October is Breast Cancer Awareness Month.
About one in five breast cancers is HER2 positive. HER2-positive cancer is a type of breast cancer that contains higher than normal levels of HER2 proteins, which help cancer cells grow and multiply. HER2-positive cancers can spread quickly, but also have one of the highest survival rates when diagnosed early, thanks to highly effective treatments that specifically target HER2 proteins.
Understanding how HER2 status is diagnosed and treated will help you advocate for yourself and make informed decisions as an important member of your medical team.
We asked Roshani Patel, MD, FACS, medical director of the breast program at Jersey Shore University Medical Center and member of the HealthyWomen Women’s Health Advisory Council, what women should know about HER2-positive breast cancer.
What is HER2-positive breast cancer?
HER2-positive breast cancer cells have parts I like to call “antennas” that send messages to the cancer cells, telling them to divide quickly. That makes this type of cancer aggressive, and that’s bad news. The good news is that your medical team can block the signal sent by the antennas. The drug we use to fight HER2-positive cancer is very effective because we have these parts that we can target – especially if we can treat the cancer early, before it spreads.
What are the risk factors?
The risk factors for HER2-positive breast cancer are the same as for all types of breast cancer. Family history plays a role: If a first-degree relative (mother, sister or daughter) has breast cancer, the risk doubles. An unhealthy diet and obesity play a role. Metabolic syndrome also contributes to your risk of breast cancer. Metabolic syndrome is a combination of at least three of five health problems: low HDL or “good” cholesterol, high triglycerides, high fasting blood sugar, high blood pressure and fat in the stomach area.
How is HER2-positive breast cancer diagnosed?
HER2-positive breast cancer is diagnosed through a biopsy. A radiologist or surgeon takes a sample of the tumor. The sample goes to a pathologist and special dyes are used to identify targets on the cells.
What are brain metastases and leptomeningeal spread in HER2 positive breast cancer?
When HER2-positive breast cancer spreads, it is one of the most likely breast cancers to spread to the brain and leptomeninges. Think of the leptomeninges as a bedsheet that acts like a thin covering around your brain and spinal cord.
Why is there a higher risk of brain metastases and leptomeningeal spread in HER2-positive breast cancer?
HER2-positive cancer cells can spread across the blood-brain barrier. The blood-brain barrier protects your brain from dangers such as germs, viruses and bacteria, but some cells can get through. HER2-positive cancer cells can spread through the blood-brain barrier because they contain substances that make them stickier. Additionally, some cells act like chameleons or shapeshifters and can change so they can pass.
What treatments are used for HER2 positive breast cancer?
HER2-positive cancer is treated with surgery, chemotherapy and targeted antibody treatments. Monoclonal antibodies like trastuzumab target the HER2 proteins to stop them from multiplying and signal the immune system to fight the cancer. Additional antibody treatments have been developed and are evolving rapidly. These medications can effectively stimulate the body’s natural immune system to fight cancer. Treatments have become so effective that survival rates in stage 1 are over 90%. The survival rate in stage 2 is 85-90%, and even in stage 3 the survival rate is over 80%.
This educational resource was created with support from Merck and Daiichi.
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