Introduction
Cancer cells are divided and named accordingly depending on the location of the presence of cancer cells. Likewise, breast cancer is a type in which the cancer cells grow rapidly in the breast region. Typing any cancer is necessary to obtain a proper treatment plan for the patient. Breast cancer typing is identified with advanced diagnostic methods. Treatment for advanced breast cancers is performed to increase the lifespan and enhance the quality of life for the patient.
What Is HER-2?
The human epidermal growth factor receptor (HER2) is a protein found in the breast cells. They help in the normal growth of the breast cells. But at times, show increasingly greater growth than usual. The presence of many HER2 proteins can lead to a higher risk of cancer, and the rate of spread can also increase.
Breast tumors with higher levels of HER 2 protein are HER2-positive breast cancer. And those with lesser levels are HER2-negative breast cancer.
What Is HER2- Negative Advanced Breast Cancer?
Advanced breast cancer is a stage that spreads from the originating site to other parts of the body. Advanced breast cancer with lower levels of HER2 proteins is called HER2-negative advanced breast cancer.
What Are the Types of HER2-Negative Breast Cancer?
Estrogen and progesterone are the hormones present in breast cancer cells.
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HER 2-Negative Hormone Receptor-Positive - It is the most common subtype. The presence of receptors for both estrogen and progesterone hormones is considered hormone receptor-positive. Estrogen receptor-positive cases are presently more than progesterone receptor cases.
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HER2-Negative Hormone Receptor-Negative - A breast cancer with both HER2 and HR negative is considered triple negative breast cancer, which is the least common.
What Are the Diagnostic Methods for HER2?
1. Immunohistochemistry (Ihc) Test - It is a diagnostic test that uses a special dye to stain the receptor on the sample. The results of the test can be as follows.
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Ihc 0 - HER2 negative.
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Ihc 1+ - HER2 negative.
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Ihc 2+ - Equivocal, meaning the result is unclear and needs to be tested with fluorescence in situ hybridization test (FISH).
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Ihc 3+ - HER2 positive.
2. Fluorescence In Situ Hybridization Test - Expensive and time taking to get results. Certain labeling molecules that bind to HER2 protein have been used to glow upon binding.
What Are the Main Goals of the Treatment for HER2-Negative Advanced Breast Cancer?
The following are the goals of the treatment:
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To increase the survival ability of the patient.
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Decreasing the side effects after the treatment.
What Are the Treatment Options for HER2-Negative Advanced Breast Cancer?
A complete cure for advanced breast cancer is not present. But the quality of life can be improved for certain years. Treatment of HER2-negative advanced breast cancer also depends on hormone receptors. Following are the treatment options for HER2-negative advanced breast cancer.
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Targeted therapy.
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Surgery.
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Hormonal therapy.
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Immunotherapy.
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Chemotherapy - It is followed, which blocks the binding of the receptor using drugs to destroy cancer cells. A single type of chemotherapy regimen is followed other than combination therapy. But in certain cases, chemotherapy is combined with targeted drug therapy. Better treatment outcomes for chemotherapy are obtained by considering the following factors.
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Previous treatment received.
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Patient's overall health condition.
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Potential side effects of the drugs.
Drugs containing estrogen receptor modulators and estrogen receptor degraders are used.
The action of estrogen can be blocked by stopping the actions of ovaries, which is called ovary suppression.
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Targeted Therapy - Targeted therapy drugs bind to proteins in cancer cells and carry out their activities. It is a treatment that targets certain genes and proteins that contribute to the growth of cancer. However, not every tumor has the same target cell. Various types of targeted therapies include:
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Monoclonal Antibodies - They recognize and attach to certain proteins in the cancer cells and destroy them.
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Small Molecule Inhibitors - The part of the cancer cell aiding in the growth and survival of the cancer cells is targeted.
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Tumor Agonistic Treatments - Tumor agonistic treatments can treat any type of cancer regardless of the type, size, or spread of the tumor.
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Surgery - Removal of the tumor and some part of healthy tissue around the tumor is performed. It is not a preferred treatment approach for advanced breast cancer, but it is recommended when removing the tumor causing discomfort. Surgery, along with radiation therapy, is mostly opted for.
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Hormonal Therapy - It is an effective treatment for many tumors that are hormone receptor-positive. Hormonal therapy aims at lowering the levels of hormones (estrogen and progesterone) in the body or blocking these hormones from getting into the cancer cells. It prevents cancer from utilizing hormones for growth. It is recommended for all HR-positive patients.
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Immunotherapy - It is also called biologic therapy, which boosts the body's natural immunity to fight cancer. Common side effects of immunotherapy include skin reactions, diarrhea, and flu-like symptoms.
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Radiation Therapy - Radiation therapy uses high-energy X-rays to destroy cancer cells. The most common type of treatment is external beam radiation therapy. In addition, a certain type of treatment that involves placing a radioactive substance in the tumor, called brachytherapy, is also carried out. On the whole, radiation therapy helps in slowing the growth of tumors or shrinking the tumor.
Can HER2-Negative Advanced Breast Cancer Be Cured Completely?
As such, there is no complete cure for advanced breast cancer. All the treatment options are limited to removing the tumor and improving the patient's quality of life. Patients tend to live alone with cancer. It is rare in certain cases that cancer, on the whole, is cured without any side effects. Proper tumor removal can be concluded as a complete treatment, which can also have a chance of recurrence and the possibility of showing side effects.
How Is It to Live as a Cancer Survivor?
It is a relief as well as worry upon completion of treatment for breast cancer. Many patients are relieved that they are cancer free and also worried about its occurrence. However, in a few patients, cancer does not go away completely. Therefore, they tend to continue the treatment to gain symptomatic relief. Typical follow-up schedules depend on the type of cancer, cancer stage, and, most importantly, the patient's clinical condition. Mammograms, pelvic examinations, and bone density tests, including a few blood and imaging tests, are advised during the follow-ups to check the patient's improvement.
Conclusion
Advanced breast cancer is a later stage that can hardly be cured completely. Nevertheless, most of the patients continue the treatment to improve their quality of life. A multidisciplinary treatment approach is followed by including experienced surgical, radiation, and medical oncologists, pathologists, along with cancer care teams come into action.
Quality of life and survival chances are increased by following the treatment procedures listed above.
