Breast cancer is the most common cancer among women.1
Contrary to common belief, breast cancer is not just one disease
In 2020, 2,261,419 new cases of breast cancer were diagnosed worldwide, and nearly 700,000 died of the disease.1 This means that one woman is diagnosed with breast cancer somewhere in the world every 15 seconds and more than 13 women die of breast cancer every 10 minutes worldwide.1
There are several types of breast cancer, which can be classified based on three proteins (known as receptors) that coat the surface of the cancer cells: the estrogen receptor (ER), the progesterone receptor (PR) and the Human Epidermal Growth Factor Receptor 2 (HER2).2 These proteins play an important role in tumor development, by signaling cells to grow and divide. Knowing the type of breast cancer a patient has helps determine the most effective treatment approach.
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Hormone Receptor (HR)-positive breast cancer is the most common type of breast cancer, accounting for approximately 80% of cases.2 Breast cancers are considered HR-positive when tumor cells produce abnormal amounts of receptors for the hormones, estrogen and/or progesterone. As these hormones signal cells to grow and divide, having too many receptors on the surface of a cell can cause uncontrolled growth and the formation of a tumor. HR-positive breast cancers are commonly treated with medicines, known as hormone therapies, that block the activity of ER and/or PR, or that reduce hormone levels.
HER2-positive breast cancer – characterised by cells that over-produce the HER2 protein – represents approximately 20% of all breast cancers.2 This type of breast cancer can be particularly aggressive. If left untreated, it is associated with faster disease progression and poorer chances of survival compared to HER2-negative disease (i.e. breast cancer cells that are coated with normal amounts of the HER2 protein).3 Today, treatments are available which specifically target HER2, blocking the signals that cause cancer cells to grow and multiply.
Triple-negative breast cancer (TNBC) is a rare form of breast cancer, accounting for around 10-15% of all breast cancers.4 It is a type of breast cancer that lacks estrogen and progesterone receptors and does not over-produce the HER2 protein. The mechanisms that drive this type of cancer are therefore largely unknown, which makes it a particularly difficult type of breast cancer to treat. Although patients may respond to chemotherapy, overall, treatment options are limited, and the prognosis is often poor.5
Early diagnosis remains the cornerstone of breast cancer control. Screening for breast cancer with mammography detects many cancers before a lump can be felt.
Early detection and treatment innovation have improved breast cancer survival.7
Breast cancer research focused on personalized care
Researchers are continuing to push for new ways to prevent, detect, and treat cancer as well as improve the quality of life for survivors.8
The diagnostic frontier is expanding with biomarker advances and studies of 3-dimensional imaging technology. Biomarkers provide objective observations of tumor profiles, including prognostic and predictive information. The use of biomarkers is advancing to help enable more precise patient stratification, better define tumor microenvironments, identify the potential for adverse drug reactions or resistance, and reveal new therapeutic targets.
Researchers are also pushing the capabilities of mammography. Unlike traditional mammography which captures detail in 2-dimensions, the new 3-D technique, called tomosynthesis, takes images from around the breast and pieces them together into a 3-D like image.8
Biomarker advances support tailored approaches
Building on the three main clinical subtypes—HR-positive, HER2-positive and Triple Negative—scientists are revealing a more detailed understanding of the genetic alterations that drive tumor growth in breast cancer.
Researchers are looking at who might be most at risk of developing breast cancer based on genetic make-up, family history, and other risk factors. These risk-based screening studies may change how frequently some people are tested each year.8
Trials of targeted therapies are currently underway using known biomarkers, such as in patients who have experienced cellular damage due to inherited BReast CAncer (BRCA) gene mutations.8 Targeted therapies tend to be well tolerated by patients which means they may be able to be used earlier with certain cancers, prevent the return of certain cancer, or be tried in combination with chemotherapies to create more treatment options for patients with more advanced forms of the disease.8
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References
1. International Agency for Research on Cancer. Cancer fact sheets. Accessed September 9, 2021. https://gco.iarc.fr/today/data/factsheets/cancers/20-Breast-fact-sheet.pdf
2. WebMD. Types of breast cancer. Accessed August 16, 2021. http://www.webmd.com/breast-cancer/breast-cancer-types-er-positive-her2-positive
3. Wolff AC, et al. Recommendations for human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists clinical practice guideline update. J Clin Oncol. 2013;31(31):3997-4013.
4. National Breast Cancer Foundation. Triple negative breast cancer. Accessed October 2018. http://www.nationalbreastcancer.org/triple-negative-breast-cancer
5. Cancer Research UK. Triple negative breast cancer. Accessed September 9, 2021. https://www.cancerresearchuk.org/about-cancer/breast-cancer/stages-types-grades/types/triple-negative-breast-cancer
6. National Cancer Institute: Surveillance, Epidemiology, and End Results Program. Cancer stat facts: female breast cancer. Accessed September 8, 2021. https://seer.cancer.gov/statfacts/html/breast.html
7. DeSantis CE, et al. Breast cancer statistics, 2019. CA Cancer J Clin. 2019;69(6):438-451.
8. National Cancer Institute. Advances in breast cancer research. Accessed September 9, 2021. https://www.cancer.gov/types/breast/research
