Chemotherapy for cancer is often recommended by doctors. Chemotherapy uses medications that kill and prevent the splitting of cancer cells.
Many chemotherapy medications have serious adverse effects. However, if a doctor recommends a person to have chemotherapy, the benefits are usually overweight over any adverse events.
As part of an overall treatment plan, a person also undergoes chemotherapy, including surgery and radiation therapy. In many cases of cancer, these treatments are successful. The efficacy, among other factors, is often dependent on the stage of cancer.
If you speak to your doctor, a person can understand what chemotherapy can mean.
What is chemotherapy?
A healthy body replaces cells continuously through a dividing and increasing cycle. Cells multiply uncontrolled as cancer happens.
Since they are rapidly forming cells in part of the body, they begin to occupy the space used by useful cells.
The ability of a cancer cell to differentiate and multiply is hampered by chemotherapy medicines.
This can be achieved by a single drug or drug mixture.
Treatment can either:
- attack cancer cells throughout the body or
- target specific sites or processes
What does chemotherapy do?
Chemotherapy drugs can:
- prevent cell division
- target the cancer cells’ food source (the enzymes and hormones they need to grow)
- trigger apoptosis, or the “suicide” of cancer cells
Some new therapies aim to stop new blood vessels from growing, which supply a tumor to hunger it. Some scientists are concerned that in some cases this strategy may stimulate cancer growth and spread.
However, other researchers concluded in 2018 that some people could be helped.
Why the use of chemotherapy?
Doctor may recommend chemotherapy:
- to shrink a tumor before surgery
- Just after surgery or remission, to remove any remaining cancer cells and delay or prevent a recurrence
- to slow disease progression and reduce symptoms in the later stages, even if a cure is unlikely
What to expect
Chemotherapy is a procedure that is invasive and which can have serious adverse effects during and after the treatment. The reason for this is that the drugs also kill both cancer cells and healthy cells.
Early treatment, however, may sometimes be completed with chemotherapy. This is worth many of the side effects. However, after the treatment stops, most of the unwanted effects go away.
How long does chemo last?
The doctor will make a plan for the person, specifying when and how many treatments will be necessary.
Depending on the type and stage of cancer, a single dose may vary from one day to several weeks.
Those who need more than one operation have a recovery period in order to heal their body.
A person can undergo therapy on a day, then a week’s rest, a day’s treatment and then a three-week rest period. A person can repeat it multiple times.
Many people may find mental and emotional cancer and chemotherapy helpful to speak to a counselor.
Blood tests assess the health of the individual to ensure that the possible side effects are met.
Health of the liver: the liver breaks up chemotherapy and other medication. Another problem can occur if the liver is overloaded. If a blood test detects hepatic problems prior to treatment, the individual may have to postpone treatment until he or she recovers.
Low red or white blood cell counts or platelets: if the blood counts are low before treatment, a person might have to wait until beginning chemotherapy for them to reach healthy levels.
In order to keep the blood and liver functions as healthy as possible and to control the effectiveness of treatment, regular blood tests should be performed during the treatment period.
How do you administer the dose?
In a clinical setting most of the guests undergo chemotherapy, but sometimes they can go home.
Ways of taking chemotherapy include:
- by mouth, as tablets, liquid or capsules
- intravenously, as an injection or infusion
- topically, onto the skin
A person can take the medicine at home in some cases. We must however visit the hospital regularly to check their health and how we respond to therapy.
The dosage is to be administered exactly as prescribed by the doctor. When you forget to take a dose at the right time, call your doctor.
A person often needs an ongoing dosage. This means that a pump that gradually supplies the medication for several weeks or months may be required. As they go about their daily lives, they can wear the pump.
Chemotherapy may lead or adverse effects ranging from mild to severe, depending on treatment type and scope. Most individuals will have little to no adverse effects.
There may be a wide range of adverse effects.
Nauseas and vomiting
Nausea and vomiting Medicines can be administered to reduce the effects by antiemetical medications. EOLBREAK EOLBREAK According to one study, taking ginger or ginger supplements will improve the efficiency of antiemetics.
Hair, nails, and skin
A few weeks after some types of chemotherapy are initiated, some people may suffer from hair loss or their hair might become thin or broken. Any part of the body will suffer.
Using a special mask, the scalp can remain cool during chemotherapy, which can avoid hair loss or rising it. But this is not possible if the procedure must reach the scalp.
