Is your breast cancer HER2-Negative? Let's talk about this simply! (HER2-Negative Breast Cancer)

I know it's hard to put into words what you feel when your doctor tells you that you have breast cancer. It's normal to have a lot of questions and fears coming to your mind. But one of the most important things that can help you through this difficult journey is to understand the exact nature of your cancer. Knowing the stage of the cancer, its type, its size, and some of the proteins in your cancer cells is very important in deciding on treatment.

Simply put, what is HER2-Negative?

Let's understand this this way. The cells in our body are like little houses. These houses have special 'antennas' that receive messages from the outside. In medicine, we call these receptors. It is from these antennas that a cell receives messages like 'to grow' and 'to divide'.

HER2 (Human Epidermal Growth Factor Receptor 2) is one such special antenna. HER2 helps control the growth of healthy cells. However, cancer cells sometimes make too much of this HER2 antenna, much more than normal. Then the cancer receives a constant message telling it to 'grow', and the cancer starts to spread very quickly. We call this condition HER2-Positive .

So, if your doctor says your breast cancer is HER2-negative , that means your cancer cells don't have this extra HER2 antenna. Simply put, your cancer doesn't have a major factor that makes it grow faster.

How do you know exactly the HER2 status of your cancer?

The symptoms of both HER2-negative and HER2-positive cancers are similar. Your doctor can't tell you which type you have just by examining you. He or she will need to take a small sample of your tumor (biopsy) and have it tested. This test will determine exactly how much of the HER2 protein is in the cancer cells.

We need to look at more than just HER2!

HER2 is not the only factor that affects the growth of cancer. There are two other types of receptors ( hormone receptors - HR) in our body that are sensitive to hormones.

• Estrogen Receptors (ER)
• Progesterone Receptors (PR)

If these receptors are present on cancer cells, the hormones estrogen and progesterone can help the cancer grow. Doctors talk about all of these receptors together. This means that your HER2-negative cancer can be further divided into two types:

1. HR-Positive / HER2-Negative: This means that the cancer is not sensitive to HER2, but is sensitive to hormones. This is the most common type of breast cancer.

2. HR-Negative / HER2-Negative: This means that the cancer is not sensitive to either HER2 or hormones. Because all three of these receptors (HER2, ER, PR) are missing, this type is also called Triple Negative .

Knowing all of these factors will help you and your doctor get a clearer picture of the biological behavior of your cancer, which will help you choose the most appropriate and effective treatment option for you.

What are the treatments for HER2-negative cancer?

Because your cancer is HER2-negative, you won't be given targeted therapy, which targets the HER2 protein. That's because the drugs need to have the HER2 antenna on the cancer cells to work. Instead, other treatments will be chosen based on the stage of your cancer and whether it's sensitive to hormones.

• Surgery and radiation: If the cancer is detected early, surgery can completely remove it. Radiation therapy may also be recommended before or after surgery.

• Endocrine/ Hormone therapy: This treatment is very important if your cancer is HR-Positive/HER2-Negative. It works by reducing the levels of hormones like estrogen in the body. When the hormones are gone, the cancer cells lose the message to grow, and the cancer may shrink or stop growing.

• Chemotherapy: Chemotherapy can sometimes be given in combination with hormone therapy for HR-positive / HER2-negative cancers. This depends on factors such as the stage and grade of the cancer, your age, and your overall health. Sometimes the side effects of chemotherapy can outweigh the benefits, so it's important to talk to your doctor about what's best for you.

• Immunotherapy: If your cancer is triple negative and advanced, and has another protein called PD-L1, this treatment may be an option. It works by stimulating your own immune system to fight the cancer.

Outlook and Prognosis

The most important thing about breast cancer is to find it before it spreads to other parts of the body. If your HER2-negative cancer is localized to the breast, the 5-year relative survival rate is very high. This is especially true if your cancer is HR-positive.

Triple-negative cancers are a bit more challenging to treat because they don't respond to hormonal therapy or HER2-targeted therapies. They can also be more aggressive.

Below are the 5-year relative survival rates based on the stage of the cancer. These are just averages, keep in mind that your individual situation may be different.

Don't be alarmed by these numbers. These are just averages from thousands of people. Your individual outlook will depend on many factors, including how your body responds to treatment and your overall health. So, be open with your doctor about your condition and any additional tests you may need.

Breast Cancer, HER2-Negative, Cancer Treatment, Hormone Receptor, Triple-Negative, Women's Health, breast cancer sinhala