Breast Cancer Receptors: Learn What You Need to Know
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- Опубликовано: 24 янв 2025
- We teach you to about breast cancer tumor receptors and why they are important in your breast cancer treatment. Chemotherapy and hormonal therapy are based on your receptor pattern.
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Questions for your Breast Surgeon and Medical Oncologist:
1. What receptors do my tumor have?
2. What type of treatment do they suggest I will need?
3. May I have a copy of all my pathology reports?
4. Do my receptors already suggest I need chemotherapy?
5. Do my receptors show I will need hormonal therapy?
6. Would I benefit from neoadjuvant chemotherapy?
What are Breast Cancer Receptors?
Once a breast biopsy is determined to be an invasive by a pathologist under the microscope, they will automatically run at least three more tests on the same tissue to determine what “receptors” are present. Receptors are tiny proteins on the surface of the cells that act like “light switches” that can turn cancer cell growth “on” or “off.” The Estrogen receptor (ER), Progesterone receptor (PR), and HER2 receptor results are incredibly important for you to know and understand. Receptors are different than “grade” and “stage” as outlined in the diagram below. All are different pieces of the breast cancer puzzle that your physicians will assemble to determine the best therapy for you. In the case of receptors, these are key determinants as to whether you will or will not benefit from hormonal therapy (pills) or chemotherapy. The receptors involving a precancerous lesion such as DCIS have different implications and are addressed in our DCIS course.
Receptors that suggest Hormonal Therapy
Estrogen Receptor Positive (ER+) tumors are always treated with hormonal therapy. Usually these types of medications (pills) are taken for a total of 5 to 10 years. It is still possible that one may need chemotherapy in addition to hormonal therapy. If you are Progesterone Receptor Positive (PR+) then you will likely need hormonal therapy, even if you are ER-. The Estrogen Receptor plays a much more important role in cancer care than the Progesterone Receptor.
Receptors that suggest Chemotherapy
Determining if you need chemotherapy is a very complex decision process and is primarily driven by your medical oncologist. Your “receptor pattern” is a key piece of information that is known early in your breast cancer journey. In about 30% of patients with an invasive breast cancer, the receptor pattern alone can strongly suggest that chemotherapy will be needed, regardless of what is found at surgery. We list a few of the more common “chemotherapy receptor patterns” below. Many factors, including a large cancer and cancer that is present in the lymph nodes, also point someone towards chemotherapy. Take our video lesson on “Will I Need Chemotherapy“ (here). Often if someone needs chemotherapy, they will likely benefit also from hormonal therapy after chemotherapy if their estrogen receptor is positive.
Estrogen Receptor Negative (ER-) tumors do not respond to anti-estrogen oral medications that are essential for treating estrogen receptor positive (ER+) tumors. Quite simply, patients with ER negative tumors will benefit from chemotherapy if they are healthy enough to tolerate it. ER negative tumors are more aggressive cancers, but respond very well to chemotherapy. This includes “triple negative” breast cancers. Progesterone Receptors (PR) play a much smaller role than estrogen or HER2 receptors and are not addressed here.
HER2 Receptor Positive (HER2+) tumors are very responsive to chemotherapy when paired with new breakthrough drugs that target these tumors, such as Herceptin and Perjeta. The same holds true if a HER2-positive tumor is also ER positive. Take our “HER2-Positive“ video lesson to learn more (here). HER2-positive tumors are more aggressive cancers, but we now can treat them more effectively with chemotherapy and “targeted immunotherapy” drugs that are designed to destroy HER2-positive cancers.
“Triple Negative” (ER-)(PR-)(HER2-) tumors are also fast growing tumors that are usually treated with a specific chemotherapy regimen. These tumors are not responsive to hormonal therapy at all, but are sensitive to chemotherapy. If you have “Triple Negative Breast Cancer“ review our video lesson (here).
Take home message:
Make sure to ask for a copy of the pathology report from your biopsy. Ask your breast surgeon and medical oncologist to explain to you what your receptors mean regarding your treatment. Sometimes the HER2 receptor results can take up to two weeks to become finalized. Inquire early on with your physicians about your benefit from hormonal therapy and/or chemotherapy.
My gosh, the way Dr. John William laid out the information was so easy to follow and very informative. Thank you so much for providing this for the public.
If only there were presentations like this for all diseases.
Thank you for breaking this down in simpler terms. My brain needs things to be squashed down into layman terms
As Always, you're the" GREATEST DOCTOR" at explaining "EVERYTHING" about "BREAST CANCER"!!!! THANK-YOU SO VERY MUCH! I AM ER+, PR+, AND HERS2-NEGATIVE. PROCEDURE: I CHOSE TO HAVE A BILATERAL TOTAL MASTECTOMIES AND LEFT ALND BECAUSE MY CANCER WAS REALLY A LEFT LUMPECTOMY WITH REMOVAL OF LYMPH NODES AS WELL!
How are you now...
