What treatment options are available for breast cancer?

Question

Hello doctor,

I am writing on behalf of my mother, who is 50 years old and was diagnosed with invasive ductal carcinoma last month. One of the things that is troubling her is that she breastfed all four of us for extended periods, often more than six continuous years. She is now blaming herself, thinking that the prolonged breastfeeding might have caused her cancer.

She had read somewhere that extended lactation actually protects against breast cancer, which is making her feel even more anxious and guilty about her diagnosis. Could you please help clarify whether there is any connection between extended breastfeeding and an increased risk of breast cancer?

Additionally, the biopsy report mentioned terms like HR positive and HER2 negative. Could you explain what these mean in relation to her treatment options and prognosis?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query and can understand your concern.

I want to reassure her that these feelings are common, and addressing her concerns is an important step toward feeling more informed and supported during this time.

Does prolonged breastfeeding cause breast cancer?

First, I want to reassure both you and your mother that extended breastfeeding does not cause breast cancer. In fact, research has shown that breastfeeding can lower the risk of developing breast cancer, especially when done over a longer period. The hormones involved in lactation help delay ovulation and reduce overall exposure to estrogen, which is a key factor in some types of breast cancer. Some studies suggest that women who breastfeed for longer durations may actually have a slightly lower risk of developing breast cancer later in life.

It is natural for your mother to feel anxious, but the reality is that breast cancer can occur for many reasons, often due to a combination of genetics, age, and environmental factors. Breastfeeding is not to blame, and it is not something she should feel guilty about.

Explanation of biopsy results: HR Positive and HER2 Negative

Now, regarding the biopsy report, I would like to explain what HR-positive and HER2 negative mean and what they could mean for her treatment:

HR positive (hormone receptor-positive): This means the cancer cells have receptors for hormones like estrogen and progesterone. Because her cancer is hormone receptor-positive, it means that the cancer cells grow in response to these hormones. The good news is that hormone receptor-positive cancers generally respond very well to treatments that block or lower the levels of these hormones in the body. This may include medications like tamoxifen (for premenopausal women) or aromatase inhibitors (for postmenopausal women), which help prevent the cancer from receiving the hormones it needs to grow.
HER2 negative: HER2 is a protein that, in some breast cancers, makes the cancer grow more aggressively. Being HER2-negative means that her cancer does not have this protein, which is actually a positive sign. HER2-positive cancers tend to be more aggressive, but HER2-negative cancers are typically less aggressive and are more likely to respond to hormone therapies. While HER2-negative means she won’t benefit from targeted therapies like Herceptin (which works specifically on HER2-positive cancers), it is also an indication that her cancer may be easier to treat with standard treatments like surgery, chemotherapy, and hormone therapy.

What this means for her treatment: Based on the biopsy results, here is a general sense of what her treatment plan might include:

Hormone therapy: Since her cancer is HR-positive, hormone therapy is likely to be a key part of her treatment plan. This might involve tamoxifen (if she is premenopausal) or aromatase inhibitors (for postmenopausal women). These treatments block the hormones that fuel the cancer, helping to reduce the risk of recurrence.
Chemotherapy: Since her cancer is HER2-negative, targeted treatments like Herceptin will not be necessary. However, chemotherapy may still be part of the plan, especially if there is concern about the cancer spreading or recurring.
Surgery and radiation: Depending on the stage of her cancer, surgery, such as a lumpectomy or mastectomy, may be recommended, followed by radiation to target any remaining cancer cells and lower the chances of recurrence.

The fact that her cancer is HR-positive is an encouraging sign, as it means she is likely to benefit from hormone therapies, which have proven effective in reducing the risk of cancer returning. Since it is HER2-negative, her cancer is likely to be less aggressive, making her treatment plan potentially more manageable.

Reassurance and support:

It is important to remind your mother that her breastfeeding history does not cause the cancer, and in fact, could have helped lower her risk. Cancer can occur for many reasons, and often, it is not something anyone could have prevented. Her anxiety and guilt are understandable, but she should feel reassured that breastfeeding is not the cause.

Regarding her treatment, having HR-positive, and HER2-negative cancer means there are effective treatments available that can work well over time. Encouraging your mother to stay in close contact with her oncologist will be important, as they will tailor the plan to her specific needs and make adjustments as needed based on her response to treatment.

Your support will be invaluable during this journey. Your mother is in good hands, and while the road ahead may seem daunting, many treatment options can help her manage and overcome this challenge. With the right care, her outlook can be very positive.

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.