Cancer Lesson #61: Three Negatives Don’t Make a Positive

Cancer Lesson #61: Three negatives don’t make a positive.

A few weeks after I finished treatment, one of my favorite cousins was diagnosed with breast cancer, beginning her own journey down the same same scary path I had so recently traveled. But her path took a different turn when she learned her cancer is triple negative.

You see, breast cancer has many variations. Pathology may show a tumor responds (is receptive) to estrogen (ER), progesterone (PR), human epidermal growth factor receptor 2 (HER2), or any combination of the three.

If cancer is ER or PR positive, hormone inhibitors are used to help prevent recurrence. A cancer that is HER2 positive tends to be more aggressive, and is treated differently. (WebMD has a good explanation of this (http://tinyurl.com/34xafpm).

But my cousin’s cancer is triple negative, meaning it isn’t ER, PR or HER2 positive, hence the name, “Triple Negative Breast Cancer” (TNBC).

Because TNBC isn’t receptive to hormones, hormone inhibitors aren’t a treatment option, so she was treated with a more aggressive chemo regimen than mine, as well as radiation.

I share these facts because people sometimes assume all breast cancer is treated similarly, varying only by stage and/or size of the tumor(s). I hope you understand now this isn’t the case.

And with HER2, it seems not only can a negative be a negative, a positive can be a negative too.

For more information about TNBC, please visit http://www.tnbcfoundation.org/index.html.

Note: I was HER2 negative and slightly ER and PR positive so I take Anastrozole/Arimidex (a hormone inhibitor), which is effective for post-menopausal women. Tamoxifen is used for women who are pre-menopausal. Here’s a good explanation of the differences from the Dr. Susan Love Research Foundation website: http://tinyurl.com/m4p7hgb.

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Cancer Lesson #16: Vocabulary Lesson

Cancer Lesson #16: Vocabulary Lesson

Having cancer broadens your vocabulary. Now instead of saying, “I had breast cancer,” I can tell people, “I had a progesterone receptor positive, estrogen receptor negative, HER2 negative, malignant neoplasm in the lower right quadrant with lymph node involvement.”

The mass was a “ductal carcinoma,” and since it had spread to a lymph node, it would also be considered “invasive.”

What does all this mean?

Well, the progesterone and estrogen parts refer to whether or not my cancerous tissue was receptive to those types of hormones. That is, did those hormones help it to grow? My mass was receptive to progesterone (PR positive) and only very slightly receptive to estrogen (almost ER negative). According to WebMD, about 75% of breast cancers are ER positive. Being ER and PR positive is a good thing because these cancers can be fought using hormone suppressors. (http://www.webmd.com/breast-cancer/breast-cancer-types-er-positive-her2-positive)

HER2 stands for Human Epidermal Growth Factor Receptor 2. It also promotes the growth of cancer cells, and HER2 positive cancers tend to be more aggressive than other types of breast cancer. (http://www.mayoclinic.com/health/breast-cancer/AN00495)

“Ductal carcinoma” simply means my cancer started in the ducts – the parts of the breast that carry milk from the lobules, where the milk is produced.

Each one of these descriptors is important because they indicate where my cancer was, how much it had spread and how it grew. These facts, in turn, defined my options for the treatment of my “progesterone receptor positive, estrogen receptor negative, HER2 negative, malignant neoplasm in the lower right quadrant with lymph node involvement,” my “invasive ductal carcinoma.”