What you need to know about Luminal B Breast Cancer!

You've probably heard a lot about breast cancer. But did you know that there are different types of breast cancer? Well, today we're going to talk about a special type called Luminal B breast cancer. This name may sound a bit complicated, but don't worry. We'll talk about it in a very simple way that you can understand. Because being aware of things like this can be very important for you and your loved ones.

What is Luminal B? What are its special features?

Simply put, Luminal B is a type of breast cancer that is hormone receptor-positive (HR+). This is because certain proteins (receptors) inside the cancer cells bind to the hormone estrogen, causing the cancer to grow. The word "luminal" refers to the cells that line the inside of the milk ducts in your breast. Think of it like the inside of a tube.

Now let's look at the other special characteristics of Luminal B cancer cells. These are like the identification card of this cancer. Doctors will study these characteristics carefully to decide what treatment is best for you.

• Estrogen receptor positive (ER+): This is the most important characteristic. Luminal B cancer cells have proteins called Estrogen Receptors (ER) that can bind to the hormone Estrogen. Estrogen is a hormone that is naturally produced in the female body. So, when this hormone binds to the cancer cells, the cancer gets a boost to grow. It’s like watering and nourishing a plant.
• Low or Negative for Progesterone receptors (PR- or low PR): Compared to the Luminal A type of breast cancer, Luminal B cells have very few, or sometimes none, of the proteins that bind to the other major female hormone, progesterone.
• HER2 status (HER2-positive (HER2+) or HER2-negative (HER2-)): This is also a very important factor. HER2 stands for a protein called 'Human Epidermal Growth Factor Receptor 2'. This is something that normally helps cells grow. However, some breast cancer cells make too much of this HER2 protein, uncontrollably. In Luminal B cancers, this HER2 protein can be present in excess (HER2-positive / HER2+), or it can be present at normal levels (HER2-negative / HER2-). Treatment methods vary depending on this status.
• High levels of Ki-67: Ki-67 is a special protein that is only found in rapidly dividing cells. Luminal B cancers tend to have higher levels of this protein. This helps doctors understand how fast the cancer cells are dividing, which means how fast the cancer is growing. That's why Luminal B cancers tend to grow faster than Luminal A cancers.
• Higher grade: The grade of a cancer is how similar or different the cancer cells are from healthy cells when viewed under a microscope. A high grade means the cancer cells are very different from healthy cells and are likely to grow and spread quickly. Luminal B cancers are usually a higher grade than Luminal A. This means they are more aggressive, can grow larger, and are more likely to recur after treatment.

You can see, all these letters, numbers, and abbreviations (like ER, PR, HER2, Ki-67) add up to a lot of information about the cancer cells in your breast. It is by analyzing this information that doctors can plan personalized treatment for you and predict what kind of results you can expect from the treatment.

How common is Luminal B breast cancer?

Now you might be wondering, 'How many people have this disease?' In fact, between 15% and 20% of breast cancer cases reported worldwide have this type of cancer. This is slightly less than the more common type called Luminal A. But, this percentage is not insignificant, right? That's why it's important to be aware of this.

What are the symptoms of Luminal B breast cancer?

Often, doctors can detect it before you have any symptoms, through routine breast screenings, such as a mammogram. That's why it's important to get these tests done at your age. But sometimes you may experience one or more of these symptoms:

• A lump in the breast: This is usually a hard, rubbery lump that doesn't move easily.
• Breast pain: You may feel pain in one or both breasts.
• Nipple discharge: You should be concerned if you have nipple discharge, especially if it is mixed with blood.
• Skin changes: You may notice skin dimpling, thickening, or discoloration of the breast skin.
• Swelling under the armpit: The lymph nodes in the armpit area can become swollen.

If you notice any of these symptoms, don't panic and see a doctor immediately . Not all lumps are cancerous, but it's wise to get them checked.

What causes Luminal B breast cancer?

In fact, Luminal B breast cancer develops when healthy breast cells suddenly mutate and start to grow uncontrollably. But experts still don't know exactly why this happens. It could be caused by a combination of factors.

As we discussed earlier, Luminal B cells contain proteins that stimulate the growth of cancer when they bind to the hormone estrogen. So, if your estrogen levels are high for a long time, it can slightly increase your risk of developing this cancer. For example:

• If your period started earlier than normal, that is, before the age of 12.
• Or if menopause, which means the complete cessation of menstruation, occurs later than normal, after the age of 55.
• Or if you have been taking hormone replacement therapy (HRT) for a long time to control menopause-related symptoms.

