Numerous treatment options are available for HR+/HER2- breast cancer, including chemotherapy, hormone therapy, and surgery. Side effects may also occur, which can vary from person to person.
HR+/HER2- breast cancer is the
Treatment options may include surgery, radiation, hormone therapy, targeted therapy, and chemotherapy.
Learn more about HR+/HER2- breast cancer, side effects, survival rates, and treatment duration.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.
Female breast cancers fall into four subcategories, the most common being HR+/HER2-.
In 2016–2020, there were
During the same period, 69% of all subtypes of female breast cancer were HR+/HER2-.
“HR” stands for hormone receptor. “HR-positive” (or HR+) means that the tumor cells contain receptors for progesterone and estrogen hormones, which can help HR-positive tumors grow.
“HER2” refers to human epidermal growth factor receptor 2. This can contribute to the development of breast cancer. If a breast cancer is HER2 negative, it means that it does not have this gene.
Several treatment options are available for people with HR+/HER2- breast cancer, which doctors primarily base on the cancer’s stage.
Surgery
The majority of people with breast cancer will have some form of surgery.
Surgery to remove cancer may involve removing part of the affected breast and leaving regular breast tissue in place. This is known as a lumpectomy, partial mastectomy, quadrantectomy, or segmental mastectomy.
A mastectomy involves the removal of the entire breast. For some people, a surgeon will perform a double mastectomy to remove both breasts.
Radiation
In radiation therapy, high energy rays help destroy cancer cells. This may occur after surgery to prevent cancer from returning or if the cancer has spread to other areas of the body.
Hormone therapy
Hormone therapy is an option for breast cancers that are positive for hormone receptors — as in HR+/HER2- breast cancer.
In these types of cancer, the breast cancer cells attach to the hormones estrogen and progesterone, which in turn helps the cancer cells to grow.
Hormone therapy works by stopping the hormones from attaching to receptors.
Hormone therapies include:
- Selective estrogen receptor degraders (SERDs): Examples include fulvestrant (Faslodex) or elacestrant (Orserdu).
- Selective estrogen receptor modulators (SERMs): These drugs include tamoxifen and toremifene (Fareston).
- Aromatase inhibitors (AIs): Examples include letrozole (Femara) and anastrozole (Arimidex).
- Ovarian suppression: This may involve surgery to remove the ovaries, chemotherapy drugs, or luteinizing hormone-releasing hormone (LHRH) agonists
Targeted therapy
Targeted therapy uses drugs to target proteins contained in breast cancer cells and either slow down their growth or destroy them.
Some forms of targeted therapy may make hormone therapy more effective, so it may be particularly helpful for those with HR+ breast cancer.
Targeted therapy options include:
- CDK4/6 inhibitors: palbociclib (Ibrance), ribociclib (Kisqali), and abemaciclib (Verzenio)
- mTOR inhibitors: everolimus (Afinitor)
- PI3K inhibitors: alpelisib (Piqray)
- AKT inhibitors: capivasertib (Truqap)
- Antibody-drug conjugate: sacituzumab govitecan (Trodelvy)
Chemotherapy
Chemotherapy uses anticancer drugs to kill cancer cells. Doctors may use it alongside surgery or when breast cancer has spread to other parts of the body.
A person may receive chemotherapy before surgery (neoadjuvant) to shrink the tumor or after surgery (adjuvant) to eradicate small groups of breast cancer cells (micrometastases).
Breast cancer treatments may cause side effects. These can differ for each person, even if they receive the same treatment.
Surgery
Possible side effects from breast cancer surgery include:
- wound infection
- lymphedema
- difficulties with wound healing, though this is not common
- excessive bleeding, but this is rare
- issues related to anesthesia
Radiation
Possible side effects from radiation therapy include:
- breast swelling
- fatigue
- skin changes in the treated area
Some people may also experience side effects later on after radiation therapy. These include:
- reduction in breast size
- the skin on the breast becomes firmer or swollen
- difficulty nursing
- numbness, weakness, or pain in the hand, shoulder, or arm
- pain and swelling in the chest or arm
- weakening of the ribs, though rare
- development of a different cancer called angiosarcoma, though this is very rare
Hormone therapy
Hormone therapy can cause various side effects that may include:
- vaginal dryness
- discharge
- hot flashes
- night sweats
- changes to the menstrual cycle
- pain in the joints, muscles, or bones
- fatigue
- headaches
- nausea
- loss of appetite
- mood swings
Targeted therapy
Possible side effects from targeted therapy include:
- nausea
- vomiting
- fatigue
- low blood cell count
- diarrhea
- headaches
- mouth sores
- shortness of breath
- cough
- increased blood lipids and blood sugars
- increased risk of serious infection
- liver, kidney, or pancreatic issues
- decrease in appetite
- weight loss
- low calcium
- issues with blood clotting
- hair loss
- severe skin reactions
- constipation
- low red blood cell count
- abdominal pain
Chemotherapy
Side effects from chemotherapy vary depending on drug combinations and length of therapy.
Possible side effects include:
- hair loss
- fatigue
- nausea
- vomiting
- diarrhea
- nail changes
- mouth sores
- weight changes
- loss of appetite
- vaginal dryness
- hot flashes
- nerve damage
Breast cancer treatments can vary in duration.
Breast cancer surgery that does not involve removing the entire breast may take 60–90 minutes. A mastectomy without an immediate breast reconstruction may take 1–3 hours.
Schedules for radiation therapy vary but may involve treatment lasting from
People typically take hormone therapy for
With targeted therapy, people may take medication
Chemotherapy typically involves
Chemotherapy before or alongside other forms of cancer treatment may be over 3–6 months. Treatment for stage 4 breast cancer that has spread to other parts of the body varies.
Cancer treatment depends on the goal, which may vary among people.
Some treatments may aim to cure cancer, while others aim to stop the cancer from spreading to other areas. Some cancer treatments may also be for reducing the side effects of other therapies or relieving symptoms due to cancer.
Signs that the treatment is working may include:
- no spread of cancer
- no growth of cancer
- no return of cancer
For people who are receiving neoadjuvant chemotherapy, the indication this is working is shrinkage of the breast mass.
Clinical trials allow doctors to test new drugs, procedures, or treatments.
People with HR+/HER2- breast cancer may choose to join a clinical trial to help others and improve treatment options.
A person can find local clinical trials by searching the
The 5-year relative survival rate for HR+/HER2- breast cancer is
The relative survival rate compares people with a specific type of cancer to the general population. This means that people with HR+/HER2- breast cancer are 94.8% as likely as people in the general population to live for at least 5 years after diagnosis.
Treatment success may depend on factors such as the stage of cancer, the speed of cancer growth, and a person’s overall health.
HR+/HER2- is the most common form of breast cancer. Numerous treatment options are available, including surgery, hormone therapy, and targeted therapy. Side effects may occur with treatments but will vary between people.
The 5-year relative survival rate of HR+/HER2- breast cancer is 94.8%.