A consultant may give advice on getting a hairstyle or another appropriate cover. Many people find that their hair grows back after the treatment has been completed.
Nails may also become brittle and flaky.
The skin may get swollen, sore and sun-sensitive. Under direct sunlight, people should be careful including:
- avoiding the sun around midday
- using sunblock
- wearing clothes that provide maximum protection
Many people may be tired. This can be felt most of the time or only after those events.
A person should try to:
- get plenty of rest
- avoid tasks that are overtiring
People with severe fatigue should talk to their doctor, as this may be a symptom of anemia
The toxins can affect the nervous system in some forms of chemotherapy, which lead to:
- tinnitus, or ringing in the ears
- temporary or permanent hearing loss
- balance problems
Any changes in the hearing should be reported to the doctor.
The number of white blood cells that protect the body against infection will fall due to chemical therapy. The immune system has been compromised and the risk for infections has been increased.
People should be careful to reduce the risk of infection.
- washing hands regularly
- keeping any wounds clean
- following appropriate food hygiene guidelines
- getting early treatment if a person suspects an infection
An antibiotic can be prescribed by a doctor to reduce the risk.
A person’s platelet count can be decreased by chemotherapy. It means that the blood no longer coagulates as normal.
The person may experience:
- easy bruising
- more bleeding than normal from a small cut
- Always nosebleeds or bleeding gums
The person might need a blood transfusion if the platelet count is too low.
People should pay extra attention to cooking, gardening and rashing activities in order to minimize the risk of damage to themselves.
Oxygen is transmitted to all body tissues by red blood cells. The levels of red blood cells may fall by chemotherapy. This causes anemia.
- shortness of breath
- heart palpitations
The body may be able to take more red blood cells to drink additional iron. People can take their diet in additional iron. The good sources of food include:
- dark green leafy vegetables
- prunes, raisins, and apricots
Call your doctor if you are suffering from serious or worsening signs of anemia. Others may need a transfusion of blood.
The mouth to anus may affect any part of the digestive system, causing mucositis, or inflammation of the mucous membrane.
The mouth is affected by oral mucositis. Self-treatment also occurs 7–10 days later. Symptoms, which may differ by dosage, can cause pain in eating or talking. Several suffer in their mouths or lips from burning pain. Bleeding may mean that a person is infected or at risk. After treatment is finished, symptoms usually disappear for some weeks.
A physician may prescribe medicines to prevent or treat them.
Loss of appetite
Chemotherapy, cancer or the two may affect the way in which the body processes nutrients that may lose appetite and weight.
The severity depends on the type of cancer and chemotherapy, but the person usually recovers after therapy.
It provides advice for resolving:
- eating smaller, more frequent meals
- consuming nutrient rich drinks, such as smoothies, through a straw, to help maintain fluid and nutrient intake
People who find it too hard to eat may have to spend some time in the hospital, where health workers may provide nutrition either intravenously or through a feeding tube.
Pregnancy and fertility
Sexual interest is often lost during chemotherapy, but usually returns after treatment.
Fertility: some chemotherapy forms in men and women can decrease fertility. This returns after treatment often, but not always. But people who want to have kids in the future may consider freezing sperm or embryos for subsequent use.
Pregnancy: How different forms of chemotherapy affect a developing fetus is not entirely clear. If a woman needs chemotherapy while pregnant, the doctor may suggest waiting for the first 12–14 weeks, since it is when the bodies of the fetus develop quickly. After the first trimester, chemotherapy may be started if a doctor deems it necessary.
A pregnant woman is given the last procedure about 8 weeks prior to delivery to reduce her or her mother’s and baby’s risk of infection.
Since chemotherapy can have serious side effects, it may be best to prevent pregnancy during treatment. A doctor can tell you about effective methods of birth control.
Anyone who is pregnant or who gets pregnant will tell the doctor straight away.
Diarrhea, constipation and expulsion of damaged cells by the body can also result from chemotherapy.
Symptoms often start a couple of days after starting treatment.
Cognitive and mental health problems
Up to 75% of the population report problems with chemotherapy, thinking and short-term memory. Cognitive problems can continue for months or years after medication for up to 35 percent of these may.
Chemotherapy can also make thought, planning and multitasking difficult. Many people have mood and depression swings.
