If your breast cancer is “HER2-positive,” it’s more aggressive than other types of breast tumors, but treatments can help.

About 1 of every 5 of breast cancers are HER2-positive. That means the cancer cells have more of a protein called HER2, human epidermal growth factor receptor 2. It causes these cells to grow and spread faster than the ones with normal levels of the protein.

You’ll work with your doctor to review the treatment options and come up with a plan that's best for you.

Causes

Doctors don’t know the exact causes of breast cancer. Experts think it may be a combination of things, including your genes, environment, and lifestyle.

You can't inherit a bad copy of the HER2 gene from a parent, and you won’t pass it on to your children.

Symptoms

The most common warning sign of any type of breast cancer is a lump in your breast that feels different from the area around it. That’s true for the HER2-positive type, too.

Other symptoms may include:

  • Breast swelling
  • A change in its shape
  • Skin irritation or dimpling
  • Pain in the breast or nipple
  • Redness or thickness of the nipple or breast skin
  • Discharge from the nipple (not breast milk)

You may have noticed a difference in your breasts during a self-exam. Or you may have had a mammogram that showed a growth.

Diagnosis

When you find out that you have breast cancer, your doctor will check to see if yours is HER2-positive. She'll probably give you one or more of these tests:

The IHC test uses certain antibodies that identify the HER2 protein in a sample of breast cancer tissue. If there is a lot of it, the cells change color in the sample.

These tests see if there are too many HER2 genes in the cancer cells:

The FISH test uses fluorescent pieces of DNA that stick to the HER2 gene in cells, which can then be counted under a microscope.

The SPOT-Light HER2 CISH and the Inform HER2 Dual ISH tests use stains that color HER2 genes in a tissue sample, so that they can be counted under a microscope.

Sometimes the results of a single test aren't clear. If that happens, your doctor may order another type.

Questions for Your Doctor

  • How are you sure my cancer is HER2-positive?
  • Where exactly is my cancer?
  • What stage is it?
  • What are my treatment options?
  • What treatment do you think will work best for me?
  • How quickly do I need to start the treatment?
  • How will the treatment make me feel?
  • Is there a clinical trial I should consider?
  • Will I be able to work?
  • Do I need to have my breast removed?
  • Do I need radiation?
  • Do I need chemotherapy?
  • Do I need hormone treatment?
  • Will my insurance cover my treatment?
  • What if my cancer doesn’t respond to the treatment?

Treatment

Because your breast cancer is HER2-positive, that makes a difference in how your doctor will treat it.

This type of the disease doesn't respond well to the hormone treatments that work for other forms of breast cancer. But there are kinds of medicines for it.

Doctors call these drugs “targeted treatments. They kill the cells that make the HER2 protein. That stops or blocks the protein from helping cancer cells grow. This greatly lowers the chances that your disease will come back.

Taking Care of Yourself

Having breast cancer can be overwhelming. Remember, though: You're in control of your treatment decisions and how you live your life.

These tips can help you stay healthy while you get treatment:

Get the support you need, whether it's information about breast cancer, talking with someone, or practical help with daily tasks. It can all make a huge difference in how you feel. Listen to your body. Exercise can help you feel better, but only when you're up for it.

Stay nourished. If you don’t have much appetite, eat smaller meals every few hours, rather than three big meals.

What to Expect

Many women do well with targeted treatments. Breast cancer of any kind is easier to treat when it’s diagnosed early. If your disease spreads or has comes back, there are still ways to treat it.

Talk with your doctor about whether a clinical trial is a good option for you. These are studies that test treatments that aren’t yet available.

Get Support

The American Cancer Society is a good starting place to find the support you and your family may need throughout your treatment and afterward.

You may want to join a support group. That’s a good way to meet people who know what you're going through, because they’ve been through it, too.

Let your family and friends know how you're feeling. Tell them what they can do to help you. They may want to help but don’t know what to do.

Also, consider talking with a counselor. That could help you handle the emotions that can come with having cancer.

WebMD Medical Reference

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Approved Use

Patients should not take AFINITOR if they are allergic to AFINITOR or to any of its ingredients. Patients should tell their health care provider before taking AFINITOR if they are allergic to sirolimus (Rapamune®) or temsirolimus (Torisel®).

AFINITOR can cause serious side effects, such as lung or breathing problems, infections, or kidney failure. Some of these side effects can be severe and can even lead to death. Your health care team may have ways to help manage side effects that do occur. It's important to talk with your doctor or nurse about side effects you experience and the best ways to manage them. Serious side effects include:

Lung or Breathing Problems: Patients should tell their health care provider right away if they have any of these symptoms: new or worsening cough, shortness of breath, chest pain, difficulty breathing, or wheezing.

