Overview Of ER-Positive Breast Cancer
ER-positive breast cancer is synonymous with breast cancer. Breast cancer is cancer that starts in the tissues of the breast.
There are two main types of breast cancer:
- Ductal carcinoma starts in the tubes (ducts) that carry milk from the breast to the nipple. Most breast cancers are of this type.
- Lobular carcinoma starts in the parts of the breast, called lobules, which produce milk.
- In rare cases, other kinds of breast cancer can start in other areas of the breast.
Commonly Associated With
Cancer – breast; Carcinoma – ductal; Carcinoma – lobular; DCIS; LCIS; HER2-positive breast cancer; ER-positive breast cancer; Ductal carcinoma in situ; Lobular carcinoma in situ
Causes Of ER-Positive Breast Cancer
Breast cancer risk factors are things that increase the chance that you could develop breast cancer:
- Some risk factors you can control, such as drinking alcohol. Others, such as family history, you cannot control.
- The more risk factors you have, the more your risk increases. But, it does not mean you will develop cancer. Many women who develop breast cancer do not have any known risk factors or family history.
- Understanding your risk factors can help you take steps to lower your risk.
- Some women are at higher risk for breast cancer because of certain genetic markers or variants that may be passed down from their parents.
- Genes known as BRCA1 or BRCA2 are responsible for most cases of inherited breast cancers.
- A screening tool with questions about your family’s history as well as yours can help your health care provider whether you are at risk for carrying these genes.
- If you are at high risk, a blood test to see if you carry the genes.
- Certain other genes may lead to an increased risk of breast cancer.
- Breast implants, using antiperspirants, and wearing underwire bras do not increase the risk for breast cancer. There is also no evidence of a direct link between breast cancer and pesticides.
Symptoms Of ER-Positive Breast Cancer
Early breast cancer often does not cause symptoms. This is why regular breast exams and mammograms are important, so cancers that don’t have symptoms may be found earlier.
As cancer grows, symptoms may include:
- A breast lump or lump in the armpit that is hard has uneven edges and usually does not hurt.
- Change in the size, shape, or feel of the breast or nipple. For example, you may have redness, dimpling, or puckering that looks like the skin of an orange.
- Fluid from the nipple. Fluid may be bloody, clear to yellow, green, or look like pus.
- In men, breast cancer symptoms include breast lump and breast pain and tenderness.
Symptoms of advanced breast cancer may include:
- Bone pain
- Breast pain or discomfort
- Skin ulcers
- Swelling of the lymph nodes in the armpit (next to the breast with cancer)
- Weight loss
Exams & Tests
The health care provider will ask about your symptoms and risk factors. Then the provider will perform a physical exam. The exam includes both breasts, armpits, and the neck and chest area.
Women are encouraged to perform breast self-exams each month. However, the importance of self-exams for detecting breast cancer is debatable.
Tests used to diagnose and monitor people with breast cancer may include:
- Mammography to screen for breast cancer or help identify the breast lump
- Breast ultrasound to show whether the lump is solid or fluid-filled
- Breast biopsy, using methods such as needle aspiration, ultrasound-guided, stereotactic, or open
- Breast MRI to help better identify the breast lump or evaluate an abnormal change on a mammogram
- Sentinel lymph node biopsy to check if cancer has spread to the lymph nodes
- CT scan to check if cancer has spread outside the breast
- PET scan to check if cancer has spread
- If your doctor learns that you do have breast cancer, more tests will be done. This is called staging, which checks if cancer has spread. Staging helps guide treatment and follow-up. It also gives you an idea of what to expect in the future.
- Breast cancer stages range from 0 to IV. The higher the stage, the more advanced cancer.
Treatment Of ER-Positive Breast Cancer
Treatment is based on many factors, including:
- Type of breast cancer
- Stage of cancer (staging is a tool your providers use to find out how advanced the cancer is)
- Whether the cancer is sensitive to certain hormones
- Whether cancer overproduces (overexpresses) the HER2/neu protein
Cancer treatments may include:
- Hormone therapy.
- Chemotherapy, which uses medicines to kill cancer cells.
- Radiation therapy, which is used to destroy cancerous tissue.
- Surgery to remove cancerous tissue: A lumpectomy removes the breast lump. Mastectomy removes all or part of the breast and possibly nearby structures. Nearby lymph nodes may also be removed during surgery.
- Targeted therapy uses medicine to attack the gene changes in cancer cells. Hormone therapy is an example of targeted therapy. It blocks certain hormones that fuel cancer growth.
Cancer treatment can be local or systemic:
- Local treatments involve only the area of disease. Radiation and surgery are forms of local treatment. They are most effective when cancer has not spread outside the breast.
- Systemic treatments affect the entire body. Chemotherapy and hormonal therapy are types of systemic treatment.
Most women receive a combination of treatments. For women with stage I, II, or III breast cancer, the main goal is to treat cancer and prevent it from returning (recurring). For women with stage IV cancer, the goal is to improve symptoms and help them live longer. In most cases, stage IV breast cancer cannot be cured.
Stage 0 and ductal carcinoma: Lumpectomy plus radiation or mastectomy is the standard treatment.
Stage I and II: Lumpectomy plus radiation or mastectomy with lymph node removal is the standard treatment. Chemotherapy, hormonal therapy, and other targeted therapy may also be used after surgery.
Stage III: Treatment involves surgery, possibly followed by chemotherapy, hormone therapy, and other targeted therapy.
Stage IV: Treatment may involve surgery, radiation, chemotherapy, hormone therapy, other targeted therapy, or a combination of these treatments.
After treatment, some women continue to take medicines for a time. All women continue to have blood tests, mammograms, and other tests after treatment to monitor for the return of cancer or development of another breast cancer.
Women who have had a mastectomy may have reconstructive breast surgery. This will be done either at the time of mastectomy or later.