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Cancer types

Breast Cancer

Breast cancer is classified mainly by hormone-receptor and HER2 status, and that classification determines the direction of systemic treatment discussion.

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HER2BRCA1 / BRCA2PD-L1

Not a diagnosis and not final medical advice. Must be reviewed by a doctor.

What is most important to know?

Breast cancer originates from glandular tissue or ducts in the breast. Pathological examination determines the cell type and markers that determine the therapeutic category.

The three large groups that are often discussed are hormone receptor positive with HER2 negative, HER2 positive, and triple negative, that is, without hormone receptors or HER2.

The triple negative group requires discussion of other markers such as PD-L1 and BRCA, and in some cases consideration of clinical trials.

Breast cancer is one of the cancers with the highest number of cases in women in many countries, including Indonesia. Specific figures are not shown without direct quotation.

Receptor status shapes systemic options.

Commonly discussed symptoms

  • Painless lump in the breast or armpit.
  • Changes in the shape, curve, or skin of the breast that resemble orange peel.
  • Discharge from the nipple, especially if it is bloody.
  • Changes in the nipples such as being pulled inward.
  • Persistent pain in one area.

These symptoms are not specific. A doctor still needs to assess the cause.

Risk factors

  • Older age and family history in some cases.
  • Inherited changes in genes such as BRCA1 or BRCA2.
  • History of chest radiation at a young age.
  • Hormonal factors such as age of first menstruation and age of menopause.

What shapes the options?

Treatment discussions usually follow this path. The more complete each step is, the more focused the discussion with your doctor becomes.

  1. Diagnosis

    Confirmed through pathology review.

  2. Subtype

    3 subtypes discussed on this page.

  3. Stage

    Staging uses the TNM system which combines tumor size, lymph node involvement, and distant spread.

  4. Biomarkers

    Relevant markers: HER2, BRCA1 / BRCA2, PD-L1.

  5. Treatment history

    Each previous line affects the next option.

  6. Progression?

    If the disease progresses, reassessment and molecular testing are usually discussed.

  7. Next step

    Further evaluation, clinical trials, or a second opinion.

Stage I

A small tumour without meaningful lymph node involvement.

Stage II

A larger tumour or involvement of lymph nodes in the armpit.

Stage III

Locally advanced tumour, including wider node involvement or skin and chest wall involvement.

Stage IV

Cancer has spread to other organs such as bone, liver, lung, or brain.

Relevant biomarkers

Molecular testing shapes categories, not decisions

Biomarker results open categories worth discussing. The final choice still considers stage, general condition, treatment history and the doctor's assessment.
Ilustrasi reseptor di permukaan sel dengan molekul ligan yang mendekat

  • HER2

    HER2 is a protein on the surface of cells that can promote growth.

    Immunohistochemistry (IHC) · FISH (fluorescence in situ hybridisation)

    View biomarker →

  • BRCA1 / BRCA2

    BRCA1 and BRCA2 are genes that play a role in repairing DNA damage.

    Next-generation sequencing (NGS) · Tumour tissue biopsy

    View biomarker →

  • PD-L1

    PD-L1 is a protein that can help cancer cells evade the immune system.

    PD-L1 immunohistochemistry · Tumour tissue biopsy

    View biomarker →

Progression and resistance concepts

  • Progression can occur locally, regionally, or as spread to other organs. The location of spread influences the discussion of therapy.
  • Hormone receptor and HER2 status may change after therapy, so repeat sampling is sometimes considered in relapsed disease.
  • In HER2 positive breast cancer, the appearance of lesions in the brain is part of the discussion because it influences the choice and sequence of therapy.
  • The next choice usually takes into account the disease-free interval, therapy history, and the patient's general condition.

Treatment options commonly discussed

The actual order and combination are always determined by the team directly examining the patient.

When are clinical trials discussed?

Trial group and treatment history

The studies below are filtered from the public registry. International patient access and site readiness have not been verified.

Clinical trials are usually discussed after standard pathways are mapped, or when biomarker results point to a specifically studied group. There are currently 0 registry records related to Breast cancer, and 0 mention a specific biomarker.

NO DATA

No studies were filtered for this cancer group in the latest registry data.

View all 0 studiesCheck my case match

What should be prepared for a second opinion?

Records usually requested

  • The most recent pathology report included receptor status and HER2 score.
  • PD-L1 and BRCA examination results if available.
  • Recent imaging includes bone or brain imaging if there are complaints.
  • Records of previous therapy, including hormonal therapy.
  • Records of previous operations and radiotherapy along with reports.

Questions for the oncologist

  • What is my hormone receptor and HER2 status, and how does that change therapy options?
  • Have PD-L1 scores and BRCA status been checked if relevant?
  • Do I need genetic testing and counseling for family risks?
  • What therapy have I had and are there any options afterward that are worth discussing?
  • Is there a clinical trial that fits my marker group?

Have HER2 and BRCA1 / BRCA2 been tested in your case?

Not sure about the next step for Breast cancer?

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Deeper references

A reference section for readers who want details on subtypes, drugs, or every study record.

Hormone-receptor-positive, HER2-negative breast cancer

Draft, not yet medically reviewed

The most common breast cancer group, with estrogen and/or progesterone receptors positive and HER2 negative.

Tumor growth depends on hormonal signals, so hormonal therapy is a major part of the discussion at many stages. Anti-HER2 antibodies are not relevant in this group.

Relevant markers

HER2

Stage note

In addition to TNM staging, the discussion often considers the risk of recurrence to determine whether additional therapy after surgery is necessary.

HER2-positive breast cancer

Draft, not yet medically reviewed

A group with HER2 expression or amplification that opens antibody and antibody-drug conjugate categories.

HER2 signaling drives tumor growth. The development of anti-HER2 drugs has changed the behavior of the disease at all stages discussed.

Relevant markers

HER2PD-L1

Stage note

HER2 score and confirmatory results influence plans. Brain involvement is a special consideration in this group.

Triple-negative breast cancer

Draft, not yet medically reviewed

A group without hormone receptors or HER2, so hormonal therapy and anti-HER2 therapy are not options.

Treatment relies on chemotherapy, immunotherapy in the PD-L1 positive group, as well as therapies targeting DNA repair weaknesses in patients with BRCA alterations.

Relevant markers

PD-L1BRCA1 / BRCA2

Stage note

Because systemic options are more limited, clinical trials are often part of the discussion at a later stage.

Next steps

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