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Selective Estrogen Receptor Modulators (SERMs)

https://www.breastcancer.org/treatment/hormonal/serms

Selective estrogen receptor modulators, called SERMs for short, block the effects of estrogen in the breast tissue. SERMs work by sitting in the estrogen receptors in breast cells. If a SERM is in the estrogen receptor, there is no room for estrogen and it can’t attach to the cell. If estrogen isn’t attached to a breast cell, the cell doesn’t receive estrogen’s signals to grow and multiply.

Cells in other tissues in the body, such as bones and the uterus, also have estrogen receptors. But each estrogen receptor has a slightly different structure, depending on the kind of cell it is in. So breast cell estrogen receptors are different from bone cell estrogen receptors and both of those estrogen receptors are different from uterine estrogen receptors. As their name says, SERMs are “selective” – this means that a SERM that blocks estrogen’s action in breast cells can activate estrogen’s action in other cells, such as bone, liver, and uterine cells.

There are three SERMs:

  • tamoxifen in pill form (also called tamoxifen citrate; brand name: Nolvadex) and in liquid form (brand name: Soltamox)
  • Evista (chemical name: raloxifene)
  • Fareston (chemical name: toremifene)

Each is a pill, usually taken once a day, except for tamoxifen in liquid form. Tamoxifen is the oldest, most well-known, and most-prescribed SERM.

SERMs can be used to treat women both before and after menopause.

Benefits of SERMs

Because tamoxifen is the most commonly used SERM, most of the studies comparing SERMs to aromatase inhibitors have looked at tamoxifen versus aromatase inhibitors. Several studies have compared tamoxifen with ar…

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HER2 Status

https://www.breastcancer.org/symptoms/diagnosis/her2

HER2 (human epidermal growth factor receptor 2) is a gene that can play a role in the development of breast cancer. Your pathology report should include information about HER2 status, which tells you whether or not HER2 is playing a role in the cancer. 

Genes contain the recipes for the various proteins a cell needs to stay healthy and function normally. Some genes and the proteins they make can influence how a breast cancer behaves and how it might respond to a specific treatment. Cancer cells from a tissue sample can be tested to see which genes are normal and abnormal. The proteins they make can also be tested.

The HER2 gene makes HER2 proteins (also sometimes referred to as HER2/neu proteins). HER2 proteins are receptors on breast cells. Normally, HER2 receptors help control how a healthy breast cell grows, divides, and repairs itself. But in about 25% of breast cancers, the HER2 gene doesn’t work correctly and makes too many copies of itself (known as HER2 gene amplification). All these extra HER2 genes tell breast cells to make too many HER2 receptors (HER2 protein overexpression). This makes breast cells grow and divide in an uncontrolled way.

Breast cancers with HER2 gene amplification or HER2 protein overexpression are called HER2-positive in the pathology report. HER2-positive breast cancers tend to grow faster and are more likely to spread and come back compared to HER2-negative breast cancers. But there are medicines specifically for HER2-positive breast cancers.

Testing for HER2 status

There are four tests for HER2. How your results appear in the report will depend on what test you have:

  • IHC test (ImmunoHistoChemistry): The ImmunoHistoChemistry test finds out if there is too much HER2 protein in the cancer cells. The results of the IHC test can be: 0 (negative), 1+…

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Invasive Ductal Carcinoma (IDC)

https://www.breastcancer.org/symptoms/types/idc

Invasive ductal carcinoma

Invasive Ductal CarcinomaLarger Version

Invasive ductal carcinoma (IDC), sometimes called infiltrating ductal carcinoma, is the most common type of breast cancer. About 80% of all breast cancers are invasive ductal carcinomas.

Invasive means that the cancer has “invaded” or spread to the surrounding breast tissues. Ductal means that the cancer began in the milk ducts, which are the “pipes” that carry milk from the milk-producing lobules to the nipple. Carcinoma refers to any cancer that begins in the skin or other tissues that cover internal organs — such as breast tissue. All together, “invasive ductal carcinoma” refers to cancer that has broken through the wall of the milk duct and begun to invade the tissues of the breast. Over time, invasive ductal carcinoma can spread to the lymph nodes and possibly to other areas of the body.

According to the American Cancer Society, more than 180,000 women in the United States find out they have invasive breast cancer each year. Most of them are diagnosed with invasive ductal carcinoma.

Although invasive ductal carcinoma can affect women at any age, it is more common as women grow older. According to the American Cancer Society, about two-thirds of women are 55 or older when they are diagnosed with an invasive breast cancer. Invasive ductal carcinoma also affects men.

