Esteemed Cancer Doctor Battles Breast Cancer
- Dr. Monica M. Bertagnolli, the Director of the National Cancer Institute and the National Institutes of Health, has breast cancer. She has been an oncologist for her entire career.
- Dr. Bertagnolli says that effective screening procedures caught the cancer early. She is treating her HER2-negative breast cancer with surgery, and also participating in a clinical trial.
- HER2 is a protein present on breast cancer cells. The amount of this protein can be used to classify breast cancer into different subtypes, such as HER2 positive for those cancers which have an abundance of the protein. HER2-negative breast cancers have low-to-no levels of the HER2 protein. This matters because it could change the treatment course.
In a statement published by the National Institutes of Health, the former surgical oncologist and Wyoming native shares that she was recently diagnosed with “early breast cancer,” and that the prognosis is “favorable.”
Read More“To anyone with cancer today: I am truly in this together with you.” Dr. Monica M. Bertagnolli The doctor goes on to share that the type of breast cancer she has is “hormone receptor-positive, HER2-negative breast cancer” and that it is confined to the breast, as far as doctors can tell. Related: Do You Have HER2-Positive Metastatic Breast Cancer? Here's A Breakdown Of Some Of Your Treatment OptionsShe also adds, “To anyone with cancer today: I am truly in this together with you.”
Dr. Bertagnolli’s parents were first-generation immigrants from France and Italy. She earned her BSE in biochemical engineering from Princeton University, and later studied at the University of Utah School of Medicine. In 1993, Dr. Bertagnolli became board certified. She is married and has two sons.
Dr. Bertagnolli’s HER2 Breast Cancer Journey
Dr. Bertagnolli says she will treat the cancer with surgery, and possible additional treatments. She describes the current state of things as being “in a waiting period” as more information about her cancer comes out.
She is being treated at Brigham and Women's Hospital and Dana Farber Cancer Institute (where she formerly worked as an oncologist, prior to joining NCI). Additionally, Dr. Bertagnolli has enrolled in a clinical trial. She says she is “pleased that my experience will contribute to the ever-expanding knowledge base about cancer and inform advances in care.”
The doctor credits effective screening procedures to catching her cancer early. Breast cancer is screened for via mammograms, which looks for lumps and early signs of cancer in the breast tissue.
Women should have annual mammograms between the ages of 45 and 54. If there is a history of breast cancer in the family, or if you have the BRCA1 or BRCA2 gene mutation, you should begin screening earlier.
When Should I Get a Mammogram?
New Treatment Paradigm for HER2-Breast Cancer
Dr. Bertagnolli has HER2-negative breast cancer. While we don’t know what her HER2 score is, Dr. Bertagnolli’s case serves as an example for the need of other women to ask their doctors about their scores, as it could change their breast cancer treatment path.
Hormonal therapy is the standard first line of treatment for HER2-negative metastatic breast cancer which is hormone receptor-positive. Hormonal therapy is given in combination with targeted therapy in many instances. Chemotherapy is also a type of treatment for this cancer. Dr. Bertagnolli is undergoing surgery for her breast cancer, and participating in a clinical trial this line of treatment may be an option for the cancer at any stage.
Related: Is Your Breast Cancer HER2 Negative? How To Get Tested For A New Drug That Prolongs Life
HER2-postive breast cancer the type Dr. Bertagnolli does not have has typically been associated with poor outcomes and higher mortality rates than other breast cancer subtypes, according to an article published by the National Library of Medicine. The research shows, reports the article, “the advent of Trastuzumab (Herceptin) has significantly changed the treatment paradigm of patients afflicted with HER2-positive breast cancer.”
The brand name of Trastuzumab is Enhertu, and it’s been shown as an effective treatment for breast cancer.
Additionally, discoveries of newer HER2-targeted therapies, such as Pertuzumab (Perjeta) have positively impacted the treatment of this disease. HER2-targeted therapies and immunotherapies in clinical trials, says the article, will become part of the standard care for this kind of breast cancer.
Treatment for HER2-Positive Breast Cancer
What is HER2 Breast Cancer?
There are different types of breast cancer, and the type of cancer a person has will impact their treatment path.
HER2 is a protein present on breast cancer cells. The amount of this protein can be used to classify breast cancer into different subtypes, such as HER2 positive for those cancers which have an abundance of the protein. HER2-negative breast cancers have low-to-no levels of the HER2 protein.
Researchers have looked to expand this definition further to include patients that have a minimal amount of HER2 expression but do not meet the classic definition for HER2-positive tumors. This group has been called HER2 "low" and is very important as it represents approximately 50 percent of all patients with breast cancer.
Separate from HER2 classification is the presence or absence of hormone receptors (HR) on the surface of cancer. The two types are:
- Hormone receptor-positive (HR-positive) breast cancer: When the cells use estrogen, progesterone, or both to grow and replicate.
- Triple-negative breast cancer: When the hormone receptors are absent. Triple-negative cancers do not have the 2 hormone receptors, nor the HER2 protein, hence triple-negativity.
For women who have early-stage hormone receptor-positive, HER2-negative breast cancer the Oncotype DX test is a genetic test that profiles the tumor and can help predict the risk of your breast cancer returning. After surgery, a piece of the tumor is sent off to be tested. The result is a number otherwise known as the "Oncotype DX score."
After surgery, a piece of the tumor is sent off to be tested. According to Memorial Sloan Kettering's website, "a group of 21 genes in this tissue are analyzed to help determine prognosis (how likely your breast cancer is to return) and if getting chemotherapy will improve your chances that the cancer will not come back."
The score determines if a woman is at low, intermediate, or high risk of recurrence and based on that result, whether a woman may benefit from the addition of chemotherapy before receiving hormonal therapy. In general, women who have a low score do not need chemotherapy. Women who have a high score may decrease the risk of the cancer coming back with the addition of chemotherapy.
What is the Oncotype DX Test and Do I Need it?
Contributing: SurvivorNet staff
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