HER2-positive breast cancer

HER2-positive breast cancer is a type of breast cancer characterized by the overexpression of the HER2 (human epidermal growth factor receptor 2) protein. This subtype of breast cancer tends to grow faster and is more likely to spread compared to HER2-negative breast cancers. However, the discovery of HER2 and its role in breast cancer has led to the development of targeted therapies, significantly improving outcomes for patients with this diagnosis.

Overview

HER2 is a protein that helps control cell growth, division, and repair. When the HER2 gene is amplified or overexpressed in breast cancer cells, it leads to the aggressive growth of tumors. Approximately 20% of breast cancer cases are found to be HER2-positive.

Diagnosis

Diagnosis of HER2-positive breast cancer involves testing tissue from a breast biopsy or surgery. The most common tests include:

• Immunohistochemistry (IHC) - measures the amount of HER2 protein on the surface of cells in the breast cancer tissue.
• Fluorescence in situ hybridization (FISH) - looks for the number of copies of the HER2 gene in breast cancer cells.
• Dual ISH - combines IHC and FISH to provide more detailed information about HER2 status.

Treatment

Treatment for HER2-positive breast cancer often involves a combination of therapies, including surgery, chemotherapy, radiation therapy, and targeted therapy. Targeted therapies specifically designed to attack HER2-positive cancer cells have significantly improved outcomes for patients. These include:

• Trastuzumab (Herceptin) - a monoclonal antibody that targets the HER2 protein.
• Pertuzumab (Perjeta) - another monoclonal antibody that works with trastuzumab to more effectively target HER2-positive cancer cells.
• Ado-trastuzumab emtansine (Kadcyla) - a combination of trastuzumab and a chemotherapy drug, which delivers chemotherapy directly to the HER2-positive cancer cells.
• Lapatinib (Tykerb) - a small molecule inhibitor that targets the HER2 protein and EGFR.

Prognosis

The prognosis for HER2-positive breast cancer has improved significantly with the advent of targeted therapies. Patients with HER2-positive breast cancer who receive targeted therapy in addition to standard treatments have a better prognosis and lower risk of recurrence compared to those who do not receive targeted treatments.

Research and Future Directions

Ongoing research is focused on improving outcomes for patients with HER2-positive breast cancer through the development of new targeted therapies, understanding resistance mechanisms to current therapies, and identifying biomarkers to predict response to treatment.

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