In addition to these, there are several other factors that can increase the risk of luminal B breast cancer:

• Family history: If your mother, sister, daughter, or close relative has had breast cancer or ovarian cancer, you are at slightly higher risk.
• Age: The risk of developing breast cancer increases after the age of 50.
• Dense breast tissue: If breast tissue appears dense on a mammogram, that is also a risk factor.
• Genetic variations: Inherited mutations in certain genes, such as BRCA1 and BRCA2, can significantly increase the risk of breast cancer.
• Past radiation therapy: If you have previously received radiation therapy to the chest or breast area for another reason.

Having these risk factors doesn't mean you will definitely get cancer. However, it's important to be aware of them.

How is Luminal B breast cancer diagnosed?

Imagine that you have symptoms of breast cancer, or a mammogram shows something suspicious. The first thing a doctor will do is do a physical exam. This means they will physically examine your breasts to check for lumps or other changes.

Then, to find out more, they often order additional imaging tests like these:

• Diagnostic mammogram: This is more detailed than a regular mammogram.
• Ultrasound scan: This can help determine whether a lump is solid or a fluid-filled cyst.
• An MRI (Magnetic Resonance Imaging) scan: This may also be necessary in some special cases.

After these tests, the doctor will definitely take a breast tissue sample (breast biopsy) and send it for testing. This is the only way to be sure whether or not cancer is present, and if so, what type it is. A biopsy involves taking a small piece of tissue from a suspicious area and sending it to a lab to be examined under a microscope.

A pathologist, a doctor who specializes in examining tissue, will examine your tissue sample to see if there are cancer cells. If cancer cells are found, they will do hormone receptor tests (for ER, PR) and HER2 tests to determine the subtype of the cancer. Of these tests, the most commonly used is a test called immunohistochemistry (IHC) . This uses fluorescent dyes and enzymes to highlight specific molecules on the cancer cells. Sometimes, Ki-67 levels are also checked this way.

These tests on your tissue sample can help your medical team know what treatments will work best for you, as well as give you an idea of ​​how likely the cancer is to come back after treatment.

How is Luminal B used to treat breast cancer?

The treatment for Luminal B breast cancer can vary from person to person. It depends on many factors, including your individual situation, the stage of the cancer, your HER2 status (HER2+ or HER2-), your Ki-67 level, and your overall health. Your medical team will consider all of these factors to create the best treatment plan for you.

The main treatment methods used are:

• Hormone therapy: Since Luminal B is a hormone-sensitive (HR+) cancer, this is the most common main treatment. This works by blocking the hormone estrogen from reaching the cancer cells, or by reducing the level of estrogen in the body. Drugs like Tamoxifen and Aromatase Inhibitors are used for this.
• Surgery: This involves removing cancer cells from the breast.
• Lumpectomy: This involves removing only the cancerous tumor and a small amount of healthy tissue around it, leaving most of the breast intact.
• Mastectomy: This involves removing the entire breast.

During surgery, the lymph nodes in the armpit may be removed to see if the cancer has spread.

• Radiation therapy: Radiation therapy is given after surgery to kill any remaining cancer cells in the area. This is often given, especially if a lumpectomy has been performed.
• Targeted therapy: This type of treatment targets specific molecules that help cancer cells grow. For example, if the Luminal B cancer is HER2-positive (HER2+), drugs that target the HER2 protein (e.g. Trastuzumab) may be given. These are determined by the stage of the cancer and other receptor profiles.
• Chemotherapy: Adjuvant chemotherapy may be given to kill cancer cells that have not been killed by other treatments, or to prevent the cancer from spreading to other parts of the body. Luminal B cancers grow faster than Luminal A and have higher Ki-67 levels, so this is recommended for some high-risk patients. Your doctor will tell you if this is a good option for you.

Remember, the treatment for someone with HER2-positive (HER2+) Luminal B cancer may be different than the treatment for someone with HER2-negative (HER2-) Luminal B cancer. That's why it's important to know all of these characteristics of your cancer.

What is the prognosis for people with Luminal B breast cancer?

The prognosis, or the hope of survival and cure, of someone with Luminal B breast cancer depends on how advanced the tumor is when it is diagnosed (the stage of cancer). As with any cancer, the sooner you start treatment, the better your chances of survival.

Depending on the stage at diagnosis, Luminal B breast cancer is curable , meaning that the disease can go into remission with treatment. However, it can also recur. Luminal B cancer is slightly more likely to recur than Luminal A.

