What is Hormone Receptor Posi... Video Transcript

Participants

Maura N. Dickler MD, Stephen E. Jones MD, Lawrence D. Wickherham MD

Summary

There are a variety of factors that determine what treatments doctors suggest for breast cancer. One crucial aspect of any breast cancer is whether it is hormone receptor positive. If it is, there are a variety of treatments that can help decrease the amount of estrogen in a woman's body helping to prevent the growth of the cancer. Discover how hormones can play a vital part in this disease.

Webcast Transcript

ANNOUNCER: A woman diagnosed with breast cancer will have dozens of questions. It's hard to know which to ask first. One of the most important things to discover is whether the cancer is hormone receptor positive. But what does that mean?

LAWRENCE WICKERHAM, MD: In breast cancers that respond to hormones, those that are estrogen-receptor positive, this protein, the estrogen receptor, actually combines with normal circulating estrogen in the woman's body. It's this combination of estrogen and estrogen receptor that is necessary for the breast cancer to continue to grow. If we interrupt that combination, that binding, we can actually stop the progress of breast cancer growth.

ANNOUNCER: Normally, many parts of a woman's body have cells that contain estrogen receptors. It helps them routinely use estrogen to ensure strong bones and may help keep blood vessels unclogged. But in breast cancer, these receptors indicates the cancer will grow in response to estrogen.

STEVEN JONES, MD:These are cancers that overexpress estrogen receptor or progesterone receptor. Again it has nothing to do with whether the woman has taken estrogen or hasn't taken estrogen. It's just a feature of the cancer. And really up to 70% or so of breast cancer is either estrogen or progesterone receptor positive.

ANNOUNCER: Identifying a cancer as hormone receptor positive is important to determine hormonal treatment is an option. Hormonal treatment works to prevent estrogen from causing the cancer to grow, either by lowering the levels of estrogen in the body or preventing the estrogen from binding to the cancer cell.

LAWRENCE WICKERHAM, MD: For premenopausal women, the standard hormonal therapy, in this country at least, has been tamoxifen. It's a pill. It's given for five years and is a highly effective treatment for breast cancer. In postmenopausal women, the options are a little bit broader now. Tamoxifen is still an effective therapy, but we also have a newer class of treatments called aromatase inhibitors.

ANNOUNCER: There are three drugs in this class: Arimidex, Femara, and Aromasin. Arimidex has been approved for adjuvant use against all types of breast cancers including early-stage disease, when the cancer has not spread beyond the breast. Femara is approved for locally advanced cancer and metastatic cancer. And Aromasin has been approved for use against metastatic cancer if tamoxifen has proved ineffective.

Studies have been going on for several years to see whether the benefits of hormone therapy can be carried even further with the use of aromatase inhibitors in post-menopausal women. In all of these studies, the aromatase inhibitors showed an improvement in reducing the risk of recurrence. This was true at all of the time points studied: women who took the aromatase inhibitors immediately after surgery, ones who switched from tamoxifen to the aromatase inhibitors after some number of years -- so-called sequencing of hormonal therapy -- and women who added aromatase inhibitors after completing five years of tamoxifen. The aromatase inhibitors have been shown to improve upon the benefits that have already been seen with tamoxifen and should be incorporated into the care of all postmenopausal women with early stage breast cancer.

ANNOUNCER: Since the type of treatment is dependant on finding out whether breast cancer is hormone receptor positive, testing for this factor is something that's done very early on.

STEVEN JONES, MD: Once a biopsy is done, any type of biopsy, might be a needle biopsy, might be removal of a mass and there's breast cancer present, the test can be done on that tissue.