Research suggests that this combination improves survival rates for people with HER2-positive breast cancer.
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How Common Is HER2?
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
When the mutation is present, the overproduction of HER2 proteins drives the growth of breast cancer cells.
Surgery
Alumpectomyormastectomyis typically recommended to remove the tumor in early-stage breast cancer.
Radiation therapy may also be recommended either before (neoadjuvant) or after (adjuvant) surgery.
Verywell / Ellen Lindner
Chemotherapy is not usually necessary for cancers at this stage.
Metastatic cancer (stage IV) has specific treatment protocols and does not always involve surgery.
Hormonal Therapies
If a tumor isestrogen receptor-positive,hormonal therapiesare recommended.
If someone is receiving chemotherapy, hormonal treatments can be started after they finish chemo and radiation if needed.
For people who are premenopausal, tamoxifen is often the first choice.Aromatase inhibitorscan be added if someone is postmenopausal.
People with early-stage breast cancer who are premenopausal andconsidered high-riskmay want to discuss ovarian suppression with their healthcare provider.
Research suggests that in some cases, aromatase inhibitors are associated with slightly higher survival rates than tamoxifen.
HER2-Targeted Therapies
Before HER2-targeted therapies, HER2 tumors were considered aggressive cancers.
With the advent of targeted therapy, survival rates have improved.
Oncologists usually start with this drug before trying other treatments.
In 2024, the FDA granted accelerated approval for Enhertu to treat anyone with advanced solid cancer.
Patients must have already received another treatment to qualify for treatment.
Radiation Therapy
For people who choose a lumpectomy,radiation therapyis usually recommended following surgery.
For tumors that have four or more positive lymph nodes, radiation therapy after a mastectomy is often considered.
First-line therapy for advanced HER2-positive breast cancer depends on the results of receptor studies.
For people who are HER2-positive, one of the HER2-targeted therapies outlined above is usually used.
If a tumor is also estrogen-receptor-positive, hormonal therapy, HER2 therapy, or both may be considered.
Chemotherapy may also be used for several months.
For cancer that progresses after trastuzumab and a taxane in the metastatic setting, T-DM1 is the preferred choice.
What is the life expectancy of a HER2-positive breast cancer patient?
Integrative Treatments
Many people ask about alternative therapies when they are diagnosed with breast cancer.
Chemotherapy and hormonal therapies are added as needed depending on receptor status and cancer stage.
In advanced stages, treatment prioritizes systemic therapies, with surgery and radiation primarily for symptom relief.
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