Skill Checkup: A 64-Year-Old Woman With a Breast Mass and Back and Hip Pain

Maurie Markman, MD

Disclosures

September 08, 2021

Correct Answer: B. HR-positive/HER2-negative

According to the National Cancer Institute, HR-positive/HER2-negative is the most common breast cancer subtype, accounting for about 68% of breast cancers, based on 2014-2018 cases. This is nearly seven times higher than the rate of triple-negative breast cancer and the rate of HR-positive/HER2-positive, which each account for 10% of cases. HR-negative/HER2-positive accounts for about 4% of cases, and in the rest of cases, the receptor status is unknown.

Triple-negative breast cancer is considered to be more aggressive and tends to have a poorer prognosis than other types of breast cancer, mainly because there are fewer targeted medicines that treat triple-negative breast cancer. Studies have shown that triple-negative breast cancer is more likely to spread beyond the breast and more likely to recur after treatment.

HER2-positive breast cancer is more aggressive and more likely to spread than HER2-negative breast cancer. However, in recent years, in de novo metastatic disease, women with the HR-positive/HER2-positive subtype have better survival than those with the HR-positive/HER2-negative subtype (often considered the best prognostic feature). This remarkable change is probably attributable to major advances in HER2-targeted therapies.

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