By Julia D. Janzen, BS, LPN, CRC
Breast cancer can be a scary diagnosis. Learning the basics about breast cancer can help to calm fears and form a knowledge base of understanding. Risk factors, diagnosis, and treatment options are areas of concern that people usually have questions about.
Types of Breast Cancer: Breast cancer may have certain receptors present or be receptor negative, which means that none of the receptors are present. Breast cancer is diagnosed in several different ways — one of the most important includes whether hormone receptors are present or not. Receptors are proteins that live in or on a cell. The receptors receive messages from substances in the bloodstream that give them instructions. Think of it as a lock and key type mechanism. Once the right substance comes along and fits in the receptor, the switch is turned on and a particular activity can take place.
The receptors in breast cancer are estrogen receptors, progesterone receptors, and human epidermal growth factor receptor 2 (HER2).
In about 10-20 percent of all breast cancer cases, there is a lack of receptors for estrogen, progesterone, and epidermal growth factor receptor 2, which is known as triple-negative breast cancer.
Risk Factors: One of the most recently discussed risk factors is being born with the BRCA1 or BRCA2 gene mutation. The BRCA1 gene mutation increases the risk for developing triple-negative breast cancer. Pre-menopausal women and women of certain ethnic groups also tend to have higher rates of triple-negative breast cancer. The BRCA2 gene mutation is most often found in people with estrogen receptor positive breast cancer. Other general risk factors for breast cancer include:
- Being female
- Increasing age
- Having a personal or family history of breast cancer
- Obesity
- Starting menarche at a younger age
- Starting menopause at an older age
- Having your first child at an older age
- Never having been pregnant
- Taking postmenopausal hormone therapy
- Drinking alcohol
Treatment: Breast cancer treatment may include combinations of medication, surgery, chemotherapy, radiation, and/or observation. Triple negative breast cancer responds well to chemotherapy. Breast cancers that have estrogen, progesterone, and/or HER-2 receptors present are typically treated with medications that target these receptors. Doctors determine treatment not only based on the receptors, but also on:
- How large the tumor is
- Has the cancer traveled to the lymph nodes near the breast
- Details of tumor based pathology tests
Treatment often involves surgery, such as a lumpectomy or mastectomy. A lumpectomy is also called a breast-conserving surgery.
Chemotherapy may be given before surgery to help shrink the tumor, known as neoadjuvant therapy. Chemotherapy is also given after surgery to kill all cancer cells in the body, this is called adjuvant therapy. Chemotherapy has two forms, intravenous (IV) or pill form. Chemotherapy is used to help prevent metastases, which is when cancer travels and develops in other distant parts of the body such as the liver, lungs, bones or brain.
Radiation is another form of treatment. It is considered a local therapy. It kills any cancer cells left after surgery where the cancer was located. This helps to prevent a local recurrence, that is, cancer coming back in the same area.
Another treatment option to consider is research clinical trials. These are research studies that test how new medications work, making sure they are safe and effective. Clinical trials can also be observational, collecting data to help other patients in the future.
There are currently two breast cancer research clinical trials taking place in our community at Mid-Illinois Hematology & Oncology Associates, Ltd. One trial is for triple-negative breast cancer with newly diagnosed metastasis. The other is for HER2 positive breast cancer patients with newly diagnosed metastasis. For further information please contact Julia at 309-451-2207 or julia.janzen@mihoaonline.org.