What Is HER2?

• Understanding the genetic changes found in your breast tumor can help you and your care team design the most effective treatment combination.
• Breast cancer cells that are HER2-positive contain high levels of HER2, a protein that encourages cell growth.
• HER2-positive breast cancer cells tend to grow and spread quickly, but can often be controlled and killed using targeted therapies.

Understanding which gene mutations your breast cancer cells have gives you and your cancer care team more information about your condition. About 20 percent of all cases of breast cancer are HER2-positive. Most breast cancers are HER2-negative, although researchers are also recognizing a newer category, HER2-low.

HER2 status is one of many factors of breast cancer that describe important characteristics of tumors and help predict how they will grow. Knowing your cancer is HER2-positive (also written as HER2+) helps your care team better predict your outlook and recommend treatments that are most likely to be effective.

The HER2 Gene

Genes often have very long, specific names. The full name of the HER2 gene is human epidermal growth factor receptor 2. This is often shortened to HER2 receptor, HER2/neu, or simply HER2. It also sometimes goes by other names, such as ERBB2.

The HER2 gene makes a protein that is also called HER2. This protein is found on the outside of normal cells within the breast. When HER2 is activated (turned on), it sends signals to the inside of the cell, telling the cell to grow. The cell then begins preparing to divide and produce new cells.

In HER2-positive breast cancer, cell damage results in gene amplification, in which many extra copies of the HER2 gene are made. Larger numbers of HER2 genes lead cancer cells to make higher than normal levels of the HER2 protein, a situation known as overexpression. The extra HER2 protein tells the cell to grow and divide at an abnormal rate. As a result, the cancer cells grow too quickly, forming a tumor. Knowing your cancer is HER2-positive helps doctors understand why your cells are growing abnormally and provides clues for how to treat the tumor.

Testing for HER2

If you are diagnosed with breast cancer, your care team will probably recommend you go through genetic testing to determine your HER2 status. This testing can be performed on your biopsy tissue or through a blood test. Genetic tests can also help your doctor see whether or not your cells have other cancer-related proteins, such as hormone receptors.

The first step of breast cancer diagnosis and HER2 testing is often getting a biopsy. During this procedure, doctors remove a sample of your breast tissue. The sample will then be examined using tests such as:

• Immunohistochemistry (IHC), which estimates the amount of HER2 protein on the outside of your cells
• Fluorescence in situ hybridization (FISH), which measures the number of HER2 genes inside your cells

Read more about diagnostic tests for HER2-positive breast cancer.

Treatments for HER2-Positive Breast Cancer

Women with all subtypes of breast cancer may need treatments like:

• Surgery to remove the tumor and all or part of the surrounding breast
• Radiation treatment to get rid of remaining cancer cells after surgery (called adjuvant treatment) or shrink the tumor before surgery (neoadjuvant treatment)
• Chemotherapy medication to kill cancer cells throughout the body, which can be administered prior to surgery as neoadjuvant treatment or after surgery as adjuvant treatment
• Hormone therapy, if your tumor is also hormone receptor-positive

Most women with HER2-positive breast cancer will receive targeted therapy. These medications can find and destroy any cell that contains the HER2 protein. Targeted therapy drugs attach to HER2, preventing it from sending signals to the cell to tell it to continue growing. This eventually leads to death of the cell.

Read more about treatments for HER2-positive breast cancer.

How Does HER2 Affect Your Prognosis?

Breast cancers that are HER2-positive tend to grow more quickly than HER2-negative breast cancers. In the past, women with HER2-positive breast cancer often didn’t have a good prognosis, or predicted outlook for survival. However, newer treatments have helped many women with HER2-positive cancer have better outcomes. When using modern treatment plans, women with HER2-positive breast cancer can live longer. More than 3 out of 4 people with HER2-positive breast cancer live for over 10 years following their diagnosis.

Sometimes, after cancer is treated the first time, it can come back. This is known as a relapse. Targeted therapies for HER2-positive breast cancer help lower the risk of relapse.

Other factors may increase or decrease this risk of relapse, however. If the tumor is large or has spread beyond the breast, the cancer may be more likely to come back. On the other hand, women with tumors that are both HER2-positive and hormone receptor-positive may have a lower risk of relapse.

Talk With Others Who Understand

MyBCTeam is the social network for women with breast cancer. On MyBCTeam, members come together to ask questions, give advice, and share their stories with others who understand life with breast cancer.

Are you living with HER2-positive breast cancer? Share your experience in the comments below, or start a conversation by posting on your Activities page.