When you are diagnosed with breast cancer, your doctor will do several tests to learn more about the cancer cells. This is usually done by taking a piece of the cancer tissue through surgery or a biopsy. One of these tests is to see if the cancer cells have ' hormone receptors '. Think of these receptors as little 'locks' on the surface of the cells. When the 'keys' called hormones fit into these locks, the cells receive a message to grow.
Progesterone is a hormone that is naturally produced in our bodies. It is very important for things like puberty, menstruation, and pregnancy in women. Some breast cancer cells have receptors on their surface that can bind to this hormone. This type of cancer is called progesterone-receptor positive, or simply PR-positive (PR+) breast cancer. What happens in this case is that the hormone progesterone comes and binds to the cancer cells and helps them grow further. So, the treatments for this try to stop this hormone process.
Another hormone that acts in a similar way is estrogen. If the cancer cells have estrogen receptors, it is called estrogen-receptor positive, or ER-positive (ER+) cancer.
Who is at higher risk for this condition?
If your cancer cells are PR-positive, ER-positive, or both, it is commonly called hormone-receptor positive (HR+) breast cancer. Fortunately, only about 7 out of 10 breast cancers diagnosed are of this type. Although this type of cancer can develop at any age, it is more common in women who have gone through menopause.
In general, the same risk factors that affect any breast cancer also affect HR-positive cancer. Let's take a look at what they are.
| Risk factor | Simply put... |
|---|---|
| Being a woman | Women are at higher risk compared to men. |
| Aging | The risk increases with age. |
| Abnormalities in breast cells | If you have previously had abnormal cell growth in the breast (e.g. LCIS ). |
| Family history | If a close family member has had breast cancer. |
| Early puberty | Menstruation begins before the age of 12. |
| Having children late | Having your first child after age 35 or never getting pregnant. |
| Late menopause | Menopause after age 55. |
| Taking hormone therapy | Taking hormone replacement therapy after menopause. |
What are the symptoms?
Most of the time, most women don't have any symptoms when they are diagnosed with breast cancer. Instead, it is discovered incidentally during a routine mammogram.
The symptoms of HR-positive breast cancer are similar to those of other types of breast cancer . Here are some of the most common symptoms.
| Symptom | Take care of this. |
|---|---|
| A new lump in the breast | Any new lump that you can feel, even if it is not painful. |
| A swelling in the breast | Swelling of the entire breast or part of it. |
| Breast or nipple pain | An unusual, persistent pain. |
| Skin changes | Sunken skin, orange peel appearance, thickening of the skin, redness, or dry, scaly skin. |
| Nipple changes | The nipple becomes indented or discharge occurs. |
| Swollen lymph nodes | Lumps in the armpit or around the neck that can be caught in the hand. |
How is hormone therapy used?
When developing your treatment plan, your doctor will definitely consider the hormonal status of your cancer. Hormone therapy is the main and most important treatment for PR-positive cancer. The goal is to prevent cancer cells from using hormones to grow.
Simply put, hormone therapy cuts off the supply of 'food' (hormones) that the cancer needs.
This can be done in two main ways:
- Surgical removal of the ovaries : This reduces the body's hormone production.
- Hormone therapy pills or injections: These medications either prevent the body from producing hormones, or block receptors (locks) on cancer cells, preventing them from binding to hormones (keys).
The type of hormone therapy you receive will also depend on whether you have gone through menopause. This treatment can be used at any stage of the cancer. Depending on the stage of the cancer, hormone therapy is given along with other treatments, such as surgery or chemotherapy.
What are other treatments?
In addition to hormone therapy, you may be given one or more of the following for PR-positive breast cancer .
- Surgery: Surgery to remove cancer cells. For example, removing only the lump (`Lumpectomy`) or removing the entire breast (`Mastectomy`).
- Chemotherapy: Powerful drugs given to destroy cancer cells.
- Radiation therapy : Uses high-energy rays to destroy any remaining cancer cells.
- Targeted Therapy: Drugs that target specific proteins that help cancer cells grow. These can also increase the effectiveness of hormone treatments.
What is the prognosis?
Here's some good news for you. Hormone-receptor-positive (HR+) cancers tend to grow more slowly than hormone-receptor-negative (HR-Negative) cancers. Also, you have an advantage in treatment because it can block the action of hormones and stop the cancer from growing. However, as with any cancer, the future cure depends on how early it is detected.
But there's something to remember. While hormone therapy can control the growth and spread of cancer, it can sometimes happen years after treatment. This is why doctors sometimes give hormone therapy for longer periods, sometimes for 5 or 10 years.
Therefore, it is very important to talk openly and clearly with your doctor about the hormone receptor status of your cancer and how it will affect your treatment plan and the way forward.
Take-Home Message
- PR-Positive (PR+) breast cancer means that the cancer cells use the hormone progesterone to grow.
- This type of cancer is very common, especially after menopause.
- Hormone therapy is a very effective and main treatment method used for this.
- The prognosis for these cancers is generally good because they grow slowly, but long-term treatment and regular medical check-ups are necessary to prevent recurrence.
- Never hesitate to talk to your doctor about your condition, treatment, and any concerns you may have.
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