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Metatstatic Breast Cancer Treatment

Metastatic breast cancer (MBC) can be categorized into different subtypes based on the characteristics of the cancer cells. Each subtype may require a different approach to treatment, so your healthcare team will tailor your care plan based on the specific type of cancer you have. Understanding your cancer’s subtype can help you and your doctors work together to choose the most effective treatment options.

Hormone Receptor-Positive (HR+,HER2-)

The cancer cells have receptors for hormones like estrogen (ER) and/or progesterone (PR). These hormones can help the cancer grow.

Treatment Options: Treatment options aim to slow down or stop the cancer’s growth. These often include hormone therapies that either block the hormones or reduce their levels in the body. Additional options may include CDK 4/6 inhibitors, mTOR inhibitors, chemotherapy, or therapies targeting inherited genetic mutations or specific mutations within the tumor.

Sources/Additional Information

American Cancer Society. (2023). “Breast Cancer Subtypes.
American Cancer Society. (2023). “Targeted Drug therapy”
National Comprehensive Cancer Network (NCCN). “Metastatic Breast Cancer Guidelines.”

HER 2 Receptor-Positive (HER2+)

The cancer cells have too much of a protein called HER2 on their surface. This protein can promote cancer cell growth.

Treatment Options: Targeted therapies, such as trastuzumab (Herceptin) or pertuzumab (Perjeta), specifically target HER2, along with other options like chemotherapy to slow down or stop the cancer’s growth.

Sources/Additional Information

American Cancer Society. (2023). “Breast Cancer Subtypes.
American Cancer Society. (2023). “Targeted Drug therapy”
National Comprehensive Cancer Network (NCCN). “Metastatic Breast Cancer Guidelines.”

Triple Negative (TNBC)

The cancer cells do not have estrogen or progesterone receptors and do not overexpress HER2. This subtype can be more challenging to treat because it doesn’t respond to hormone therapies or HER2-targeted treatments.

Treatment Options: Treatments often include chemotherapy, and sometimes newer therapies or clinical trials are considered. The NCCN guidelines recommend genetic and biomarker testing, as results may open up additional treatment options that may include therapies targeting inherited genetic mutations or specific mutations within the tumor.

Sources/Additional Information

American Cancer Society. (2023). “Breast Cancer Subtypes.
American Cancer Society. (2023). “Targeted Drug therapy”
National Comprehensive Cancer Network (NCCN). “Metastatic Breast Cancer Guidelines.”

Triple Positive (HR+,HER2+)

The cancer cells have receptors for estrogen and progesterone and overexpress HER2. This subtype has characteristics of both HR+ and HER2-positive cancers.

Treatment Options: Treatment usually involves a combination of hormone therapies and HER2-targeted therapies, along with other options like chemotherapy.

Sources/Additional Information

American Cancer Society. (2023). “Breast Cancer Subtypes.
American Cancer Society. (2023). “Targeted Drug therapy”
National Comprehensive Cancer Network (NCCN). “Metastatic Breast Cancer Guidelines.”

HER2 Receptor- Low and Ultralow (HER2-Low, HER2-Ultralow)

HER2-low breast cancer means that the cancer cells have a small amount of the HER2 protein on their surface, but not enough to be classified as HER2-positive.

HER2-ultra low breast cancer has even less of the HER2 protein than HER2-low cancer, but still more than HER2-negative. This type of cancer might benefit from some treatments aimed at HER2.

Treatment Options: Targeted therapies, such as Trastuzumab Deruxtecan (T-DXd) or (Enhertu), is an antibody drug conjugate specifically targeting HER2 to slow down or stop the cancer’s growth.

Sources/Additional Information

American Cancer Society. (2023). “Breast Cancer Subtypes.
American Cancer Society. (2023). “Targeted Drug therapy”
National Comprehensive Cancer Network (NCCN). “Metastatic Breast Cancer Guidelines.”

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