HER2 (human epidermal growth factor receptor 2) is a protein receptor. Normally, this protein helps breast cells to grow, divide, and repair themselves. But sometimes, some changes occur in the genes that controls the HER2 protein and make the cells grow in a cancerous manner.
If your healthcare provider suspects cancer presence in your mammogram, biopsy or breast MRI, they will first try to identify the type of breast cancer. This information will be the key to understand cancer behaviour and in determining treatment plans.
What is HER2 Status?
If the reports show HER2-positive, it means that the breast cancer cells contain very high levels of HER2 protein. If the HER2 status shows HER2-negative, it means that the cancerous cells do not contain high levels of HER2 protein. Although, HER2 is an aggressive type of cancer, treatment options are available and vary with each status. About 1 of 5 breast cancers are HER-2 positive.
Symptoms
You may feel any lumps that can felt in or around your breasts (self-exam). In such cases, seek a healthcare provider and get breast screening done.
While lumps are common symptom, there are symptoms that can be visibly noted, these include:
- Sudden change in your breast size
- Pain in the breast or nipple area
- Fluid leakage from breasts (fluid can smell different too)
- Inverted nipples (nipples that are inward and not pointing out)
- A skin irritation
Breast screening procedures include mammography, breast MRI and biopsy to detect breast cancer.
Who is more likely to get HER2 positive breast cancer?
A combination of factors is said to influence breast cancers, including genetic changes (mutation), environment and lifestyle. Younger women are more likely to get affected by HER2-positive breast cancer than HER2-negative.
Though HER2 positive is a result of genetic changes, it is not inherited from a parent nor be passed down to your children.
Common factors may include:
- Sex (female)
- Physical inactivity
- Being overweight
- Substance abuse (smoking, alcohol or tobacco intake)
How is testing done for HER2?
Depending on your biopsy results, your healthcare provider may run a HER2 test with either,
- Immunohistochemistry (IHC) test, OR
- Fluorescence in situ hybridization (FISH) test
These tests are used to find out if the cancer cells have high levels of HER2 protein. It is not clear if both the tests are required to identify HER2 protein levels. However, IHC test is more likely to be the first choice of test. On the other hand, FISH test is known to be an expensive procedure, and is also time taking.
IHC test results are ranked as follows:
- If IHC result is 0 to 1+ à indicates HER2-negative cancer
- If IHC result is 2+ (called equivocal) à this means the result is not clear and requires further testing such as FISH test to confirm
- If IHC result is 3+ à indicates HER2-positive cancer
How does HER2 Status affect breast cancer treatment?
HER2-positive result could mean your healthcare provider will treat it with different means than other breast cancer types. The treatment plans are also influenced by the stage of the cancer (0 to IV). Generally, a HER2-positive cancer is metastatic (stage IV), where it spreads to other parts from its origin. However, early detection can make treatments effective and improve the outlook for cancer and increase survival rates.
Following are some of the treatment options:
HER2-positive result could mean your healthcare provider will treat it with different means than other breast cancer types. The treatment plans are also influenced by the stage of the cancer (0 to IV). Generally, a HER2-positive cancer is metastatic (stage IV), where it spreads to other parts from its origin. However, early detection can make treatments effective and improve the outlook for cancer and increase survival rates.
Following are some of the treatment options:
- Surgery: Cancer tumours are removed by surgery by lumpectomy or mastectomy. The decision on the type of surgery depends on the tumour number, size, location, extent of cancer that is spread and if lymph nodes are to be removed or not.
- Radiation therapy: High energy radiation such as use of X-rays is done to clear out or shrink any tumour that is present after the surgery.
- Chemotherapy: Powerful drugs are used to shrink and destroy the tumour that has grown or spread to other areas in the body.
- Targeted therapy: Targeted therapies are an effective treatment option and have proven to show a positive result in many HER2-positive cancer patients. These work by using certain drugs that target the cells that express HER2 protein. This treatment is less harmful as this does not affect the healthy cells (noncancerous cells) in anyway unlike other treatment options.
- Hormone therapy: This can be an option if the cancer is hormone receptor-positive. Special drugs are taken to block or lower the hormone estrogen levels in your body, so they do not bind with your cancer cells.
- Clinical trials: This treatment option is not common and can only be taken if your healthcare provider gives a clearance. These include test treatments on stage IV cancer patients. Probability of these to work is indefinite. However, some patients go for this option in hope that their cancer cells might respond to these treatments.
Encouragement for Recovery
A HER-2 positive status can be disheartening and make you weary. However, with right treatments, support from family and loved ones, and right care can improve your cancer experience. A combination of treatments has proven effective in recovery.
Some tips to help your in your cancer journey:
- Being informed by reading or talking to other cancer survivors. This can build hope and courage to make decisions in treatment.
- Finding a hobby or including a physical activity with moderate intensity can help relax your mind and body.
- As difficult as it can be, look for positivity in little things in life.
- Indulge in positive conversations.
- Gratitude and appreciating your surroundings can help.
- Meditation will ease your mind and body.
References:
- Breast Cancer HER2 Status. Cancer.org. https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/breast-cancer-her2-status.html
Accessed on 24-03-2022 - HER2 Status. Breastcancer.org. https://www.breastcancer.org/pathology-report/her2-status
24-03-2022 - HER2-positive breast cancer: What is it? MayoClinic. https://www.mayoclinic.org/breast-cancer/expert-answers/faq-20058066
24-03-2022 - HER2 (Breast Cancer) Testing. MedlinePlus. https://medlineplus.gov/lab-tests/her2-breast-cancer-testing/
24-03-2022 - Tumour Characteristics. Suman G. Komen. https://www.komen.org/breast-cancer/diagnosis/factors-that-affect-prognosis/tumor-characteristics/
24-03-2022