Skill Checkup: A 56-Year-Old Woman With a History of Breast Cancer and Pain in Her Ribs and Spine

Pavani Chalasani, MD, MPH


January 14, 2022

According to the National Cancer Institute, the breast cancer subtype HR-positive/HER2-negative is the most common. It accounts for about 70% of breast cancers. This is nearly seven times the triple-negative breast cancer rate and the HR-positive/HER2-positive rate, which account for 10% each. HR-negative/HER2-positive accounts for about 4%, and in the rest of cases, the receptor status is unknown.

Triple-negative breast cancer tends to be more aggressive and has a poorer prognosis than other types of breast cancer, mainly because fewer targeted medicines are available to treat it. This type of 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 attributable to major advances in HER2-targeted therapies.


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