Infections: AFINITOR may make patients more likely to develop an infection, such as pneumonia, or a bacterial, fungal, or viral infection. Viral infections may include reactivation of hepatitis B in people who have had hepatitis B in the past. Patients may need to be treated as soon as possible. Patients should tell their health care provider right away if they have a temperature of 100.5°F or above, have chills, or do not feel well. Symptoms of hepatitis B or infection may include the following: fever, chills, skin rash, joint pain and inflammation, tiredness, loss of appetite, nausea, pale stools or dark urine, yellowing of the skin, or pain in the upper right side of the stomach.

Angioedema: Patients who take an angiotensin-converting enzyme (ACE) inhibitor medicine during treatment with AFINITOR are at a possible increased risk for a type of allergic reaction called angioedema. Talk with your health care provider before taking AFINITOR if you are not sure if you take an ACE inhibitor medicine. Get medical help right away if you have trouble breathing or develop swelling of your tongue, mouth, or throat during treatment with AFINITOR.

Kidney Failure: Patients taking AFINITOR may develop kidney failure. Patients should have tests to check their kidney function before and during their treatment with AFINITOR.

Delayed Wound Healing: AFINITOR can cause incisions to heal slowly or not heal well. Call your health care provider right away if your incision is red, warm, or painful; if you have blood, fluid, or pus in your incision; if your incision opens up; or if your incision swells.

Before taking AFINITOR, tell your health care provider about all your medical conditions, including if you:

  • Have or have had kidney problems
  • Have or have had liver problems
  • Have diabetes or high blood sugar
  • Have high blood cholesterol levels
  • Have any infections
  • Previously had hepatitis B
  • Are scheduled to receive any vaccinations. You should not receive a live vaccine or be around people who have recently received a live vaccine during your treatment with AFINITOR. If you are not sure about the type of vaccine, ask your health care provider
  • Have other medical conditions
  • Are pregnant or could become pregnant. AFINITOR can cause harm to your unborn baby. If you are able to become pregnant, you should use effective birth control while using AFINITOR and for 8 weeks after your last dose. Talk to your health care provider about birth control options while taking AFINITOR
  • Are breastfeeding or plan to breastfeed. Do not breastfeed during treatment and for 2 weeks after your last dose

Tell your health care provider about all of the medicines you take, including prescription and nonprescription medicines, vitamins, and herbal supplements. Using AFINITOR with certain other medicines can cause serious side effects. Keep a list of medicines you take and show it to your health care provider when you get a new medicine. Especially tell your health care provider if you take St John's wort (Hypericum perforatum), medicines that weaken your immune system (your body's ability to fight infections and other problems), or medicines for:

  • Fungal infections
  • Bacterial infections
  • Tuberculosis
  • Seizures
  • HIV-AIDS
  • Heart conditions or high blood pressure

If you are taking any medicines for the conditions listed above, your health care provider might need to prescribe a different medicine or your dose of AFINITOR may need to be changed. Tell your health care provider before you start taking any new medicine.

Common Side Effects

The most common side effect of AFINITOR in treating advanced hormone receptor-positive, HER2-negative breast cancer was mouth ulcers and sores (67%). Tell your health care provider if you have pain, discomfort, or open sores in your mouth. Your health care provider may tell you to use a special mouthwash or mouth gel that does not contain alcohol, hydrogen peroxide, iodine, or thyme.

Other common side effects of AFINITOR include:

  • Infections (50%)
  • Rash (39%)
  • Feeling tired (36%)
  • Diarrhea (33%)
  • Loss of appetite (30%)
  • Nausea (29%), vomiting (17%)
  • Weight loss (25%)
  • Cough (24%), shortness of breath (21%)
  • Abnormal taste (22%)
  • Headache (21%)
  • Pain in arms and legs (9%), back (14%), joints (20%)
  • Swelling of arms, hands, feet, ankles, face, or other parts of the body (19%)
  • Nose bleeds (17%)
  • Fever (15%)
  • Constipation (14%)
  • High blood glucose (14%)
  • Difficulty sleeping (13%)
  • Feeling weak (13%)
  • Itching (13%)
  • Dry mouth (11%)
  • Hair loss (10%)

Other side effects that may occur with AFINITOR:

  • Absence of menstrual periods (menstruation). You may miss 1 or more menstrual periods. Tell your health care provider if this happens
  • AFINITOR may affect fertility in females and males, and may affect your ability to become pregnant if you are female or your ability to father a child if you are male. Talk to your health care provider if this is a concern for you

Tell your health care provider if you have any side effect that bothers you or does not go away.

These are not all the possible side effects of AFINITOR. For more information, ask your health care provider or pharmacist. Call your doctor for medical advice about side effects.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please see full Prescribing Information for AFINITOR, including Patient Information.

The brands listed are the trademarks or register marks of their respective owners and are not trademarks or register marks of Novartis.

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