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Triple-negative breast cancer (TNBC) is any breast cancer that either lacks or shows low levels of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) overexpression and/or gene amplification (i.e. the tumor is negative on all three tests giving the name triple-negative). [1]
Estrogen deprivation therapy, also known as endocrine therapy, is a form of hormone therapy that is used in the treatment of breast cancer.Modalities include antiestrogens or estrogen blockers such as selective estrogen receptor modulators (SERMs) like tamoxifen, selective estrogen receptor degraders like fulvestrant, and aromatase inhibitors like anastrozole and ovariectomy.
The increase in breast cancer risk with estrogen and progestogen therapy was shown to be causal with conjugated estrogens plus medroxyprogesterone acetate in the Women's Health Initiative randomized controlled trials. [122] [155] Breast cancer risk with combined estrogen and progestogen therapy may differ depending on the progestogen used.
Moreover, breast cancer risk is heightened following use of the combined oral contraceptive pill and combined hormone replacement therapy. [4] Armed with this evidence that endogenous and exogenous changes in estrogen and progesterone levels modulate the risk of breast cancer, it is apparent that hormones can play a key role in breast cancer.
Staging breast cancer is the initial step to help physicians determine the most appropriate course of treatment. As of 2016, guidelines incorporated biologic factors, such as tumor grade, cellular proliferation rate, estrogen and progesterone receptor expression, human epidermal growth factor 2 (HER2) expression, and gene expression profiling into the staging system.
Surgical castration, or removal of the testes in males and ovaries in females, have been widely used in the past to treat hormone-responsive prostate cancer and breast cancer respectively. However, these invasive methods have been widely supplanted by the use of GnRH agonists, and other forms of pharmacologic castration. [3]
NSAIs are used to treat hormone-dependent breast cancer. If almost all cancer cells express either estrogen or progesterone receptors it is a possibility that anti-estrogen treatment will work. If there are more hormone receptors on the cancer cells then the treatment is more likely to be efficient. The receptors need estrogen and progesterone ...
It is used as endocrine therapy for women with estrogen or progesterone receptor-positive, stage 4 or recurrent metastatic breast cancer [7] and has demonstrated similar efficacy compared to tamoxifen as adjuvant treatment of breast cancer and in the treatment of metastatic breast cancer. [6]