How many chance invasive duct carcinoma grade 3 to return after chemo and lumpectomy the reccurence chance ?
Thank you so much Sir. You explain everything very easily.
You're very informative.thank you doctor.
why do only some cancer cells have estrogen receptors and other don't. can you explain the underlying pathophysiology?
I just learned yesterday that I'm VERY receptive to hormone receptors. 💗
Big salute sir . very informative .
What about anti-angiogenics approach to any cancer?
Thank you. I talked to my doctor. I’m going to have neo adjuvant chemotherapy.
I’m estrogen and progesterone positive.
Hope you are doing well!
I am too, but was asked to do surgery and radiation. I don't want to do any Radiation.
So do people who have high or low estrogen and progesterone tend to get the progesterone and estrogen receptor positive breast cancer?
Thank you 💝
Patient with stage 4, advance level, ER & PR are positive and HER2 is negative.. will it cuered?
I have stage 2 HER2 triple positive breast cancer. I’m doing chemo first b4 surgery n after chemo I might have radiation. My question: 98% of estrogen is produced by ovaries, n the rest by brain, would it be beneficial to have a full hysterectomy since I don’t want any more kids? I had to do my own research about HER2 n discovered that it COULD cause ovarian cancer.
Allah bless 🙏 💖 you
Is there any corelationship between ER and Ki67 in breast cancer?
Sir My mother was 46 yrs old she had recently done her masectomy in Invasive ductal carcinoma and after surgery she had tested and result was Triple negative thn what we do for this?
Same doubt
I’ve been recently diagnosed with breast cancer, and it seemed that my surgeon knew more on what to do then the oncologist that I met a week later. Why is that?
You will probably be sent for a few different test (results) before the oncologist can tell you what the best treatment options will be for your specific tumor type.
@@kristinreese2281Thank you. I’ve had an MRI, CT scan, onco score is 16 which is good. I have spoken more to my surgeon and I have only spoken to my oncologist once. I found out the results of my CT scan Monday morning, good results, have yet to get a call from the oncologist regarding that or my other blood test results. Patient portals are great because at least I can see the results. It’s like he doesn’t have the time……
I did not get a good vibe from him and did not feel comfortable. I am looking into a different oncologist.
Hi I'm just turn 49
I was diagnose stage 2 breast cancer on right n 1 cancer lymph node. estradiol
I had done lumpectomy n done chemo A/C and Taxol almost done 2 more cycles .
Then my oncologist says I producing less estrogen .
Suggest radiation for 5 weeks
Then have my estrogen cut off either by daily shots or removal of my ovaries.
I'm confuse why remove ovaries? can I just take hormones pills to help block it ? I hate needles why daily shots to turn off and with hormones
Is this consider necessary??
I'm with kaiser
I'm scare too I don't want to do either one of daily shots or remove ovaries but will do hormones.
It be Rem++++ hormone something.
I already started young menopausal at 42 or 43 and my period stop too
I'm married h
I have 2 grown kids, 31yr and 18 yr
Please respond back thank you
As if I'm going to take a drug made by Astra Zeneca for 5-10 yrs!! Haha!! I'll be using diet and modified citrus pectin and other herbs and mistletoe therapy. thank you very much.
Try low dose aspirin if your body can safely have aspirin. There are a lot of trials in this area.
ER 7/8(proportion score 4. Intensity score 3)
PR 7/8(proportion score 4. Intensity score 3)
HER2 3positive.. Could please clear what it means
I'm a 59 year old women with stage 1 breast cancer, 1.8mm, HER2, with CHEK-2 mutant gene. My surgeon recommends I have both my breasts removed.
Sorry to hear you are going through this. A relative was just diagnosed with breast cancer as well and was advised by others that have been in this situation to go see an Oncologist before any surgery for they have more knowledge if you will need a mastectomy or not. Sad to say they’re incidents where the surgeon with do an unnecessary mastectomy because the patient didn’t consult an oncologist first. I pray for God to touch and heal your body and bring peace and comfort in this time need. 🙏
What did you decide to do?
@@msalas915 excellent advice from someone not knowing this. Oncologist and radiation Dr so full of info. Surgeon just wants to operate then gone. Oncologist will be a very long companion.
I have breast cancer grade 2 with astrogene positive 3+ but doctors said I should start by chimio for 8 seances then surgery, is that correct please??
It is a long process. Go to the Breast Cancer School for Patients and take our specific lesson on “”Neoadjuvant chemo" www.breastcancercourse.org/neoadjuvant-chemotherapy-2/ I hope it helps.
hasnaa tellili hi how are u doing now and what did u decide on with chemo or which ? Hope ur doing well 🙏🏽
I am ER negative, PR negative, Her 2.. negative....my Neo adj chemo started on 4th July 2022...my hysterectomy was done in 2014 ... Breast cancer occurred in 2022
CB1 & CB2 receptors are far more relevant -
this music is so annoying man, can barely hear the doc