“Doctor, has my pathology report come out?” 45-year-old Ms. Wang nervously asked as she entered the consultation room. A few weeks ago, she had undergone a breast ultrasound examination which revealed a tumor, leading her to undergo surgical treatment.
“Yes, your breast cancer is classified as hormone receptor-positive (HR+ HER2-) early-stage breast cancer,” the doctor said.
Breast cancer is one of the most common types of cancer affecting women worldwide. It occurs when abnormal cells in the breast grow and divide uncontrollably, forming a tumor. Early detection and timely treatment are crucial in improving the chances of survival and reducing the risk of complications.
Ms. Wang’s case is particularly significant as her breast cancer is hormone receptor-positive. This means that the cancer cells have receptors for hormones, specifically estrogen and progesterone. These receptors allow the cancer cells to receive signals from these hormones, promoting their growth and division. However, this also presents an opportunity for targeted treatment.
The doctor explained to Ms. Wang that her tumor is HER2-negative, which means it does not overexpress the human epidermal growth factor receptor 2 (HER2) protein. HER2-positive breast cancers tend to grow more aggressively and have a higher risk of recurrence. However, HER2-negative tumors have a better prognosis and respond well to hormone therapy.
Treatment options for Ms. Wang may include surgery, radiation therapy, chemotherapy, and hormone therapy. The doctor reassured her that her cancer was detected at an early stage, increasing the likelihood of successful treatment and a positive outcome.
Breast cancer treatment is often multidisciplinary, involving a team of healthcare professionals, including surgeons, oncologists, radiologists, and pathologists. The pathology report plays a crucial role in determining the characteristics of the tumor, such as its size, grade, and hormone receptor status. This information helps guide the treatment plan and prognosis.
Ms. Wang’s proactive approach in seeking medical attention and undergoing regular screenings has proven beneficial in detecting her breast cancer early. It serves as a reminder for women to prioritize their health and be vigilant in monitoring any changes in their breasts.
As Ms. Wang continues her journey towards recovery, she is grateful for the medical advancements and the expertise of her healthcare team. With their support and her determination, she remains hopeful for a future free from breast cancer.級、Ki-67指數大於20%，便屬於高復發風險族群〔4〕。
腫瘤分化程度可分為三級，第一級分化較好，屬於低度惡性；第三級分化較差，屬於高度惡性。郭玟伶醫師說，Ki-67指數是細胞生長速度的指標，當Ki-67大於等於20%，代表是生長較快的乳癌，復發風險較高。
病人的年紀也要留意，年紀愈輕、風險愈高。郭玟伶醫師說，在綜合評估各項因子後，會跟患者討論，擬定個人化的治療策略。
「治療乳癌，並不是只有開刀就好！」郭玟伶醫師強調，「臨床上必須根據乳癌復發風險，使用不同強度的輔助治療。」
以荷爾蒙陽性（HR+HER2-）早期乳癌為例。郭玟伶醫師說，復發風險較低的乳癌患者，術後可使用荷爾蒙治療；病程進展較嚴重的乳癌患者，術後可使用荷爾蒙治療搭配化學治療；高復發風險的乳癌患者，術後可使用荷爾蒙治療搭配化學治療與細胞週期抑制劑。
細胞週期抑制劑能夠阻斷調節細胞分裂週期的細胞週期素激酶，抑制癌細胞的分裂。起初，細胞週期抑制劑是用於治療荷爾蒙陽性（HR+HER2-）的晚期或轉移性乳癌，能夠發揮顯著的治療成效。郭玟伶醫師說，後續的研究發現，使用細胞週期抑制劑有助降低早期乳癌的復發風險約三成，改變許多患者的命運。
荷爾蒙陽性（HR+HER2-）早期乳癌術後，一定要使用荷爾蒙治療，並視狀況搭配化學治療。郭玟伶醫師說，現在可以針對高復發風險族群加上細胞週期抑制劑，進一步降低復發機率，讓乳癌治療能更加完整。
貼心小提醒
乳癌是台灣女性發生率最高的癌症，郭玟伶醫師提醒，乳癌初期大多摸不到、也沒有症狀，大家最好定期接受檢查，利用乳房超音波或乳房攝影偵測早期乳癌。
確診乳癌後，請與醫師討論，及早接受治療。郭玟伶醫師說，乳癌的治療工具愈來愈多，治療成效也持續進步。荷爾蒙陽性（HR+HER2-）早期乳癌術後，可依照復發風險使用荷爾蒙治療、化學治療、細胞週期抑制劑等，幫助更多乳癌患者達成治癒的目標！
