Breast cancer cells obtained through biopsy or surgical procedures undergo testing to determine the presence of specific proteins known as estrogen or progesterone receptors. These receptors play a crucial role in stimulating cancer growth when bound by the hormones estrogen and progesterone. Based on the presence or absence of these receptors, cancers are classified as hormone receptor-positive or hormone receptor-negative.
Understanding the hormone receptor status is a critical factor in determining appropriate treatment options. If you are undergoing cancer treatment or have just been diagnosed with cancer, it is advisable to consult your doctor regarding your hormone receptor status and its implications for your specific case to get a professional treatment plan.
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Explaining estrogen and progesterone receptors
Receptors are proteins present within or on cells that can bind to specific substances circulating in the bloodstream. Both normal breast cells and certain breast cancer cells possess receptors that can attach to the hormones estrogen and progesterone. These hormones are essential for the growth of these cells.
In breast cancer cells, there may be one, both, or none of these receptors, depending on the type of cancer.
Breast cancers that have estrogen receptors are called ER+ cancers, while those with progesterone receptors are called PR+ cancers. If a cancer has one or both receptors, it is a hormone receptor positive cancer (HR+). Conversely, if it has neither of these receptors, it is a hormone receptor negative cancer (HR-).
To prevent the growth and development of these cancers, estrogen and progesterone must be prevented from attaching themselves to the receptors. This can be done doing targeted therapies. Therefore, it is essential to understand what hormone receptors are – and what is present – in the disease, and it is usually within the first steps in diagnosis. A clinician will use an immunohistochemistry (IHC) test to find out if the cancer cells contain these receptors before proposing a treatment plan.
Hormone receptor biomarker testing – purposes
For HR+ breast cancers, typical treatment plans will include the administering of hormone therapy drugs that aim to lower estrogen levels or block estrogen receptors. This can lead to cancers growing more slowly than HR- subtypes.To monitor the efficacy of treatment, biomarker testing may be done alongside other methods of screening and scanning, with the biomarkers being the hormone receptor status of the cancer.
There are several purposes of conducting biomarker testing regularly.
1. Treatment decision-making
The first and perhaps most important application of using a biomarker test for breast cancer regularly is that it can guide treatment decision-making. Knowing how aggressive the tumor is and how it is responding to therapies can indicate whether treatment is effective, and it can lead clinicians to select the right approach for each patient, from dosage to strength of medicines administered.
In HR+ breast cancers, hormone receptor status plays a big role in guiding treatment decisions, as these cancer cells rely on hormones for growth and proliferation.
2. Predicting treatment response
Knowing the hormone receptor status of the cancer’s response to hormone therapy can also help clinicians better predict treatment progress and response. When testing hormone receptor status, patients can be identified when they are most likely able to benefit from relevant treatments that are hormone-based.
3. Reducing unnecessary treatment
Once treatment efficacy is determined by how hormone receptors behave over time, clinicians can also potentially reduce unnecessary pain by cutting out ineffective therapies or inefficient medicines. Clinicians can closely monitor disease progression and create tailored treatment plans that are designed specifically for the patient and the type of tumor they have, which can reduce costs and minimize the chances of complications arising.
Word of caution when using biomarker activity to monitor treatment status and efficacy
It is essential to note that while biomarker activity and presence can reveal valuable information about treatment efficacy, it does not tell the whole story. Other monitoring methods – such as biopsies and scans – should be used to avoid having knowledge gaps in tumor growth and development.
This is because HR+ breast cancer is a multifaceted disease, and cancer treatment should be determined on a range of factors, from age, health status and location to medical preferences and accessibility. There is also a need to adhere to clinical guidelines and treatment protocols, and clinicians should work with patients to determine the most appropriate monitoring methods.
Final Words
All invasive breast cancers should be tested for estrogen and progesterone receptors either with a biopsy sample or when the tumor is removed. Knowing the hormone receptor status of your breast cancer is important, as it can help doctors and healthcare providersdetermine the best course of treatment and follow-up monitoring. This may include biomarker testing and having health scans and check-upsat regular intervals, which will require trust and close collaboration between patients and healthcare providers.