The risk of cancer recurrence depends on several factors, including the stage of the disease, its growth rate, Ki-67 levels, HER2 status, and response to treatment. Therefore, even if you are in remission, your doctor will continue to monitor your health. It is important to have regular follow-ups. They may also recommend additional treatments (such as hormone therapy) after surgery and radiation therapy to reduce the risk of the cancer coming back.

Luminal B Breast Cancer Survival Rates

Now let's talk about these statistics for a moment. But you have to remember that these are just averages . They don't tell you exactly how long you will live or how you will respond to a particular treatment. They are based on data from a large group of patients.

• The five-year survival rate for people with HR+/HER2+ (hormone receptor positive/human epidermal growth factor receptor 2 positive) breast cancer is about 91.5% . This means that out of every 100 people with this type of cancer, about 91 will be alive five years after diagnosis.
• This percentage of people with HR+/HER2- (hormone receptor positive/human epidermal growth factor receptor 2 negative) breast cancer is about 95.1% .

The most important thing is to talk openly with your doctor to understand exactly how these statistics affect you. He or she can explain them to you in a way that is appropriate for your individual situation.

How does Luminal B reduce the risk of breast cancer?

We cannot change some risk factors, such as a family history of the disease. However, making certain lifestyle changes can help reduce the risk of developing any type of breast cancer, including luminal B:

• Avoid smoking: Smoking is a risk factor for many cancers.
• Increase physical activity: It is very good to exercise for at least 30 minutes several days a week.
• Limit alcohol intake: It is important to minimize alcohol consumption.
• Maintain a healthy weight: Maintaining a healthy weight for your height is very important, especially after menopause.
• Balanced diet: Eat a diet rich in fruits, vegetables, and whole grains.

How do I take care of myself? What should I do when living with cancer?

Luminal B Living with breast cancer can be very challenging, both physically and mentally. Some days you may feel great, and the next day you may feel overwhelmed, stressed, sad, and scared. That's normal. So, it's important to take good care of yourself throughout your diagnosis and treatment.

Here are some things that can help you:

• Eat well: Eat nutritious foods. Include fruits, vegetables, lean proteins, and whole grains in your diet. If you experience loss of appetite during treatment, consult your doctor or a nutritionist.
• Find ways to manage stress: You can relax your mind through things like meditation, yoga, breathing exercises, and engaging in a hobby that brings you joy.
• Get lots of rest: Getting enough sleep is very important. Don't work all day long, take a little break in between.
• Join a supportive community: Ask your doctor about cancer survivorship programs or support groups. These groups can help you meet people who are going through the same things as you, share ideas, and reduce feelings of loneliness. Your family and friends can also be a great source of support.

When should I see a doctor?

During and after treatment, if you develop any new symptoms or if your symptoms get worse, tell your doctor right away. Also, tell your doctor if you feel any pain or weakness in any part of your body. Don't miss your follow-up appointments.

What questions should I ask my doctor?

When you find out you have Luminal B breast cancer, it's normal to have a lot of questions on your mind. Don't be afraid to ask your doctor any questions you have. Here are some questions you can ask:

• Is my cancer HER2-positive or HER2-negative?
• What is the grade and stage of my cancer?
• What treatment options do I have?
• How does this treatment work?
• How often do I need to see the doctor after treatment (follow-ups)?
• What are the side effects of treatment? How should I deal with them?
• What is my Ki-67 percentage? What does it mean?
• What can you tell me about my prognosis?

Hearing the words "you have cancer" can be the scariest thing you'll ever hear. It's normal to have a lot of questions running through your mind as you adjust to this new situation and the uncertainty. Your medical team is there to help you. Trust them. With Luminal B breast cancer, they can tailor your treatment plan based on information at the molecular level of your cells. Talk to your doctor to learn more about how your lab results will affect your treatment plan. Remember, you are not alone.

Finally, things to remember (Take-Home Message)

Luminal B breast cancer is a type of breast cancer that is hormone-sensitive and usually grows rapidly. It is estrogen receptor (ER) positive (+), HER2 status can be positive (+) or negative (-), and Ki-67 levels are usually high.

• Be aware of symptoms: If you notice anything like a lump in the breast, pain, discharge from the nipple, or skin changes, seek medical advice immediately.
• Accurate diagnosis is important: A biopsy and related tests are the only way to know the exact type of cancer.
• There are treatment options: hormone therapy, surgery, radiation therapy, targeted therapy, and chemotherapy. Your doctor will decide what is best for you.
• Early treatment leads to better outcomes: Early diagnosis and treatment increase the chances of recovery.
• You are not alone: ​​There are doctors, nurses, family, friends, and a support group to help you on this journey.

We hope this information has helped you gain some understanding of this disease. Stay healthy!

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