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October is Breast Cancer Awareness Month.
About one in five breast cancers has a mutation in the HER2 gene. Cancers with HER2 gene mutations are a type of breast cancer with high levels of HER2 proteins, which promote the growth and proliferation of cancer cells. Cancers with a HER2 gene mutation can spread quickly, but also have the highest survival rates when diagnosed early, thanks to highly effective treatments that specifically target HER2 proteins.
Understanding how the HER2 gene mutation is diagnosed and treated will help you advocate for your well-being and make informed decisions as an important member of your medical team.
We asked Roshani Patel, MD, FACS, medical director of the Breast Health Program at Jersey Shore University Medical Center and member of HealthyWomen’s Women’s Health Advisory Board, what women should know about HER2-mutant breast cancer.
What is breast cancer with a HER2 gene mutation?
Breast cancer cells with a HER2 gene mutation have parts I call “antennas” that send messages to the cancer cells, causing them to divide quickly. That’s why this type of cancer is aggressive and that’s bad news. The good news is that your medical devices can block the signal sent by these antennas. The drug we use against cancer with a HER2 gene mutation is very effective because there are parts that can be targeted, especially if we can treat the cancer early before it spreads.
What are the risk factors?
The risk factors for breast cancer with a HER2 gene mutation are the same as for all breast cancers. Family history plays an important role: if a first-degree relative (mother, sister or daughter) has breast cancer, the risk doubles. Unhealthy diet and obesity are important factors. Metabolic syndrome also contributes to the risk of breast cancer. Metabolic syndrome is a combination of at least three of five medical problems: low LDL or “good” cholesterol levels, high triglyceride levels, high fasting blood sugar, high blood pressure and fat in the stomach area.
How is breast cancer with a HER2 gene mutation diagnosed?
Breast cancer with a HER2 gene mutation is diagnosed through a biopsy. A radiologist or surgeon takes a sample of the tumor. The sample is sent to the pathologist and special dyes are used to identify targets on the cells.
What are brain metastases and leptomeningeal spread associated with breast cancer with a HER2 gene mutation?
When breast cancer with a HER2 gene mutation spreads, it is one of the breast cancers most likely to spread to the brain and leptomeninges. Imagine that the leptomeninges act like a thin blanket around your brain and spinal cord.
Why is there a high risk of brain metastasis and leptomeningeal spread in breast cancer with a HER2 gene mutation?
Cancer cells with a HER2 gene mutation can spread across the blood-brain barrier. The blood-brain barrier protects your brain from germs, viruses and bacteria, but some cells can pass through it. Cancer cells with a HER2 gene mutation can spread across the blood-brain barrier because they have substances that can make them stickier. In addition, some cells act like chameleons and can change shape as they pass through.
What treatments are available for breast cancer with a HER2 gene mutation?
Cancer with a HER2 gene mutation is treated with surgery, chemotherapy and targeted antibody treatments. Monoclonal antibodies like trastuzumab target HER2 proteins to prevent them from multiplying and signal the immune system to fight cancer. Additional antibody treatments have been developed and are evolving rapidly. These medications can effectively harness the body’s natural immune system to fight cancer. Treatments are now so effective that survival rates for stage 1 cancer are over 90%. The survival rate for stage 2 cancers is between 85 and 90%, and even for stage 3 cancers the rate is over 80%.
This educational resource was created with support from Merck and Daiichi.
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