Metastasis Risks During HER2 Breast Cancer Treatment - Oncology

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Is there a possibility of metastasis during breast cancer treatment?


Hello, doctor.
My mother was diagnosed with breast cancer (HER2 type) in May 2015.
She has completed six rounds of chemotherapy and has undergone surgery for local excision, targeted therapy, and radiation therapy, which are currently ongoing.
Initially, a PET scan was performed, and everything was normal at that time.
I would like to ask if there is a possibility of liver or brain metastasis during the treatment period.
If so, will the medications we are using also target and kill the cancer cells? Additionally, is HER2-positive breast cancer more likely to metastasize to the brain? Thank you, doctor!

Ada, 30~39 year old female. Ask Date: 2016/01/03

Dr. Lai Yicheng reply Oncology


Hello, Miss:
1.
It is relatively uncommon for breast cancer patients undergoing chemotherapy, surgery, radiation therapy, and targeted drug treatment to experience distant metastasis (unless the breast cancer is at a very advanced stage with a high number of infected axillary lymph nodes).
May I ask what stage of cancer your mother was diagnosed with?
2.
The medications used in treatment are designed to kill cancer cells.

3.
"HER-2 positive" breast cancer has a 1/3 higher likelihood of recurrence and metastasis compared to "non-HER-2 positive" breast cancer.

Radiation Oncology
Dr.
Lai Yi-Cheng

Reply Date: 2016/01/03

More Info


Understanding the risks of metastasis during HER2-positive breast cancer treatment is crucial for patients and their families. Your mother's journey through breast cancer treatment, including chemotherapy, surgery, targeted therapy, and radiation, reflects a comprehensive approach to managing HER2-positive breast cancer.
HER2-positive breast cancer is known for its aggressive nature and higher likelihood of metastasis compared to other types of breast cancer. The HER2 gene, when overexpressed, leads to rapid cell growth and division, which can result in a higher risk of the cancer spreading to other parts of the body, including the brain and liver. Studies have shown that patients with HER2-positive breast cancer have an increased risk of brain metastases, particularly if the cancer is not adequately controlled.

During treatment, the goal is to eliminate as many cancer cells as possible, and the medications used—such as chemotherapy and targeted therapies like trastuzumab (Herceptin)—are designed to attack rapidly dividing cancer cells. However, while these treatments can be effective, they may not always prevent metastasis entirely. The risk of metastasis can still exist, especially if there are residual cancer cells after initial treatment.

In terms of your specific concerns about liver and brain metastases, it is important to note that while the risk is elevated for HER2-positive breast cancer, not all patients will experience these complications. Regular monitoring through imaging studies, such as PET scans or MRIs, can help detect any potential metastases early. If metastasis is detected, treatment options may include systemic therapies, radiation, or other interventions tailored to the patient's specific situation.

The treatment regimen your mother is undergoing is designed to minimize the risk of recurrence and metastasis. Chemotherapy and targeted therapies work synergistically to attack cancer cells, and radiation therapy can help eliminate localized disease. It is essential to maintain open communication with her healthcare team, as they can provide personalized insights based on her response to treatment and any emerging symptoms.

Additionally, lifestyle factors, such as diet, exercise, and stress management, can play a role in overall health and may influence treatment outcomes. Encouraging your mother to engage in supportive care practices, such as nutritional counseling and physical activity, can help her maintain her strength and resilience during treatment.

In summary, while HER2-positive breast cancer does carry a higher risk of metastasis, especially to the brain, proactive treatment and monitoring can significantly improve outcomes. It is essential to stay vigilant and work closely with her healthcare team to address any concerns and adjust treatment plans as necessary. Your mother's journey is a testament to the advancements in breast cancer treatment, and with continued care and support, there is hope for a positive outcome.

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