor Negative
- Hormone receptor-positive breast cancer cells have either estrogen or progesterone receptors. These breast cancers can be treated with hormone therapy drugs that lower estrogen levels or block estrogen receptors. HR-positive cancers tend to grow more slowly than those that are HR-negative. HR-positive cancers are generally more common in women after menopause.
- Hormone receptor-negative breast cancers do not have estrogen or progesterone receptors. These types of cancers will not benefit from hormone therapy drugs and typically grow faster than HR-positive cancers. HR-negative cancers are more common in women who have not yet gone through menopause.
Estrogen And Progesterone Give Fuel To Breast Tumor Growth
Some breast cancers feature malignant cells which have an abnormally high level of estrogen and/or progesterone receptors in the nucleus.
Estrogen and progesterone are hormones which more or less give fuel to cancer growth. Breast cancers with high levels of estrogen or progesterone receptors are often described as ER/PR positive.
On the one hand, it means that the breast cancer may be somewhat more aggressive, and prone to grow quickly.
On the other hand, breast cancers which have higher levels of estrogen and progesterone receptors are highly receptive to endocrine therapy and are easier to overcome.
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Hormone Receptor Status And Early Breast Cancer 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 about 5 years, this difference begins to decrease and over time, goes away .
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For a summary of research studies on hormone receptor status and survival, visit the Breast Cancer Research Studies section. |
How To Manage A Hormone Receptor
Several -approved treatments available for hormone receptor-positive breast cancer are effective at reducing the risk of breast cancer . Because of this, you may hear people say that hormone receptor-positive breast cancer is the best breast cancer to have. We know hearing others say these kinds of things can be difficult or angering having any kind of cancer is challenging. Remember that your experience with breast cancer is your own. Its OK to feel overwhelmed, scared, depressed, and angry, because we all handle emotional and physical treatment side effects differently.
It’s important after a cancer diagnosis to surround yourself with people you trust and who allow you space to experience your emotions as they come. Not everyone in your life will be able to do this, and that can feel isolating. Here are some strategies to help you navigate your emotions after diagnosis:
- Write your feelings a journal
- Talk to a trusted friend or family member
or anti-estrogen , only works in hormone receptor-positive cancers. Different hormonal therapies work in different ways. One way is to block the estrogen and progesterone that the cancer relies on to grow and survive. Another way is to decrease the amount of estrogen produced in the body. These treatments disrupt the growth signals sent by the hormone receptors to cancer cells.
Depending on the type, hormonal therapy works by:
When used as recommended, it can:
Learn more about Types of hormonal therapy.
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