Advanced breast cancer ER-, grade three?


Question from carrieNJ: Is it true that most advanced breast cancers are estrogen-receptor-negative, nuclear grade 3-type tumors at initial diagnosis?
Answers - Eric Winer, M.D. Probably not. Certainly, many are estrogen-receptor-negative, and if a woman has estrogen-receptor-negative cancer, she is at higher risk of developing metastatic breast cancer than a woman with an estrogen-receptor-positive cancer who receives hormonal therapy. But because so many more breast cancers are estrogen-receptor-positive, if we look at all women living with metastatic breast cancer in the U.S., we find that a majority have estrogen-receptor-positive cancer.
Musa Mayer Intuitively, it must seem that because your pathology report may have said when you were first diagnosed that these are very aggressive features, that if you do have a recurrence, it's because of those features. But those are just statistical predictions. Most of the women I know and work with who have metastatic cancer, like Eric says, have hormonally sensitive cancers and can be treated with drugs like tamoxifen and aromatase inhibitors, often for long periods of time. Metastatic cancers can behave very differently. Sometimes, they can be very slow growing, and sometimes extremely aggressive.
Eric Winer, M.D. The good news is that one of the most aggressive forms of metastatic breast cancer, which used to be HER2/neu-positive metastatic breast cancer, can now be treated with a drug called Herceptin, which can be extraordinarily effective in some women. It has really changed the course of HER2-positive metastatic breast cancer. So, more and more, we're figuring out ways to help women live longer and better lives, even if they develop metastatic breast cancer.
Marisa Weiss, M.D. Based on what Dr. Winer is saying, it is important to use the information that you can learn from your pathology report to help tailor the best treatment plan for you. Breastcancer.org offers a whole section on how to understand your breast cancer pathology report.

On Wednesday, September 17, 2003, our Ask-the-Expert Online Conference was called Metastatic Breast Cancer. Musa Mayer, Eric P. Winer, M.D., and Marisa Weiss, M.D. answered your questions about treatment and quality of life issues related to advanced (metastatic) breast cancer.

The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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