With the use of new HER2 targeted biologic therapies, early stage HER2-positive breast cancer can now be cured.

Whether later stages of HER2-positive breast cancer can be cured depends on the stage. Stages are used to describe how much the breast cancer has worsened or spread.

Stages and Treatments

Stage 0 – This stage of HER2-positive breast cancer is called ductal cancer in situ and is a breast cancer that has not spread beyond the breast ducts. Treatment for Stage 0 HER2-positive breast cancer may include breast conserving surgery, also called lumpectomy, followed by radiotherapy; hormone therapy; and HER2 targeted drugs.

Stage I (A/B) – In this stage of HER2-positive breast cancer, the cancer has spread from the breast ducts to the surrounding fatty breast tissue. The breast tumor is smaller than 2 centimeters and has not spread to lymph nodes. Treatment for Stage I (A/B) HER2-positive breast cancer may include breast conserving surgery, also called lumpectomy; partial mastectomy, or removal of the affected portion of the breast; removal of nearby lymph nodes; radiotherapy; hormone therapy; and HER2 targeted drugs.

Stage II (IIA/B) – In this stage of HER2-positive breast cancer, the cancer has spread from the breast ducts to the surrounding fatty breast tissue and may have spread to nearby lymph nodes. The breast tumor is between 2 to 5 centimeters wide. Treatment for Stage II HER2-positive breast cancer may include breast conserving surgery, also called lumpectomy; partial mastectomy, or removal of the affected portion of the breast; radiotherapy; hormone therapy; and HER2 targeted drugs.

Stage III (IIIA/B) – In this stage of HER2-positive breast cancer, the tumor is larger than 5 centimeters. The cancer may or may not have spread to lymph nodes. The tumor may also be smaller, and the cancer has spread to lymph nodes. Treatment for Stage III (A/B) HER2-positive breast cancer may include chemotherapy before surgery, called neoadjuvant chemotherapy; breast conserving surgery, also called lumpectomy; partial or full mastectomy, or removal of part or the whole affected breast; radiotherapy; hormone therapy; and HER2 targeted drugs.

Stage IV – This stage of HER2-positive breast cancer is called metastatic breast cancer, which means that the cancer has spread to lymph nodes and other parts of the body, such as the liver, lungs, brain, or bones. Treatment for Stage IV HER2-positive metastatic breast cancer may include chemotherapy before surgery, called neoadjuvant chemotherapy; breast conserving surgery, also called lumpectomy; partial or full mastectomy, or removal of part or the whole affected breast; radiotherapy; hormone therapy; and HER2 targeted drugs.

Types of Treatments

Treatments for HER2-positive breast cancer may include surgery with lumpectomy, which is also called breast conserving surgery; partial or full mastectomy, which is the removal or part or all of the affected breast; removal of nearby lymph nodes; radiotherapy; chemotherapy; hormone therapy; targeted therapy; and breast reconstruction.

Lumpectomy, or Breast-Conserving Surgery, is a surgical procedure where the breast lump is removed, along with a few nearby lymph nodes to check to see if the cancer has spread. This surgery is usually done for early stage HER2-positive breast cancer and may be followed with radiation therapy.

Partial or Full Mastectomy is a surgical procedure where the breast is partly or completely surgically removed, along with nearby lymph nodes to see if the cancer has spread. Some patients may be able to have Breast Reconstruction done at the same time.

Radiation Therapy is the use of X-Rays or other forms of radiation to kill cancer cells. Radiation therapy can also help to alleviate some of the symptoms caused by the cancer as well as relieve cancer pain when the cancer has spread.

Chemotherapy is used to kill any cancers cells that may have spread elsewhere in the body. Standard chemotherapy drugs in combination with targeted HER2 therapies are often used for the treatment HER2-positive breast cancer.

The treatment goals of both radiotherapy and chemotherapy are to destroy the cancer cells and to stop the cancer from returning or spreading.

Hormone Therapy – Hormone therapy with tamoxifen or an aromatase inhibitor is used in the treatment of HER2-positive breast cancer to slow the growth of cancer cells.

Targeted HER2 Therapy, or Biologic Therapy, is a newer treatment for HER2-positive breast cancer that helps the patient’s own immune system, or natural defenses, to kill cancer cells. HER2-positive targeted therapy drugs may include as trastuzumab, pertuzumab, or neratinib, or a combination of both. The treatment goal of immunotherapy is to increase the ability of the body’s immune system to fight the cancer.

Patients undergoing treatment for HER2-positive breast cancer may experience treatment-related side effects, such as swelling in the arm, nausea and vomiting, skin and nail changes, and loss of hair. Treatment for cancer treatment-related side effects is an essential part of breast cancer care.

Other Treatments

Some patients with HER2-positive breast cancer do not respond to the targeted treatments and/or develop resistance to these medications. Newer medications for these patients include docetaxel and fam-trastuzumab.

Palliative Care

In addition to standard treatments, patients with Stage IV metastatic HER2-positive breast cancer may also be treated with palliative care. Palliative care is used to relieve pain and other symptoms to make a patient more comfortable.

Long-Term Follow-Up

Ongoing, long-term follow-up is an essential part of the treatment for patients with HER2-positive breast cancer because the cancer can reoccur even after it has been treated.

Sources

This content was written by the MediFind Medical Team. Last updated: 6/9/2022