Such symptoms can also be caused or worsened by both the treatment and an uncertainty about the disease.
Chemotherapy types include:
alkylating agents: these damage the DNA and destroy the cells at various stages during the process of cell life.
Antimetabolites: These mimic proteins to live in cells. These are of no use if the cells eat them, and the cells are starving.
Plant alkaloids: Those prevent a growth and breakdown of the cells.
Antibiotics: Those keep cells from breeding. Antibiotics: These differ from those used to treat an infection with antibiotics.
A suitable alternative would be recommended by the doctor. You may recommend that chemotherapy be combined with other treatments, such as radiation or procedure.
Factors that influence the type and function of chemotherapy include:
- the location, type, and stage of the cancer
- the person’s age, overall health, and any existing medical conditions
The outlook for a person receiving chemotherapy will largely depend on the cancer type, stage, and location and overall health of that person. This can achieve complete remission in some cases.
However, adverse effects can occur and during treatment, a person may need to adjust their lifestyle or work routine. These usually resolve after termination of treatment, however.
A person may wish to discuss with his or her doctor before starting treatment:
- why they are recommending chemotherapy
- what the other options are
- which types are available
- how much it will cost
- what to expect in terms of adverse effects
They should also speak to:
- their insurance provider about covering the costs
- their employer about how treatment may affect their work routine
- their loved ones about what to expect
A doctor may often contact a person with a counselor or support group, who may help.
I knew some people who had declined chemotherapy when they had cancer at a later stage. Is that really a good idea?
The situation is different for every person. No-one should make a decision without exploring all the options available. Getting an frank, open discussion with friends, family, and their doctors about outcome potentials and expectations is very critical.
Alan Carter, PharmD
Answers represent the views of our experts in medicine. All content is strictly informative, and the medical advice should not be considered.
Breast pain: The most common causes
Mastalgia, or breast pain, is fairly common. Hormonal fluctuations, an inappropriate bra fit, and infections are also potential causes. In certain situations, transferred pain from other parts of the body, such as the back or neck, is to blame.
Breast pain affects almost two-thirds of women during their reproductive years, and it is one of the most common complaints among people aged 15 to 40.
Although breast pain is not a common sign of breast cancer, it should be discussed with a doctor if it occurs in conjunction with other breast abnormalities such as a lump or discharge.
Continue reading to discover more about some of the causes of breast pain and how to deal with this condition.
Scar tissue can form as a result of both surgery and radiation therapy for breast cancer. This can lead to:
- numbness or pain, if the scar tissue develops around nerves
- an increase in firmness or a rounder appearance of the breast
- formation of a lump if the scar forms around a surgical stitch
Treatment options include:
- In physical therapy, if the scar tissue causes pain, stiffness, and pressure
- Surgical removal of scar tissue, if it is very painful
- If a person finds scars bothersome, they may opt to use creams and ointments to reduce their appearance.
Back, neck, or shoulder sprains
Breast pain might come from the exterior rather than the inside of the breast. Sprains or injuries to the back, neck, or shoulder, for example, might result in pain in the breast.
Cervical root disorders, sometimes known as a pinched nerve, can induce breast pain, according to a 2020 study. A nerve root in the neck is damaged or inflamed in certain illnesses.
Referred pain occurs when people experience pain in a different location than where it originates. The treatment is based on identifying the underlying issue. If a person suffering from breast pain has a pinched nerve, physical therapy or spinal surgery to relieve the pinched nerve may help.
Inflammation of the costal cartilage, which links the ribs to the breastbone, is known as costochondritis. Sharp chest pain and tenderness can accompany the condition, which can develop gradually or suddenly.
The following variables may aggravate the discomfort:
- Avoid activities that worsen the pain.
- applying heat to the area
- Take one of the following medications:
- undergoing transcutaneous electrical nerve stimulation (TENS), a procedure that applies an electric current to an area to reduce pain.
Chest wall pain
Pain in the chest wall can be caused by a variety of factors. Even though it is not, this discomfort might sometimes feel like it is coming from the breast.
The pain might range in intensity from a single spot to a large area of the breast. A person may have the following experiences:
- burning or sharp pain
- pain that spreads down the arm
- pain that occurs when someone applies pressure to the chest wall
- pain that worsens upon movement
Possible causes include:
Treatment will depend on the cause, but it may include pain management and avoiding movements that aggravate the pain until the core cause has been addressed.
