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Some breast cancer cells have receptors, which allow particular types of hormones or proteins to attach to the cancer cell. Your doctors need to know if you have receptors for hormones or proteins to help them choose the most appropriate treatment| for you.
If you’ve previously been treated for breast cancer, a sample of the breast tissue will usually have been tested to see if it has these receptors. If you haven’t been treated for breast cancer before, your doctor will take a biopsy| of the secondary cancer to find out what type of receptors the cancer has. Even if you’ve had a previous biopsy, your specialist may recommend that you have another one because the secondary cancer may have different receptors from the primary cancer.
Some cancers have receptors for the hormones oestrogen and progesterone. Hormones act as chemical messengers and influence how cells grow and what they do.
Breast cancer that has a significant number of oestrogen receptors is known as oestrogen-receptor positive or ER positive. If a breast cancer doesn’t have oestrogen receptors it’s known as ER negative. Oestrogen receptors are known as ER because of the American spelling of oestrogen as estrogen.
If the cancer is ER positive it’s likely to respond to hormonal treatment.| Hormonal therapies change the way particular hormones in the body are produced or how they work.
Some cancers have receptors for a protein known as HER2 (human epidermal growth factor 2). Cancers with high levels of HER2 receptors are called HER2 positive|. Treatments known as biological therapies| such as trastuzumab (Herceptin®)| may be used to treat women whose breast cancer is HER2 positive.
Since 2006, all women in the UK newly diagnosed with breast cancer are tested for HER2. If you have secondary breast cancer and your original biopsy wasn’t tested for HER2 receptors, this will now be done. Samples of cancer tissue from previous biopsies, or surgery, may be used or you may have a biopsy of the secondary cancer.
Some women whose hormone and HER2 receptors were checked when first diagnosed with breast cancer may have this repeated when the cancer comes back. This is because the secondary cancer may have different hormone or HER2 receptors. It means taking a biopsy of the secondary cancer and your cancer specialist will advise you if this is appropriate in your situation.
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.