A breast cancer diagnosis, either for yourself or a loved one, can be incredibly jarring news. In my own experience with a loved one, that diagnosis prompted an immediate search for information. What are the types of breast cancer? What is treatment going to entail? Can this be cured? And what in the world do all those negatives and positives mean when you hear someone say “triple-negative breast cancer” or “hormone-receptor positive breast cancer”?
Shayna Showalter, MD, a breast surgical oncologist at UVA, stresses that no matter what type of breast cancer you have, your care team will tailor your treatment specifically to you. Depending on the type of breast cancer you have, your treatment may include a combination of surgery, radiation, chemotherapy and anti-estrogen medications.
There have been incredible advances in breast cancer treatment in recent years, and breast cancer has become a very treatable, and curable, disease.
Common Types of Breast Cancer
There are many types of breast cancer, but the most common ones are:
- Ductal carcinoma in situ (DCIS)
- Invasive ductal carcinoma (IDC)
- Invasive lobular carcinoma (ILC)
Lobular or ductal describes whether the cancer originated in the lobules or the ducts of the breast. An in situ cancer is located within the ducts or lobules and has not invaded into the breast tissue. An invasive cancer has invaded normal tissue within or beyond the breast.
Testing the Tumor
Doctors will test a sample of affected breast tissue to learn more about the tumor’s genetic makeup and how to treat it most effectively. They’re looking at several components of the tumor. The most common receptors doctors analyze are:
- Estrogen receptor
- Progesterone receptor
- HER2/neu receptor
This is where those negatives and positives come in, as in “triple-negative breast cancer” or “hormone-receptor positive breast cancer.”
Hormone-Receptor Positive Breast Cancer
If your cancer tests positive for estrogen receptors (“ER-positive”) or progesterone receptors (“PR-positive”), that means your cancer cells essentially feed off of the estrogen or progesterone in your body. Typically, that means hormone therapy will be a part of your treatment.
Hormone therapy helps block the estrogen that the body naturally makes. Generally, doctors will prescribe hormone-therapy medication (tamoxifen or an aromatase inhibitor, for example) for at least 5 years.
HER2/neu Positive Breast Cancer
Some breast cancers produce too much of a protein called HER2/neu. Typically, specific anti-HER2/neu medications are part of the treatment plan for this type of cancer. These medications attach to the HER2/neu protein and slow the growth of the cancer cells. HER2/neu-positive breast cancers are curable but are typically treated with both chemotherapy and anti-HER2/neu medications.
Triple-Negative Breast Cancer
If your breast cancer tests negative for progesterone, estrogen, and HER2 receptors, your cancer is triple-negative breast cancer. Your doctor will very likely recommend chemotherapy as part of your treatment.
Looking for a Second Opinion?
Make an appointment with the UVA Breast Cancer Program.
According to Showalter, about 15-20% of new breast cancer diagnoses are triple-negative. “Triple-negative breast cancer tends to be a bit more aggressive, with a higher likelihood of recurrence, but it is still curable if discovered prior to metastasizing” Showalter says.
She adds, “The cancer community is now smart enough that we no longer have to treat every breast cancer the same. We individualize the treatment to the patient, their specific breast cancer, any other medical issues they have, as well as their wishes. It’s a back-and-forth conversation between the doctors and the patient.”