Breast cysts are fluid-filled sacs seen in the breast. They’re noncancerous, soft, and more common in women who aren’t yet menopausal. Some cysts are asymptomatic, while others cause pain and nipple discharge.
Treatment isn’t necessary unless the cysts are particularly large or painful. If therapy is required, the fluid will be drained with a needle.
When cells in the breast change and multiply uncontrollably, breast cancer develops. Breast pain is not commonly caused by cancer, but it is a cause. Other signs and symptoms could include:
- a lump in the breast
- pain in any part of the breast
- any nipple discharge — bloody, clear, or otherwise
- dimpling or irritation of breast skin
- pulling in at the nipple or pain in the nipple
- flaky, inflamed skin in the nipple area
- thickening or swelling of part of the breast
- change in the shape or size of the breast
Rarely, people can develop inflammatory breast cancer, which causes different symptoms. These include:
- a painful, tender, or itchy breast
- pink, red, or purple discoloration that covers at least one-third of the breast
- swelling of the skin, making one breast look larger than the other
- pitting of the skin, similar to that of orange peel
- a retracted or inverted nipple
Surgery, chemotherapy, hormone therapy, radiation therapy, and biologic therapy are all options for treating breast cancer. Often, people will get more than one of these treatments.
Breasts that are tender or swollen are frequently due to hormonal changes that occur before a period. Tenderness in both breasts is common with this type of breast pain, which can also spread to the armpit.
Cyclic breast pain occurs when breast pain is linked to the menstrual cycle. Premenstrual syndrome (PMS) is a group of symptoms that occur before a period, however cyclic breast discomfort can also occur on its own.
Other PMS symptoms include:
PMS is just transient, and it normally disappears a few days after your period starts. People can address the symptoms in the meanwhile by using over-the-counter (OTC) pain medicines, wearing a comfortable and supportive bra, and applying moderate heat to the area.
Other hormonal changes, such as those that occur during pregnancy or in the early stages of menopause, can also cause breast pain.
Bras that are overly tight or have an underwire that digs into the skin or breast tissue can cause breast pain. If a person has cyclic breast discomfort, they may notice that their regular bras feel too small or uncomfortable at certain periods during their menstrual cycle.
Many major stores provide free bra fittings to help people choose the proper size. If women have soreness before their period, they may want to invest in non-wired, supportive, and comfy bras.
When exercising, supportive bras might also be beneficial. According to a 2021 article, 60–70% of women report decreased breast soreness when they exercise while using a sports bra.
Breast fibrocystic changes
Due to hormonal changes, fibrocystic breast alterations are harmless but potentially painful symptoms that cause the breasts to feel lumpy or have a distinct texture. The most frequent type of noncancerous breast condition is fibrocystic breast disease.
The following are examples of symptoms:
- breasts that feel firmer or thicker than usual
- lumps or cysts
- sensitive nipples
Before a period, the symptoms may become more severe, but they normally subside following menopause.
The following procedures may be used to treat or manage fibrocystic breasts:
- taking OTC pain medication, such as acetaminophen (Tylenol) or ibuprofen (Advil)
- applying cool or warm compresses when the breasts are more painful
- avoiding a large intake of salt, caffeine, or fat in the diet
- starting or stopping birth control pills
If you think your fibrocystic breast changes are linked to a new contraceptive, talk to your doctor before changing your dose.
Mastitis is the medical word for breast inflammation or swelling. Infection is the most common cause. Although the condition most commonly affects breastfeeding mothers, it can also afflict non-breastfeeding people.
Mastitis can cause the following symptoms:
Some drugs have been linked to the onset of breast pain. These are some of them:
- Bigitalis preparations, such as digoxin (Digox), which treat congestive heart failure and abnormal heart rhythm
- chlorpromazine (Thorazine), a medication for mental health disorders
- certain potassium-sparing diuretics, such as eplerenone (Inspra) or spironolactone (Aldactone)
- oxymetholone (Anadrol), which treats low red blood cell count
- methyldopa (Aldomet), which is a treatment for high blood pressure
People who are experiencing breast pain should consult a doctor to see if any of their prescriptions are the source of their symptoms.