On the following pages you can learn more about:

  • <a title="Signs and Symptoms of Invasive Ductal Carcinoma" href="https://www.breastc…

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Tamoxifen in Pill Form (Brand Name: Nolvadex)

https://www.breastcancer.org/treatment/hormonal/serms/tamoxifen

Tamoxifen, the generic name of Nolvadex, is the oldest and most-prescribed SERM. Tamoxifen is approved by the U.S. Food and Drug Administration (FDA) to treat:

  • women and men diagnosed with hormone-receptor-positive, early-stage breast cancer after surgery (or possibly chemotherapy and radiation) to reduce the risk of the cancer coming back (recurring)
  • women and men diagnosed with advanced-stage or metastatic hormone-receptor-positive disease

Tamoxifen also is used to:

  • reduce breast cancer risk in women who haven’t been diagnosed but are at higher-than-average risk for disease

Tamoxifen won’t work on hormone-receptor-negative breast cancer.

Tamoxifen is a pill taken once a day. Most doctors recommend taking tamoxifen at the same time each day. Tamoxifen is also available as a liquid under the brand name Soltamox.

You should not take tamoxifen if you are breastfeeding, pregnant, trying to get pregnant, or if there is any chance that you could be pregnant. Tamoxifen may cause damage to developing embryos. You should use an effective non-hormonal type of birth control — such as condoms, a diaphragm along with spermicide, or a non-hormonal I.U.D. – while you are taking tamoxifen and for 2 months afterward. Ask your doctor which type of non-hormonal birth control would be best for you.

Benefits of tamoxifen


Cell with estrogen receptors blocked by tamoxifen and helper proteins

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Community Get-Together Photo Slideshow

https://www.breastcancer.org/community/get-together-photos

BCO ladies take a group photo at lunch at George’s Restaurant in Long Beach, California on June 3, 2014

Left to right: _ann_ (in black), badger (behind), hbcheryl (in front of badger), ruthbru, kindergarten, SlowDeepBreaths, 2nd_time_around, whippetmom, and sweetandspecial

Targeted Therapy

https://www.breastcancer.org/treatment/targeted_therapies

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Targeted cancer therapies are treatments that target specific characteristics of cancer cells, such as a protein that allows the cancer cells to grow in a rapid or abnormal way. Targeted therapies are generally less likely than chemotherapy to harm normal, healthy cells. Some targeted therapies are antibodies that work like the antibodies made naturally by our immune systems. These types of targeted therapies are sometimes called immune targeted therapies.

Pregnant women should not get targeted therapies. The little research that has been done suggests that targeted therapies are not safe during pregnancy. Visit the Treatment for Breast Cancer During Pregnancy page for more information.

These are the targeted therapies doctors use to treat breast cancer:

Afinitor
Afinitor (chemical name: everolimus) is an mTOR (mammalian target
of rapamycin) inhibitor. Afinitor works against
hormone-receptor-positive breast cancers that have stopped responding to
Arimidex or Femara by stopping the cancer cells from getting the energy
they need.
Avastin
Avastin (chemical name: bevacizumab) works by blocking the growth
of new blood vessels tha…

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Targeted Therapies to Treat Metastatic Breast Cancer

https://www.breastcancer.org/symptoms/types/recur_metast/treat_metast/options/targeted

Targeted therapies are treatments that target specific characteristics of cancer cells, such as a protein that allows the cancer cells to grow in a rapid or abnormal way. Targeted therapies are generally less likely than chemotherapy to harm normal, healthy cells. Some targeted therapies are antibodies that work like the antibodies made naturally by our immune systems.

There are currently seven targeted therapies doctors use to treat metastatic breast cancer:

Afinitor (chemical name: everolimus) works against locally advanced-stage or metastatic, hormone-receptor-positive, HER2-negative breast cancer in postmenopausal women previously treated with Femara by interfering with the mTOR kinase (a protein in the body that if acting abnormally, can help certain breast cancers grow). Afinitor is a pill given in combination with Aromasin (chemical name: exemestane). Treatment with Afinitor can be continued indefinitely in order to keep the cancer under control. Your doctor would only recommend you stop taking Afinitor if the cancer stopped responding to it or if you experienced any severe side effects.

Avastin (chemical name: bevacizumab) is given intravenously in combination with Taxol (chemical name: paclitaxel), a type of chemotherapy, to treat people diagnosed with metastatic, HER2-negative breast cancer who haven’t yet received chemotherapy for metastatic breast cancer. Avastin works against HER2-negative breast cancer by blocking the growth of new blood vessels that cancer cells depend on to grow and function. More research is needed to determine whether you can stop taking Avastin if the cancer stops progressing.

On Nov. 18, 2011, the U.S. Food a…

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