All About ER Positive, HER2 Negative Breast Cancer

All About ER Positive, HER2 Negative Breast Cancer

About one in eight women in the United States will develop breast cancer, according to commonly used statistics.

But other reports indicate that breast cancer rates are on the decline, likely because of improved recognition, prevention, and treatment. One advancement is the ability to identify different breast cancer types based on specific molecules found in tumors. The distinction greatly aids in breast cancer treatment selection and helps doctors predict how aggressive cancers will advance.

A crucial step in the process of beast cancer evaluation is testing tumor tissue removed during a biopsy or surgery to determine if it has estrogen and progesterone receptors –  molecules that the hormones bind to.

Cancerous cells may have none, one, or both receptors. Breast cancers that have estrogen receptors are called ER-positive (or ER+). Those with progesterone receptors are referred to as PR-positive (or PR+).

In addition to hormone receptors, some breast cancers have high levels of a growth-promoting protein called HER2/neu. If a tumor has this property, it is called HER2-positive. HER2 positive cancers are more aggressive than HER2 negative cancer.

Knowing breast cancer type, leads doctors to determining best treatments.

For example; in ER positive/HER2 negative breast cancer, tumors that are ER positive are much more likely to respond to treatments that block estrogen. Treatment possibilities include selective estrogen-receptor response modulators (SERMs), aromatase inhibitors, estrogen-receptor downregulators (ERDs) and luteinizing hormone-releasing hormone agents (LHRHs).

HER2 negative cancers will not respond to treatment with drugs that target HER2, such as trastuzumab (Herceptin) and lapatinib (Tykerb).

The most common treatment for ER positive and HER2 negative breast cancer is hormone blocking therapy.  Although chemotherapy can also be used, no specific type is recommended by the American Society for Clinical Oncology (ASCO). Available drugs can include taxanes, anthracyclines, platinum-based drugs, capecitabine (Xeloda), eribulin (Halaven), gemcitabine (Gemzar), ixabepilone (Ixempra), and vinorelbine (Navelbine).

The prognosis for patients with ER+ and HER2- breast cancer depends on how advanced the cancer was when it was detected. Prognosis is also influenced by the size of the tumor and if the cancer has spread to other organs.

Most women with very early stage breast cancers will live a normal lifespan. Five-year survival rates are based on the stage (0-4) of breast cancer according to the American Cancer Society, with stage 4 at  22% and  stage 0 at 100%. Stage 4 is metastatic breast cancer, which means that cancerous cells have spread to other regions of the body.

Overall, estrogen receptor-positive breast cancer is treatable, especially when diagnosed early.

30 comments

  1. Pam Chester says:

    I believe my oncologist should NOT have placed me on Anastrozole…..I am both ER and PR positive, have had two partial mastectomies in one breast and 25 radiation treatments for Stage 0, grade 3
    73 year old with osteopenia and osteoporosis with family history of same bone ailments.

  2. Eva Cristobal says:

    Im 47 newly diagnosed; I have HR+/HER2- early stage and opted for bilateral mastectomy. I do hope I wont need chemo or radiation.

    • Melissa says:

      Hi Eva! I am recently diagnosed and am 47 also. I have the same type as well. I was wondering how large your tumor was. They are saying mine is 4.5 cm. And the doctor is now recommending a mastectomy. Your thoughts??

      • Tracy says:

        Hi Melissa, I’m ER/PR+ and HER2-, my tumor was 3.7 cm and I did the double mastectomy. I believe my chance of reoccurrence will be lower by opting to do this. I had chemo, the “red devil” and Cytoxen (sp?) for two months, then Taxol for 3 months, (they stopped a month early because of my neuropathy getting bad though). My Onco Score was 49 but after the chemo treatment it knocked it down to 20% chance of reoccurrence.

    • Maureen Wray says:

      Hi Eva I have just found myself in a similar situation and dread the thought of Chemo. Can I ask if you had it?

  3. Christina says:

    I am newly diagnosed and I had a biopsy says idc ER+ PR+ HER2- neg.. Tumor grew to 7 cm in 3 months I feel it spreading. More pain and still no info of what doctors are going to do. I am 29 years old with strong family history. This is good info but I am scared and confused.

    • Tim Bossie says:

      Thank you for taking the time to comment Christina. Being newly diagnoses is a time of confusion and fear. Knowing that you have cancer is terrifying. Keep talking with your doctor about what you need to do next. They should have a plan in place for you for next steps. Keep educating yourself… information is power! And find a good support group where you can talk with others, gain some new friends, and get the support you need.

    • Jason says:

      My wife is er+ pr+ her2 neg. when she first found it was 4.4 cm. Doctor biopsied. Took 4 1/2 months to find the right doctor that we trusted. She had bi lateral mastectomy. After 4 months it was the size of a baseball. Keep researching and go with your gut. I hope all goes well.

