ER/PR- and HER-2NEU - breast cancer

[jebs1566]

Someone please tell what these things mean. And if the Premerion I was taking could of caused the 3 centimeter high grade invasive ductal cancer I was diagnosed with 3 yrs ago. I was just wondering since no one explained why i wasn't put on any type of HRT after my chemo.

[Fernando Roque, MD]

Hi.  ER means "Estrogen Receptor" and PR means "Progesterone Receptor".  ER/PR refers to the amount of hormone receptors found on the surface of cancer cells which your breast cancer has.  Having a lot of these receptors (or a positive ER/PR) indicates that the cancer is hormone-sensitive and would benefit from treatment which would counteract the effects of estrogen stimulation.  Since you're ER/PR negative, this means that your tumor is not sensitive to hormonal effects, and so you would not benefit from treatment with Tamoxifen or similar drugs.  HER-2NEU refers to a type of epidermal growth factor receptor also found on the surface of cancer cells.  Having a positive HER-2NEU implies a more aggressive type of breast cancer.  HER-2 positivity also implies that your tumor is sensitive to some of the new cancer drugs like Herceptin.  Being HER-2 negative means that you would not benefit from Herceptin use.

The Premarin (conjugated estrogen tablets) you were taking did not cause your breast cancer, but could have provided an added stimulus for the growth of your cancer.

[Cheskalyn]

Hello Doc. I am also from the Philippines and would like to see if you can give me informations re: ER/PR- and HER-2NEU +... The oncologist says my sister needs to have 6 sessions of ACT but it is very expensive so she made a 2nd option taht the first 3 sessions is AC and the last three is ACT..is it acceptable? is it also effective like teh first one? If we don't have money to buy the 1st option and take the 2nd option, does it also guarantee taht my sister will be cured? Please help us.. we are not rich to undergo these kind of expensive treatments.

[Fernando Roque, MD]

Hi.  HER-2NEU positive tumors are ideally treated with Herceptin, which is an antibody specifically targeting HER-2NEU receptors found on the surface of breast cancer cells.  Tumors with a HER-2 positive subtype are also found to be particularly susceptible to treatment with taxanes and anthracyclines, which are two of the drugs found in the regimen your doctor is planning to give your sister.  

You're asking if three cycles of AC (Doxorubicin - Cyclophosphamide combination) followed by three cycles of TAC (AC plus Docetaxel) is acceptable in terms of efficacy compared to six cycles of TAC.  Well for one thing, it depends on the stage of your sister's cancer.  If your sister has an earlier stage of cancer (e.g. stage II), then having only three cycles with Docetaxel (T) is probably acceptable.  The assumption here is that 3 AC followed by 3 TAC is less effective than 6 cyles of TAC.  However, as far as I know, there is no clinical trial which has been done to test the effectiveness of 3 AC followed by 3 TAC, since this is not a standard chemotherapy regimen.  So we really don't know how much the effectiveness will be lessened if we take away Docetaxel in the first three cycles.  

If you wish to have another cheaper option than 6 cycles of TAC, I suggest a regimen consisting of 3 cycles of FEC (Fluorouracil-Epirubicin-Cyclophosphamide) followed by 3 cycles of Docetaxel single agent.  This regimen has almost the same efficacy as TAC.

[Cheskalyn]

Thank you so much, Yes, we went to another oncology and that's what she recommend the 1st three cycle of FEC followed by three cycles of Taxotere.. Thanks again

just have another question: my sister lymph nodes test result is : Sinus Histocytosis.. Can you explain what is that? The oncology says it's a negative lymph nodes..