Receiving a breast cancer diagnosis can feel overwhelming. The often overwhelming emotional impact combined with the mental impact of being flooded with unfamiliar medical terms can seem like your life is changing in an instant.
The medical terms associated with an advanced breast cancer diagnosis provide important information about your cancer and can help guide conversations with your care team about treatment options that may be right for you.
For Black women, having those conversations and a solid understanding of what the terms mean is especially important. Black women are significantly more likely to die from breast cancer and be diagnosed at younger ages and with more advanced disease than white women. While many factors contribute to these disparities, being informed about your diagnosis is one way to take an active role in your care.
Whether you’re newly diagnosed with advanced breast cancer or supporting someone who is, learning your cancer type and understanding your biomarker status can help you feel more prepared for the road ahead.
What Is Advanced Breast Cancer?
Advanced breast cancer is also called metastatic or Stage 4 breast cancer. It occurs when cancer has spread beyond the breast and nearby lymph nodes to other parts of the body, such as the bones, liver, lungs, or brain. Some people are diagnosed with advanced breast cancer during their initial diagnosis, while others develop metastatic disease months or years after treatment for early-stage breast cancer.
Although advanced breast cancer is not considered curable, treatment options have expanded significantly in recent years. Many people are living longer with advanced disease thanks to therapies that are personalized based on the unique characteristics of their cancer.
What Does HR-Positive Mean?
One of the first things your healthcare team will determine is whether your cancer is hormone receptor (HR)-positive.
Hormones like estrogen and progesterone help regulate many normal functions in the body. Some breast cancer cells also use these hormones as fuel to grow. When a tumor has receptors for estrogen, progesterone, or both, it is considered hormone receptor-positive.
Knowing whether your cancer is HR-positive helps your oncologist determine whether endocrine (hormone) therapy may be part of your treatment plan. These medications work by lowering hormone levels or preventing hormones from attaching to cancer cells which helps slow or stop cancer growth.
What Does HER2-Negative Mean?
Another important test looks at a protein called human epidermal growth factor receptor 2 (HER2).
Some breast cancers make too much HER2, which can cause cancer cells to grow more quickly. These cancers are called HER2-positive.
If your cancer is HER2-negative, it means your tumor does not have excess HER2 protein. While that may sound like just another label, it helps your healthcare team determine which treatments are most likely to be effective for your specific type of breast cancer.
When breast cancer is both HR-positive and HER2-negative, treatment often includes endocrine therapy along with other medications designed to improve treatment outcomes.
What Is a Biomarker and Why Does It Matter?
Beyond determining hormone receptor and HER2 status, your healthcare team may recommend biomarker testing.
A biomarker is a characteristic found in your tumor that provides additional information about how the cancer behaves and which treatments may be most appropriate. Biomarker testing often examines changes, or mutations, in specific genes within the cancer cells.
Unlike inherited genetic testing, which looks for changes passed down through families, biomarker testing analyzes the cancer itself.
The results can help your healthcare team develop a treatment plan tailored to your specific diagnosis.
Understanding the PIK3CA Mutation
One biomarker your care team may test for is a PIK3CA mutation.
PIK3CA is a gene involved in how cells grow, divide, and survive. In some HR-positive, HER2-negative breast cancers, changes in this gene can cause cancer cells to continue growing even when they receive treatment.
Not everyone with advanced breast cancer has a PIK3CA mutation, which is why testing matters. If a mutation is present, it may influence treatment discussions and whether certain targeted therapies or clinical trials are appropriate to consider.
Knowing your PIK3CA status helps ensure you and your healthcare team have as much information as possible when making treatment decisions.
Personalized Treatment Starts With Information
Even when two people receive the same diagnosis, differences in biomarkers, overall health, previous treatments, and personal preferences all influence treatment decisions.
Today’s treatment plans may include combinations of different types of therapies depending on the biology and makeup of the tumor.
The more your healthcare team understands about your cancer, the more personalized your treatment plan can become.
Questions to Ask Your Care Team
Medical appointments can feel rushed, and it’s easy to forget questions. Consider bringing a notebook or asking a loved one to attend appointments with you.
Some questions you may want to ask include:
- What type of breast cancer do I have?
- Is my cancer HR-positive or HER2-negative?
- Have I had biomarker testing? If so, what were the results?
- Should my tumor be tested for a PIK3CA mutation or other biomarkers?
- What treatment options are available for my specific diagnosis?
- Are there targeted therapies that may be appropriate for me?
- Should I consider participating in a clinical trial?
These conversations can help you better understand your diagnosis and make informed decisions together with your care team.
Why Clinical Trials Matter
Clinical trials help researchers evaluate potential new treatments while advancing our understanding of diseases like breast cancer. They are carefully designed research studies that follow strict safety standards.
For Black women, clinical trials also represent an opportunity to improve representation in research. Historically, Black patients have been underrepresented in many breast cancer studies, limiting what researchers know about how treatments perform across diverse populations.
Participation in a clinical trial is voluntary, and not every trial is appropriate for every person. If you’re interested in learning more, your oncology team can explain whether a clinical trial may be an option based on your individual diagnosis and treatment history.
Knowledge Is Power
A breast cancer diagnosis can bring uncertainty, but understanding your cancer type can help you feel more confident asking questions and participating in decisions about your care.
Learning whether your cancer is HR-positive, HER2-negative, and whether it has a PIK3CA mutation can provide valuable information that helps guide treatment discussions. While every journey is unique, having a clear understanding of your diagnosis is an important first step.
Know your type. Know your options. Talk to your doctor about clinical trials. Learn more about HR-positive, HER2-negative advanced breast cancer with a PIK3CA mutation and talk with your care team about biomarker testing, treatment options, and whether a clinical trial may be an option. Visit Lilly’s clinical trial guide to learn more.
HR-Positive, HER2-Negative Advanced Breast Cancer
Supported by Lilly
References:
- American Cancer Society. Cancer Facts & Figures for African American/Black People
- NIH National Cancer Institute. Breast Cancer Treatment
- NIH National Cancer Institute. Biomarker Testing for Cancer Treatment
- American Cancer Society. Biomarker and Tumor Marker Tests
- National Cancer Institute. Cancer Clinical Trial Information for Patients and Caregivers
- Chen L, Li CI. Racial disparities in breast cancer diagnosis and treatment by hormone receptor and HER2 status. Cancer Epidemiol Biomarkers Prev. 2015 Nov;24(11):1666-72. doi: 10.1158/1055-9965.EPI-15-0293.