參考資料：
1. 乳癌細胞有荷爾蒙接受體才可以接受荷爾蒙治療，什麼是荷爾蒙接受體？臺北榮民總醫院乳房醫學中心
2. Salvo EM, Ramirez AO, Cueto J, et al. Risk of recurrence among patients with HR-positive, HER2-negative, early breast cancer receiving adjuvant endocrine therapy: A systematic review and meta-analysis. Breast. 2021;57:5-17. doi:10.1016/j.breast.2021.02.009
3. Chen BF, Tsai YF, Huang CC, et al. Clinicopathological characteristics and treatment outcomes of luminal B1 breast cancer in Taiwan. J Chin Med Assoc. 2022;85(2):190-197. doi:10.1097/JCMA.0000000000000632
4. Johnston SRD, Harbeck N, Hegg R, et al. Abemaciclib Combined With Endocrine Therapy for the Adjuvant Treatment of HR+, HER2-, Node-Positive, High-Risk, Early Breast Cancer (monarchE). J Clin Oncol. 2020;38(34):3987-3998. doi:10.1200/JCO.20.02514
E-CGA-ONC-010-23-Jul-05「本衛教文章由台灣禮來協助提供」
本圖文由「照護線上」授權轉載，原文出處 手術了然後呢？荷爾蒙陽性早期乳癌，啟動避險治療，細胞週期抑制劑降低復發風險，乳房外科醫師圖文解說
2023-08-17 03:56:42
#手術了然後呢荷爾蒙陽性早期乳癌啟動避險治療細胞週期抑制劑降低復發風險乳房外科醫師圖文解說
Can you explain the role of hormone therapy in treating Ms. Wang’s hormone receptor-positive breast cancer
On entering the consultation room, 45-year-old Ms. Wang anxiously asked her doctor if her pathology report had been released. Several weeks ago, she had undergone a breast ultrasound examination that revealed the presence of a tumor, leading her to undergo surgical treatment.
The doctor informed Ms. Wang that her breast cancer is classified as hormone receptor-positive (HR+ HER2-) early-stage breast cancer. Breast cancer is one of the most common types of cancer affecting women globally. It occurs when abnormal cells in the breast grow uncontrollably, forming a tumor. Early detection and timely treatment are crucial in improving survival rates and reducing the risk of complications.
Ms. Wang’s case is particularly significant as her breast cancer is hormone receptor-positive, meaning that the cancer cells have receptors for estrogen and progesterone hormones. These receptors allow the cancer cells to receive signals from these hormones, promoting their growth and division. However, this also presents an opportunity for targeted treatment.
The doctor explained to Ms. Wang that her tumor is HER2-negative, indicating that it does not overexpress the human epidermal growth factor receptor 2 (HER2) protein. HER2-positive breast cancers tend to grow more aggressively and have a higher risk of recurrence. However, HER2-negative tumors have a better prognosis and respond well to hormone therapy.
Treatment options for Ms. Wang may include surgery, radiation therapy, chemotherapy, and hormone therapy. The doctor reassured her that her cancer was detected at an early stage, increasing the likelihood of successful treatment and a positive outcome.
Breast cancer treatment often involves a multidisciplinary approach, with a team of healthcare professionals including surgeons, oncologists, radiologists, and
This article provides valuable insights about hormone receptor positive early breast cancer treatment. Thank you for sharing!
I found this article incredibly informative and it helped answer a lot of questions I had about post-operative treatment for hormone receptor positive early breast cancer. Thank you for sharing this valuable information!