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Treating Breast Cancer Early

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What to Expect After a Diagnosis of HR+/HER2- Early Stage Breast Cancer

Medically Reviewed By Teresa Hagan Thomas PHD, BA, RN

If your oncologist has determined that you have HR+/HER2- cancer, this information can inform both of you about the best possible treatment options.

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Not entirely sure what the HR+/HER2- designation means? HR stands for “hormone receptor.” If your cancer is HR+, it has tested positive for receptors for either estrogen or progesterone — or both. Essentially, one or both hormones fuel your breast cancer and contribute to its spread.

Meanwhile, HER2- stands for “human epidermal growth factor receptor 2.” The HER2 gene produces HER2 proteins, which can drive tumor development and progression. If your cancer status is deemed to be HER2-, that means your cancer does not seem to be overexpressing or overproducing this particular protein.

Understanding your diagnosis

Here’s how your HR+/HER2- cancer fits into the greater scheme of things. According to the American Cancer Society (ACS) Trusted Source American Cancer Society Highly respected international organization Go to source , experts can use genetic info about breast cancers to assign them to one of four molecular subtypes, although the categories can have some overlap from time to time. The four categories are: 

  • luminal A (HR+/HER2-)
  • luminal B (HR+/HER2+)
  • basal-like (HR-/HER2-)
  • HER2 enriched (HR-/HER2+)

The category that applies to you is the first one: luminal A, or HR+/HER2-. According to the ACS, this is the most common type of breast cancer. HR+/HER2- cancers account for about 68% Trusted Source American Cancer Society Highly respected international organization Go to source of breast cancer in the United States.

Understanding your prognosis 

In addition to being the most common kind of breast cancer, HR+/HER2- breast tumors tend to grow more slowly than many other types of cancer. In fact, cancers with a negative HER2 status tend to be less aggressive and less likely to spread than cancers with a positive HER2 status. Also, HR+/HER2- breast cancers typically have the best prognosis

Understanding your treatment options

After you receive your diagnosis, your doctor will explain the treatment options typically recommended for your type of cancer. The treatment choices can vary based on the stage of your cancer, the tumor size and its spread, your health history, and any previous cancer treatments you may have undergone.

Genetics also play a role in your treatment options. The cancer’s status as hormone-positive cancer also will drive the treatment choices. HR+/HER2- cancers tend to respond well to hormonal therapy, which seems to be part of the reason for the good prognosis.

Why hormone therapy? Tumors that are HR+ use estrogen or progesterone to drive their growth, but hormone therapy can reduce the levels of those hormones and interrupt that growth. It might even prevent the hormones from getting to the cancerous cells in the first place, which cuts off this source of fuel for development.

You may have heard of tamoxifen, a drug known as a selective estrogen-receptor response modulator (SERM), which is a commonly used type of hormonal therapy. Others include fulvestrant, an estrogen-receptor downregulator (ERD), aromatase inhibitors, and ovarian suppression drugs. All of these drugs can have side effects that you’d need to be aware of since they affect your hormones.

Sometimes hormonal therapy is offered in tandem with targeted therapy to females with metastatic HR+/HER2- breast cancer. Depending on the progression of your cancer, this might eventually be an option for you. The oral medications in this category include:

  • Palbociclib (Ibrance)
  • Ribociclib (Kisqali)
  • Abemaciclib (Verzenio)

The treatment recommendations may vary for females who haven’t gone through menopause yet or males diagnosed with this type of breast cancer. 

Ask questions

It’s a lot to grapple with, so don’t be afraid to ask questions at any stage of the experience. Your cancer care team is there to help you learn more about your specific diagnosis of HR+/HER2- early stage breast cancer.

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Medical Reviewer: Teresa Hagan Thomas PHD, BA, RN
Last Review Date: 2023 Mar 31
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