Cyclic vs. noncyclic pain
There are certain fundamental differences between cyclic pain and noncyclic pain, which is linked to the menstrual cycle. The table below contrasts and compares the two forms of pain:
|Cyclic pain||Noncyclic pain|
|varies with hormones in the menstrual cycle||does not vary with the menstrual cycle|
|common among females in their 20s, 30s, and 40s||more common after menopause|
|generally affects both breasts equally||tends to affect one or more localized areas of one breast|
|may occur alongside tenderness, swelling, or lumpiness||pain often feels sharp and burning|
Hormones may not be the main cause of cyclic pain, especially if one breast hurts more than the other.
Keeping a symptom diary can help you figure out if your pain is cyclic. Alternatively, to discover if there is a trend, people can utilize applications that track menstruation and its associated symptoms.
It can be beneficial to provide a numerical value to the pain severity every day during one or more menstrual cycles in a symptom diary. It’s possible that the pain is cyclic if it happens or gets worse at the same time every cycle. During a doctor’s visit, people might discuss this information with them.
Managing breast pain
Mastalgia pain can be alleviated in a variety of people. These are some of them:
- wearing a supportive bra that fits well
- taking OTC pain medications
- limiting the intake of chocolate, coffee, tea, and soft drinks
- applying hot or cold compresses to the breasts
- getting regular exercise
- engaging in relaxation methods to reduce stress, anxiety, and tension
Before attempting self-care practices, consult with a healthcare professional to ensure that they are acceptable. Medical intervention may be required in some cases.
Breast pain, also known as mastalgia, can be caused by a variety of factors. It’s possible that this ailment is cyclic or noncyclic. If the discomfort is cyclic, it is caused by the menstrual cycle’s fluctuating hormones.
PMS, fibrocystic breast changes, traumas and sprains, and inflammation around the ribs can all cause noncyclic breast pain. This symptom is sometimes caused by cysts or infections.
Despite the condition that breast cancer is rarely the cause of breast discomfort, anyone experiencing this symptom should see a doctor to rule it out.
Stage 4 breast cancer: What you need to know
Gender and sex exist on a spectrum. This article will use the terms “male,” “female,” or both to refer to the sex assigned at birth. To learn more, visit here.
When cancer spreads to distant organs, tissue, or lymph nodes, it is classified as stage 4 breast cancer. Stage 4 breast cancer is often known as advanced cancer, secondary breast cancer, or metastatic breast cancer by healthcare experts.
Symptoms differ depending on where the cancer has spread. Treatment for stage 4 breast cancer attempts to keep the cancer under control, reduce symptoms, and provide the best possible quality of life for the patient.
This article goes through the signs and symptoms of stage 4 breast cancer, as well as the outlook and treatment choices.
Stage 4 breast cancer
Stage 4 breast cancer develops when cancerous cells migrate beyond the breast and nearby lymph nodes to other parts of the body.
Breast cancer most usually spreads to the lungs, liver, and bones, according to the American Cancer Society (ACS). It can potentially spread to other organs like as lymph nodes, skin, and the brain.
Stage 4 breast cancer can be diagnosed as either a new case (de novo) or a recurrence of a previous case (recurrence).
Rates of survival
The Surveillance, Epidemiology, and End Results (SEER) Program database is used by the American Cancer Society to track 5-year relative survival rates.
A relative survival rate estimates how long a person with a certain ailment will survive after obtaining a diagnosis in comparison to those who do not have the condition.
If the 5-year relative survival rate is 70%, it signifies that a person with the ailment has a 70% chance of living for 5 years as someone who does not have the condition.
The type of breast cancer a person has can also affect the 5-year relative survival rate. For example, the 5-year survival rate for a person with triple-negative breast cancer is 12%, and it is 19% for those with inflammatory breast cancer.
According to the American Cancer Society, survival statistics are dependent on a number of criteria but do not account for every facet of a person’s health and well-being.
The following are some aspects that survival rates do not consider:
- the person’s age and overall health
- the size of the tumor
- the cancer’s response to treatment
- the cancer’s HER2 status
- the presence of hormone receptors on cancer cells
- new treatment options that improve the long-term outlook
As a result, it’s essential to keep in mind that these figures are estimations. A person might inquire about how their disease is going to effect them from a healthcare practitioner.
Is it treatable?
Experts consider stage 4 breast cancer to be incurable, according to a 2016 report. Treatments, on the other hand, can assist to relieve symptoms, decrease the tumor, and extend survival time.
