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What is the plan for treating my breast cancer? Anatomy of the Female Breast Chest wall Ribs Fatty tissue Lymph nodes Muscle Muscle Lobe Ducts Areola Nipple Nipple Areola Tumor Biology Lobules Details Tumor Assessment HER2 receptor status Size approximation Hormone receptor status (ER/PR) Grade Details ER=estrogen receptor; PR=progesterone receptor. What are the next steps in my treatment? Should I be referred to a medical oncologist before surgery? My medical oncologist is: My surgeon is: Node Status Clinical node assessment Details Understanding HER2-positive early-stage breast cancer What is early-stage breast cancer? In early-stage breast cancer, the tumor is only in the breast. Although there may be cancer cells in nearby glands (called lymph nodes), this stage is considered “early” because the cancer hasn’t metastasized (spread to other parts of the body). People can be treated for early-stage breast cancer, and for some people the cancer may not return. What is HER2-positive breast cancer? HER2 (human epidermal growth factor receptor 2) is a type of protein found on the surface of cells in everyone. This protein tells cells to grow and divide. HER2-positive breast cancer cells, however, have more HER2 receptors than normal breast cells. Having more HER2 receptors causes tumor cells to grow and divide faster, which increases the risk of the cancer spreading outside of the breast. Approximately 20%-25% of all breast cancer tumors are HER2-positive. HER2-POSITIVE CANCER CELL NORMAL CELL HER2 receptor HER2 receptor Normal amount of HER2 • Cells grow and divide normally KNOWING IF YOU HAVE HER2-POSITIVE BREAST CANCER IS IMPORTANT • Without treatment, HER2-positive breast cancer has a higher risk of spreading to other parts of the body than many other types of breast cancer • HER2-positive breast cancer has been studied extensively, and there are specific treatments that can target HER2 in this type of cancer Too much HER2 • Cells grow and divide faster What should I be considering prior to surgery if I have HER2-positive early-stage breast cancer? • If you have HER2-positive early-stage breast cancer, there may be options available to treat the cancer before surgery, as part of a complete treatment plan • Some therapies target HER2 receptors and may help keep the cancer from growing What are the possible steps in HER2-positive early-stage breast cancer treatment? Treatment options for early-stage breast cancer might include medicine before and/or after surgery. THERAPY BEFORE SURGERY (NEOADJUVANT TREATMENT) MAY: • Help shrink the tumor and potentially decrease the chance of cancer cells spreading outside of the tumor • Allow your healthcare team to see how the tumor responds to the therapy. This may help them determine which therapies are likely to work after surgery SURGERY MAY: • Remove any remaining tumor from your breast • Remove or test (biopsy) lymph nodes THERAPY AFTER SURGERY (ADJUVANT TREATMENT) MAY: • Help eliminate remaining breast cancer cells and potentially lower the risk of tumors growing back © 2015 Genentech USA, Inc. All rights reserved. PER/110714/0036(1) Printed in USA. 06/15