  4. Gail A Terry Dey says:

    I also is newly with breast cancer ER Positive HER2 negative it spread i am on exomethane pills for 2/12 months now an my self examimation i am not feeling the lump any more i am due for my check up soon . I am staying positive about it not afraid although I lost my mom to breast cancer 22 years ago at a young age .

  5. Sherri says:

    I was diagnosed HR+, (originally HER2+, but the FISH test showed -) August 15th 2017, bilateral skin saving mastectomy on both breasts. I am doing Aromatise therapy that is actually implanted in the muscle in my hip along with testosterone. I also take a supplement that stops the testosterone from turning in to estrogen. I feel this is the best therapy for myself (although somewhat unconventional ) and have had NO side effects from the hormone blocking therapy. I had the pellets put in three days before surgery, my doctor watches my hormone levels closely and I’ll have it put in every three months or so. Though insurance doesn’t pay for it, this therapy is worth the $500+ tri monthly, just so I feel as normal as I can.

  6. pam says:

    hello to you all i was diagnosed with HER2 positive in may 2016 been a bit of a bumpy ride, two opp chemo radio herceptin injections for a year and drugs for the next 12 years, oh forgot about the 3 tattoos for the radio;)i would like to thank all the people, before me both men and woman who have gone thought this without you my treatment wouldn’t have been so good,to you who have just been diagnosed don’t be be scared you can do it, i did

  7. Sebastian Giliberto says:

    I’m a male I had stage 3 A Breast Cancer had a double mastectomy 6 months of chemo 25 rounds of radiation two years later it’s in stage 4 in my bones very confused at this point on chemo again and had 10 more rounds of radiation maxed out on radiation now staying positive but still scared of how long I have to live now I’m 53 yrs old

    • Jill says:

      There are many chemo options out there. I have had stage 4 metastatic breast cancer for nearly 12 years now. I was originally diagnosed with stage 3+ 22 years ago. I have been on a variety of chemo drugs; some more than once. I am well and lead a normal life. Stay positive and get another opinion from other leading oncologists in your area. There ARE options out there for you.

      • Sandy says:

        Jill, this gives me hope. I was diagnosed with stage IV breast cancer in Aug 2017. So far my treatment is working well. I am feeling well too. I hope that I can get many years.

      • PK says:

        Jill this is an encouraging post… my wife initially diagnosed in 2010 was re-diagnosed in may 2017 with stg 4 MBC. no organ involvement and placed on ibrance combination hormone suppression and bone injection therapy. she has been moved to verzenio (spelling)? but you referenced “many” chemo options?
        just curious the others and appreciate you sharing.
        the very best to you and your continued good track!

  8. Lisa says:

    I strongly suggest checking with doctors who are knowledgeable in doing cryoablation of lesions.
    Dr.Peter Littrup in Crittenton Rochester MI
    Dr. Jason Williams, of Williams Cancer Institute
    Are a couple doctors that I know of.
    Read the book, “They’re Mine and I’m Keeping Them” by Laura Ross-Paul to learn history of cryoablation.
    Cryoablation has been used and covered by insurance for prostate cancer since approx. 1999 and yet it is still not available or covered the same way to breast cancer.
    This tells us what we need to know.
    Injustice.
    China has been using cryoablation successfully for a very long.
    Contact both or one of the above doctors, and read the book.
    Don’t believe doctors who do NOT do or know the right facts on cryoablation.

  9. Rob says:

    My wife was diagnosed with IDC 3 weeks ago. 1.5 cm pr+ER+HER2- said early stage. We are both less than 50 scared to death. Surgery Jan 12th.

  10. Rhon says:

    I was diagnosed with IDC 3 weeks sho. 1.4 cm ER+ PR+ HER2- said early stage on left breast.I am so scared and nervous to find out if it spread to nodes. I’m told 10% chance it could have spread. First radiologist did not see it. I was called back to re-image right breast due to a possible cyst. When the 2nd radiologist reviewed the films, she saw a suspicious finding in my left breast also, and recommended ultrasound. So grateful to the 2nd radiologist who found it. I’m having lumpectomy this week.

  11. Tammy Petersen says:

    I was diagnosed with HER-, ER+, PR+ AND FISH- in Dec. of 2016. Stage 4 Metastatic. I have a tumor in my right hip bone, 2 vertebra and 2 ribs. My treatment is Faslodex and Exgeva injections every 30 days and iBrance daily. My hip tumor is responding to the exgeva and is shirinking (very slowly mind you but still). My first bout of breast cancer was a lump in my right breast 4.5 cm with lymph nodes completely clear in May of 2012. Lumpectomy and thought I was good. Never underestimate the power of disease. Anyway, my treatment is helping and I just want you all to know that. Be very involved with your oncologist and your treatment options. If your dr doesn’t want to have you completely involved, you need to find another. Good luck to all!!!

  12. Lilly says:

    How do you decide what treatment to use for HR+/HER- stage IV metastatic breast cancer?! There are so many options, what were the conversations like that you had with your DR?

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