A person with stage 4 breast cancer should consult with a specialist to discover the best therapy choices for them.
The specific symptoms that a person may encounter depend on where the cancer is located.
The following are some examples of potential symptoms:
- bone pain
- issues with balance
- weight loss
- weakness anywhere throughout the body
- a constant dry cough
- loss of appetite
- severe headaches
- issues with vision
- a constant state of nausea
Spread to bones
When breast cancer spreads to the bones, it can cause:
- new and noticeable pain that comes and goes to begin with but becomes constant over time
- fractures, which cause sudden and severe pain
- back or neck pain
- weakness and numbness
- difficulty urinating
- difficulty passing bowel movements
- loss of appetite
Spread to brain
Symptoms related to cancer that spread to the brain include:
- memory problems
- changes in personality and mood
- slurred speech
- blurred vision
- issues with balance
Spread to liver
When breast cancer spreads to the liver, it can cause symptoms such as:
Spread to lungs
If breast cancer spreads to the lungs, a person may experience:
- shortness of breath
- a persistent cough
- coughing up blood and mucus
- pain in the lung
Stage 4 breast cancer cannot be cured with treatment. The treatment’s goal is to:
- slow down and control the growth of the cancer
- relieve any symptoms
- increase life expectancy and quality of life
Researchers are continually exploring for new ways to treat stage 4 breast cancer.
Currently, the most common treatments that doctors may recommend include:
- targeted medications
- hormone therapy
- a combination of therapies
- radiation therapy
Stage 4 breast cancer may take both a physical and emotional toll on a person. An important part of treatment is helping the person cope with the emotions and stress connected with the diagnosis.
Palliative care may also be an option. This sort of care gives an extra layer of assistance to people with serious diseases and their families. It helps treat physical and mental problems and can optimize the person’s quality of life while they live with advanced cancer.
Some potential approaches for mental health care include:
- reaching out to family and friends
- talking with a social worker
- having regular meetings with a psychologist or psychiatrist
- joining support groups
BreastCancer.org recommends obtaining professional and experienced counselors and workers wherever feasible. However, it also indicates that people who are having problems paying may wish to seek therapy through a psychologist training program or clinic.
Chance of remission and recurrence
When cancer goes into remission, tests that seek for cancer cannot detect it. A doctor may refer to this pathological complete response.
Treatment may also produce partial remission. This suggests that therapy has destroyed a portion of the cancer but that testing can still discover the cancer.
Stage 4 breast cancer will not go away completely. However, Breastcancer.org states that therapy can help manage the cancer for years. It states that the cancer might be aggressive at times and go into remission at other times.
Because stage 4 breast cancer is not treatable, it will not vanish and then resurface.
Having stage 4 breast cancer indicates that cancer cells from the breast tissue have spread to distant areas of the body.
Signs and symptoms might vary dependent on where the cancer has progressed to. However, they may include bone discomfort, unexplained weight loss, lack of appetite, and severe headaches, among others.
Stage 4 breast cancer is not currently treatable. However, certain treatment methods can delay the spread of the cancer, reduce the symptoms, and prolong survival.
What to know about HER2-negative breast cancer
HER2-negative breast cancer suggests that the cancerous cells do not have high amounts of the protein HER2. There are a variety of therapy options for this form of breast cancer, but the prognosis varies.
Human epidermal growth factor receptor 2 is abbreviated as “HER2.” It could be referring to the HER2 gene or the protein that the gene produces.
HER2 receptors are proteins found on the surface of breast cells. They normally aid in the regulation of healthy breast tissue growth and repair.
When the HER2 gene malfunctions and starts generating too many copies of itself, HER2 proteins on the surface of breast cells are overproduced. This can lead to cancer that is HER2-positive.
This page offers an overview of HER2-negative breast tumors, which are cancers that develop for reasons other than a defective HER2 gene.
We detail the treatment choices for various forms of HER2-negative cancers, as well as the prognosis and survival rates.
A doctor will need to ascertain the type of breast cancer a person has in order to make a diagnosis. This entails extracting a small amount of breast tissue for testing during surgery or a biopsy.
Testing indicates which genes and proteins are involved in the progression of cancer. This aids in determining the best therapy alternatives.
