ABOUT THE BREAST CANCER
EARLY DETECTION: DO YOU KNOW THE FACTS?
Each year, 182,000 women are diagnosed with breast cancer and 43,300
die. One woman in eight either has or will develop breast cancer
in her lifetime. In addition, 1,600 men will be diagnosed with breast
cancer and 400 will die this year.
If detected early, the five-year survival rate exceeds 95%. Mammograms
are among the best early detection methods, yet 13 million U.S.
women 40 years of age or older have never had a mammogram.
The National Cancer Institute and U.S. Department of Health and
Human Services recommend that women in their forties and older have
mammograms every one to two years. A complete early detection plan
also includes regular clinical breast examinations by a trained
medical professional. Monthly breast self-exams are suggested in
addition.
For more information about breast cancer and the issues surrounding
it, read below:
Are Some Breast Cancers Different than Others?
Summary & Participants
Certain breast cancers mean different things. Learn what tests can
determine the type of breast cancer you have, and how this information
can affect your treatment.
ANNOUNCER: When a woman is diagnosed with breast cancer, physicians
study the cancer's characteristics and try to develop the most effective
treatment plan for her specific type of cancer. In addition to hormone
receptor status, another classification that doctors establish is
the cancer's HER2 status.
RUTH O'REGAN, MD: HER2 stands for human epidermal growth factor.
It's a member of a family of growth factor receptors which are on
the surface of certain cancer cells. And the HER2 refers to the
second growth factor receptor of this family.
ANNOUNCER: HER2 is a naturally occurring protein, controlled by
the HER2 gene that helps regulate cell growth and development.
RUTH O'REGAN, MD: We're not really clear what role it plays in
a healthy breast cell. We know, in cancer cells, that it appears
to make them more aggressive and is associated with poor prognosis.
ANNOUNCER: It has also been observed that when the HER2 gene is
over-expressed, or exists at abnormally high levels, it may contribute
to the uncontrolled growth of cells, thereby serving as a catalyst
for breast cancer.
When a woman is initially diagnosed with breast cancer, tests
are performed at the time of the original biopsy to establish a
tumor's HER2 status on a scale that ranges from 0 to 3+. A score
of 0 or 1+ means the cancer is HER2-negative. A score of 2+ is borderline
and usually requires a confirmatory test to establish HER2 status.
A score of 3+ indicates the cancer is HER2-positive, indicating
it's more aggressive but also more likely to respond to anti-HER2
therapy.
MAURA DICKLER, MD: HER2-positive breast cancer is only a subset
of women who have breast cancer. It makes up about 20 to 25 percent
of breast cancer. In HER2-positive breast cancer, HER2 appears to
be the driver or the activator of growth in that type of breast
cancer.
ANNOUNCER: There are two reasons physicians want to determine a
tumor's HER2 status early on.
RUTH O'REGAN, MD: The first one is because it gives prognostic
information so that patients whose tumors are HER2/neu-positive
are usually more aggressive with a slightly worse prognosis. But
the main reason for testing for HER2/neu is because of the developments
in the monoclonal antibody called Herceptin.
ANNOUNCER: Herceptin, also known as trastuzumab, is a monoclonal
antibody that specifically targets the HER2 protein. A therapeutic
antibody contains millions of identical copies of a single antibody,
all of which attack the same targets, in this case: the HER2 receptor.
Herceptin is given by IV infusion and has been found to be a very
effective treatment option in women with both early stage HER2-positive
breast cancer and metastatic HER2-positive breast cancer, or cancer
that has spread beyond the breast.
RUTH O'REGAN, MD: What Herceptin does is it basically binds to
the HER2/neu protein on the surface of the breast cancer cell, and
somehow, which we don't really understand, it basically works through
some pathways in the cell and basically prevents the cancer cell
multiplying and eventually the cancer cell dies.
MAURA DICKLER, MD: Herceptin was initially approved by the FDA
in 1998 for the treatment of women who had HER2-positive metastatic
breast cancer. And it's very effective for women with that type
of breast cancer recurrence, and it can cause major shrinkage in
about 20 to 30 percent of those tumors, and it can cause disease
stabilization in about half of women.
Recently, studies have been presented that have shown that the
use of Herceptin earlier in the course of the disease is very effective
at reducing the risk of HER2-positive breast cancer from coming
back or metastasizing.
ANNOUNCER: The development of Herceptin as an effective treatment
option for women with breast cancer has focused physicians on the
importance of establishing a cancer's HER2 status. And testing for
HER2 has increasingly become standard of care.
RUTH O'REGAN, MD: Pretty much every woman with breast cancer should
be tested for HER2, so that really will be regardless of the stage
of presentation. If it's positive, then they need to ask their physician
about whether they're a candidate for Herceptin or not.
What I typically tell a patient with a HER2/neu-positive breast
cancer is that they are more aggressive cancers with a worse prognosis,
but that, with the use of Herceptin, we can markedly improve their
outcome from this type of breast cancer.
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