Early Breast Cancer: Importance of Hormonal Therapy in ER-positive Breast Cancer

A young lady in her early 40s had left breast cancer, pT2N2MO (stage III), ER positive, HER2 negative. She completed surgery, chemotherapy and radiotherapy. When I told her that she will need hormonal therapy for up to 10 years based on latest study, she said the study must be pharma-sponsored to encourage longer use of…… Continue reading Early Breast Cancer: Importance of Hormonal Therapy in ER-positive Breast Cancer

Living Longer: Advanced Breast Cancer (ABC) – HER2 over-expressed (II)

What happen when first-line treatment fails? In advanced or metastatic breast cancer, first-line treatment will fail after certain duration of time. This is because cancer cells developed resistance to the treatment and not because the treatment is ineffective. Life doesn’t end when first-line treatment fails. We just continue fighting the cancer with other effective second-line…… Continue reading Living Longer: Advanced Breast Cancer (ABC) – HER2 over-expressed (II)

Living Longer: Advanced Breast Cancer (ABC) – HER2 over-expressed (I)

Introduction HER2 over-expression constitutes 20% of all breast cancer. Two different methods are being used to test for HER2 over-expression, immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) Immunohistochemistry (IHC); identifies HER2 expression on the cell surface, with a grading system of 0 to 3+ positive. tumors are classed as HER2-positive if they have a…… Continue reading Living Longer: Advanced Breast Cancer (ABC) – HER2 over-expressed (I)

Living Longer: Advanced Breast Cancer (ABC) – Triple Negatives; ER/PR/HER2 (-ve)

Introduction Breast cancer is not a single disease but comprised of distinct biological subtypes with different prognosis and treatment options: Luminal A: ER/PR+ve, Her2-ve Luminal B: ER/PR+ve, Her2+ve HER2 over-expressed: Her2+ve Triple negatives/ basal-like: ER/PR-ve, Her2−ve Among the different subtypes above, triple negative breast cancer (TNBC) accounts for 10%-15% of breast cancer diagnosed. TNBC carries the worst prognosis and…… Continue reading Living Longer: Advanced Breast Cancer (ABC) – Triple Negatives; ER/PR/HER2 (-ve)

Living Longer: Advanced Breast Cancer (ABC) – Hormone positive; ER (+ve), HER2 (-ve)

Introduction In patients with advanced breast cancer AND ER positive AND HER2 negative AND no presence/ impending visceral crisis, the recommended treatment by various international guidelines is hormonal therapy. Chemotherapy is only for rapidly progressive disease OR in the setting of visceral crisis OR no more response from available hormonal therapy. HER2 directed treatment is applicable…… Continue reading Living Longer: Advanced Breast Cancer (ABC) – Hormone positive; ER (+ve), HER2 (-ve)