The presence or lack of hormone receptors on the surface of cancer cells is used to differentiate HER2-negative breast cancer into two types in most studies:
- hormone receptor-positive (HR-positive) breast cancer
- triple-negative breast cancer
Hormones such as estrogen and progesterone have a function in the development of healthy breast tissue. Individual protein receptors on the surface of breast cells exist for each hormone. Hormones are taken up by the receptors, which tell the cells to expand.
As we’ll see below, there are several subtypes of these cancers:
Luminal (HR-positive) breast cancers
Breast cancers that grow in the inner, or luminal, cells are known as Luminal Breast Cancers. The mammary ducts are lined by these cells.
HR-positive Luminal cancers are those that involve at least one type of hormone receptor.
Luminal A (LA) and Luminal B (LB) are the two kinds of luminal breast cancer (LB).
The main difference between the two types is that LA cells have a lower concentration of a protein known as Ki-67. This protein regulates the rate at which tumor cells develop. As a result, LA malignancies grow more slowly than LB cancers and have a better prognosis.
Luminal A breast cancer
According to certain research, LA breast cancer accounts for 30–45 percent of all breast cancers.
The following are some of the characteristics of LA cancer:
- cells that are HER2-negative
- cells that test positive for estrogen receptors
- lower levels of Ki-67
- low-grade tumors
Luminal B breast cancer
According to some estimates, LB breast cancer accounts for 10–20 percent of all breast cancers.
HER2-negative or HER2-positive LB cancers exist. It is also characterized by the following characteristics:
- cells that test positive for estrogen receptors
- higher levels of Ki-67
- higher-grade tumors
- larger tumors
- a higher chance of spreading to a lymph node
Triple-negative breast cancer
Approximately 10–15% of all breast cancers are triple-negative. Triple-negative breast cancer tests negative for three receptors:
Triple-negative breast cancer is more common in:
- people who have a mutation in the BRCA1 gene
- Black people
- people below the age of 50
- premenopausal people
Several factors influence the type of treatment a person receives, including:
- the stage of cancer
- whether and where the cancer has spread
- whether there are hormone receptors in the cells
- genetic mutations
- previous treatments
- overall health
Surgery, chemotherapy, radiation therapy, bisphosphonates, or a combination of these treatments may be required for those with HER2-negative breast cancer.
Most people with breast cancer have surgery to remove the tumor. There are two main types of surgery:
Breast-conserving surgery: This involves the removal of the tumor and some of the surrounding healthy breast tissue.
Mastectomy: This involves the total removal of the affected breast.
Chemotherapy medications work by limiting cancer cells’ capacity to divide and develop.
For triple-negative breast cancers, chemotherapy is more common than for luminal breast cancers. Both forms, however, may require chemotherapy, especially if the tumor is larger than 1 centimeter (cm) ,
High-intensity X-rays are used to kill cancer cells in this treatment.
Some people may be prescribed bisphosphonates by their doctors to help prevent breast cancer from spreading to their bones.
Bisphosphonate medications include zoledronic acid and sodium clodronate, to name a few.
Some luminal breast cancer treatments will not be appropriate for triple-negative breast cancer, and vice versa.
Specific treatment methods for both categories are listed in the sections below:
Options for luminal (HR-positive) breast cancer
Hormone therapy is given to the majority of people who have luminal or other forms of HR-positive breast cancer. This is referred to as endocrine therapy by others.
Because it is HR-negative, triple-negative breast cancer does not respond to hormone therapy.
Anti-estrogen therapy works by inhibiting estrogen from binding to breast cancer cells’ estrogen receptors.
Anti-estrogen therapy is divided into four categories:
- selective estrogen-receptor response modulators, such as tamoxifen
- aromatase inhibitors
- estrogen-receptor downregulators, such as fulvestrant (Faslodex)
- luteinizing hormone releasing agents, including goserelin (Zoladex) and leuprolide (Lupron), prevent the ovaries from producing estrogen
The type of anti-estrogen therapy a person receives depends on various factors, including:
- the stage of the breast cancer
- whether the person has any other medical conditions
- whether the person has been through menopause
A person usually continues hormone therapy for at least 5 years.
Other hormone therapies
HR-positive breast cancer may not respond to the therapy listed above in some circumstances. As a result, for more advanced cancer, a doctor may consider one of the hormone therapy listed below:
- progestin medications, such as megestrol (Megace)
- an anabolic steroid, such as fluoxymesterone (Halotestin)
Targeted therapies target specific genetic alterations that contribute to the growth and spread of cancer. These medications are frequently used in conjunction with hormone therapy.
