Receiving a positive diagnosis of breast cancer can be devastating regardless of the type. However, some diagnoses carry more weight than others. HER2-positive breast cancer is a more aggressive and fast-growing type of breast cancer that requires swift action for the best possible outcome. Here, the oncology team at Richmond University Medical Center offers insight into what HER2 breast cancer is, including what to expect after receiving a positive diagnosis.
What Is HER2-Positive Breast Cancer?
HER2 refers to human epidermal growth factor receptor 2, a protein that controls breast cell growth and division to replace damaged or dying cells as needed. HER2-positive breast cancer occurs when breast cells have too many copies of the HER2 protein. When there are too many copies, cells can multiply too quickly. This can lead to tumors that grow and spread faster than other types of breast cancer.
It is estimated about one in every five of all breast cancer diagnoses are HER2-positive. A biopsy sample or tumor sample removed during surgery helps diagnose HER2-positive breast cancer. Tests such as immunohistochemistry (IHC) or fluorescence in situ hybridization (FISH) are performed to determine if the cancer cells have high levels of HER2.
Physicians recommend every invasive breast cancer be tested for the presence of HER2. This is because the results significantly impact treatment recommendations and decisions moving forward.
Who Is at Risk?
The risk factors for HER2-positive breast cancer are similar to those for other types of breast cancer (HER2-negative breast cancers). Like other forms of breast cancer, patients can develop HER2-positive breast cancer even without the following risk factors:
- Having certain genes like BRCA1 and BRCA2.
- Being over 50 years old.
- Having dense breasts, meaning they have more glandular and fibrous tissue and less fatty tissue.
- Starting your period before age 12 or going through menopause after age 55.
- Having a family history of breast or ovarian cancer.
- Being overweight or obese, especially after menopause.
- Taking certain types of hormone replacement therapy (HRT).
- Taking birth control pills, which contain synthetic sex hormones.
- Drinking more than one alcoholic beverage a day.
- Not being physically active or having a sedentary lifestyle. /li>
- Undergoing radiation therapy to the chest, especially before age 30.
- Being diagnosed with breast cancer previously.
What Are the Symptoms of HER2 Positive Breast Cancer
Like risk factors, the signs of HER2-positive breast cancer closely mimic the symptoms of other types of breast cancer and can include:
- A lump in the breast that feels different from the surrounding area
- A change in the shape, size, or appearance of the breast or nipple
- Breast tenderness, swelling, hardness, or warmth
- Discharge from the nipple that is not breast milk
- Skin irritation or dimpling on the breast or nipple
- Pain in the breast or nipple
- Redness or thickness of the nipple or breast skin
Just like other forms of breast cancer, patients with HER2-positive may not show any obvious symptoms, especially in the early stages. Therefore, routine screenings, like those performed at our Comprehensive Breast and Imaging Center are imperative.
What to Expect
After oncologists have identified the HER2 protein and categorized breast cancer as HER2-positive, immediate action is necessary. Breast cancer identified as HER2-positive tends to grow and spread to other areas of the body faster.
Although HER2-positive breast cancer is known as an aggressive form of cancer, the introduction of targeted treatments has improved the prognosis. Breast cancer treatment depends on factors like cancer stages and HER2 status but includes:
Targeted Therapy
Targeted therapy for HER2-positive breast cancer uses drugs to block the growth of breast cancer cells by interfering with specific proteins, like HER2. Common targeted therapies for HER2-positive breast cancer include:
- Monoclonal antibodies: These man-made versions of immune system proteins (antibodies) attach to the HER2 protein on cancer cells, which can help stop the cells from growing.
- Antibody-drug conjugates: Antibody-drug conjugates (ADC) attach to the HER2 protein on cancer cells and act as a homing signal for chemotherapy drugs, bringing them directly to them.
- Kinase inhibitors: These drugs block kinases, proteins in cells that signal the cell to grow.
The side effects of targeted therapy can vary depending on the specific drug used. Whether drugs are used alongside other forms of treatment can also inform possible side effects. Patients may experience:
- Nausea and vomiting
- Diarrhea
- Fatigue
- Mouth sores
- Skin irritation, including rashes or dry skin
- Hair loss
- Allergic reactions
- Infections, especially in the lungs, mouth, throat, sinuses, and skin
- Complications with the heart, lungs, or liver
Chemotherapy
Chemotherapy is a common treatment for HER2-positive breast cancer. Because chemotherapy drugs do not specifically target the HER2 protein, they are often used in combination with other approaches to treatment, including targeted therapy.
Chemotherapy is effective in shrinking tumors before they are removed by specialists during surgery. Patients typically undergo chemotherapy treatments in cycles, usually over three to six months, with days or weeks off between treatments to allow the body to recover.
Short-term side effects of chemotherapy may include:
- Fatigue
- Nausea and vomiting
- Hair loss
- Loss of appetite
- Constipation or diarrhea
- Mouth sores
- Changes to the skin or nails
- Nerve damage
These side effects typically go away after treatment but can sometimes be long-lasting.
HER2-Positive Breast Cancer Care in Staten Island
A diagnosis of HER2-positive breast cancer can be alarming for patients and their families. Proper care is necessary and can lead to positive outcomes. The oncology program at Richmond University Medical Center in Staten Island, New York, has been continuously accredited by the American College of Surgeons Commission on Cancer for over 80 years, making it the longest continually accredited cancer program on Staten Island, a testament to the highest standards of cancer care we provide our patients. Our oncologists are dedicated to treating patients with all forms of breast cancer, including HER2-positive. Contact us today to learn more about your options or schedule an appointment with our nationally recognized oncology team.