Treatments for HR-positive, HER2-negative metastatic breast cancer target and block CDK4/6, a protein thought to drive tumor growth, according to specialists.
CDK4/6 inhibitors include the following:
- abemaciclib (Verzenio)
- palbociclib (Ibrance)
- ribociclib (Kisqali)
Targeted therapy is paired with a gonadotropin-releasing hormone analog or ovarian suppression in men and women who have not yet reached menopause.
Triple-negative breast cancer treatment options
The following therapies may be used instead of or in addition to the more general cancer treatments listed above for some persons with triple-negative breast cancer:
Immunotherapy medications like atezolizumab (Tecentriq) and pembrolizumab (Keytruda) assist the immune system in attacking cancer cells.
Cancer cells can hide from the immune system thanks to proteins like the PD-L1 protein. Tecentriq inhibits the development of PD-L1, a protein that the immune system uses to recognize and kill cancer cells.
Therapy that is specific to the patient
In triple-negative breast cancer, doctors also use targeted medicines to treat specific genetic abnormalities. For those who have already had two treatments, the medication sacituzumab govitecan-hziy (Trodelvy) was approved in 2020. It’s an antibody drug conjugate, which means it binds to cancer cells and kills them.
Inhibitors of PARP
Triple-negative breast cancer is caused by a mutation in the BRCA1 or BRCA2 genes in certain patients. PARP inhibitors may be beneficial to these folks.
Poly ADP-ribose polymerase is the acronym for poly ADP-ribose polymerase. It’s a DNA-repair enzyme that works in both healthy and malignant cells.
PARP inhibitors prevent the PARP enzyme from working properly. Cancers with a BRCA1 or BRCA2 gene mutation have a tougher time surviving DNA damage as a result of this. Olaparib (Lynparza) and talazoparib are two examples (Talzenna).
The percentage of people who are alive after a given amount of time after being diagnosed with cancer is referred to as the cancer survival rate.
The survival rate for breast cancer is determined by a variety of factors, including the tumour’s grade and stage.
Under a microscope, the grade indicates how aberrant the malignant cells appear. Cells that appear abnormal proliferate and spread more quickly.
The cancer’s stage refers to how big it is and how far it has spread. This is normally measured on a scale of 0 to 4 by doctors.
Cancers at stage 0 are ones that are still in the early stages of development and have not spread to neighboring cells. Cancers in stage 4 are the most advanced and have the worst prognosis.
Cancer survival rates are also influenced by the following factors:
- whether the cancer is HR-positive or HR-negative
- the person’s age at diagnosis
- the person’s overall health
Cancer-specific survival rates
Survival statistics for several forms of breast cancer are included in a 2019 overview of breast cancer therapy.
HR-positive cancers, such as luminal cancers, had a greater survival rate than triple-negative breast cancers, according to the findings.
Stage 1 cancer survival rates
Stage 1 HR-positive breast cancer has a 5-year survival rate of roughly 99 percent.
Furthermore, because LA breast cancer has lower Ki-67 levels than LB breast cancer, it grows more slowly. As a result, clinicians are more likely to discover LA cancer at an earlier stage, giving patients a somewhat better prognosis.
Stage 1 triple-negative breast cancer has an 85 percent 5-year survival rate. These cancers have a faster growth rate and respond to fewer treatments.
Metastatic cancer survival rates
Breast cancers can spread to other parts of the body, which is known as metastasis. The prognosis for metastatic cancer is substantially worse.
Following a diagnosis of metastatic cancer, people with HR-positive breast cancer usually live for another 4–5 years. Following the same diagnosis, people with triple-negative breast cancer may live an extra year.
It’s crucial to keep in mind that survival statistics are estimations based on the outcomes of people who have had cancers that are similar to yours.
However, cancer survival rates are influenced by a variety of complex circumstances. These variables will differ from one person to the next.
HR-positive breast cancer and triple-negative breast cancer are the two main kinds of HER2-negative breast cancer. Treatments for various cancers differ in some ways.
Breast cancers that are HR-positive have a better prognosis than cancers that are triple-negative.
People can use survival rates to estimate how successful their treatment will be. People should, however, speak with their doctor for further information regarding their specific treatment plan and prognosis.