Estrogen Receptor-Positive Breast Cancer (ER+): Symptoms, Causes, Treatment

What are the symptoms of estrogen receptor-positive breast cancer?

Estrogen receptor-positive (ER-positive) breast cancer is a type of breast cancer that grows in response to the hormone estrogen. Symptoms of ER-positive breast cancer are similar to other types of breast cancer and may include:

Lump in the Breast or Armpit: The most common symptom of breast cancer is a new lump or mass in the breast or armpit.
Changes in Breast Size or Shape: Breast cancer can cause one breast to become larger or lower than the other, or change in shape or contour.
Changes in the Skin: This can include dimpling or puckering of the skin, redness or scaling of the nipple or breast skin, or a rash around the nipple.
Nipple Changes: This can include nipple inversion (turning inward), discharge (other than breast milk), or changes in appearance.
Pain: While breast cancer usually does not cause pain, some women may experience breast pain or discomfort.

It’s important to note that these symptoms can also be caused by conditions other than breast cancer. However, if you experience any of these symptoms, it’s important to see a healthcare provider for evaluation and diagnosis. Early detection and treatment can improve outcomes for breast cancer.

What are the causes of estrogen receptor-positive breast cancer?

Estrogen receptor-positive (ER-positive) breast cancer occurs when breast cells develop changes (mutations) in their DNA that make the cells more sensitive to estrogen. While the exact cause of these mutations is not always clear, several factors are known to increase the risk of developing ER-positive breast cancer:

Hormone Levels: High levels of estrogen in the body, either naturally or from hormone therapy, can increase the risk of ER-positive breast cancer.
Age: The risk of breast cancer increases with age, with most cases occurring in women over 50.
Family History: A family history of breast cancer, especially in first-degree relatives (such as a mother, sister, or daughter), increases the risk.
Genetics: Inherited gene mutations, such as BRCA1 and BRCA2, can increase the risk of breast cancer, including ER-positive breast cancer.
Personal History: Women who have had breast cancer in one breast have an increased risk of developing breast cancer in the other breast.
Reproductive History: Early onset of menstruation (before age 12), late onset of menopause (after age 55), and never having children or having children later in life can increase the risk.
Dense Breast Tissue: Women with dense breast tissue have a higher risk of breast cancer, including ER-positive breast cancer.
Lifestyle Factors: Factors such as obesity, lack of physical activity, and excessive alcohol consumption can increase the risk of breast cancer.

It’s important to note that having one or more risk factors does not mean that a woman will develop breast cancer. Many women with one or more risk factors never develop breast cancer, while some women with no known risk factors do. Regular screening and early detection are important for reducing the risk of ER-positive breast cancer.

How is the diagnosis of estrogen receptor-positive breast cancer made?

The diagnosis of estrogen receptor-positive (ER-positive) breast cancer is typically made through a combination of imaging tests, such as mammograms or ultrasounds, and biopsy procedures. Here’s an overview of the diagnostic process:

Clinical Examination: A healthcare provider will perform a physical examination of the breasts and surrounding areas to check for any lumps, changes in skin texture, or other abnormalities.
Imaging Tests: Mammograms are commonly used to screen for breast cancer. If an abnormality is detected on a mammogram or if a woman has symptoms such as a lump, additional imaging tests such as ultrasound or MRI may be recommended.
Biopsy: If an imaging test suggests the presence of breast cancer, a biopsy is usually performed to confirm the diagnosis. During a biopsy, a small sample of tissue is removed from the suspicious area and examined under a microscope. The biopsy also helps determine the hormone receptor status of the cancer cells, including whether they are ER-positive.
Hormone Receptor Testing: Once breast cancer is confirmed, the cancer cells are tested for hormone receptors, including estrogen receptors (ER) and progesterone receptors (PR). This helps determine if the cancer is ER-positive, PR-positive, both, or neither.
Additional Testing: Depending on the results of the biopsy and hormone receptor testing, additional tests such as imaging scans (CT scan, PET scan, bone scan) may be done to determine the extent (stage) of the cancer and whether it has spread to other parts of the body.

Once a diagnosis of ER-positive breast cancer is confirmed, further tests may be done to help guide treatment decisions, such as genetic testing to assess the risk of recurrence or the need for targeted therapies.

What is the treatment for estrogen receptor-positive breast cancer?

The treatment for estrogen receptor-positive (ER-positive) breast cancer depends on several factors, including the stage of the cancer, the presence of other health conditions, and individual preferences. The main treatment options for ER-positive breast cancer may include:

Surgery: Surgery is often the first treatment for ER-positive breast cancer and may involve removing the tumor (lumpectomy) or the entire breast (mastectomy). Lymph nodes in the armpit may also be removed and examined to determine if the cancer has spread.
Radiation Therapy: Radiation therapy may be used after surgery to destroy any remaining cancer cells and reduce the risk of recurrence. It may also be used before surgery to shrink the tumor.
Hormone Therapy: Hormone therapy is a key treatment for ER-positive breast cancer, as these cancers are fueled by estrogen. Hormone therapy may involve medications that block the action of estrogen (such as tamoxifen or aromatase inhibitors) or medications that reduce estrogen levels in the body (such as ovarian suppression in premenopausal women).
Chemotherapy: Chemotherapy may be recommended for some women with ER-positive breast cancer, particularly if the cancer is large, aggressive, or has spread to the lymph nodes or other parts of the body.
Targeted Therapy: Targeted therapy drugs, such as Herceptin (trastuzumab), may be used in combination with other treatments for ER-positive breast cancer that also have HER2-positive receptors.
Clinical Trials: Participation in clinical trials may be an option for some women with ER-positive breast cancer. Clinical trials test new treatments or treatment combinations to determine their safety and effectiveness.

Treatment for ER-positive breast cancer is often individualized based on the specific characteristics of the cancer and the patient’s overall health. It’s important for women with ER-positive breast cancer to discuss their treatment options with a healthcare provider to determine the most appropriate plan for their situation.

What is the survival rate of estrogen receptor positive breast cancer?

The survival rate of estrogen receptor (ER) positive breast cancer depends on several factors, including the stage and grade of the cancer, the presence or absence of other receptors (such as progesterone receptors and HER2), and the effectiveness of treatment.

Overall, women with ER-positive breast cancer tend to have a better prognosis than those with ER-negative breast cancer. According to the American Cancer Society, the 5-year survival rate for women with ER-positive breast cancer is around 93%.

Here are some general survival rates for ER-positive breast cancer:

Stage I: 99%
Stage II: 92%
Stage III: 78%
Stage IV: 22%

It’s important to note that these are general statistics, and the actual survival rate for an individual woman with ER-positive breast cancer can vary significantly depending on a number of factors, including:

The extent of the tumor at the time of diagnosis
The presence or absence of lymph node involvement
The presence or absence of distant metastases (cancer that has spread to other parts of the body)
The type and effectiveness of treatment received

Additionally, some studies have suggested that women with ER-positive breast cancer who receive hormonal therapies (such as tamoxifen or aromatase inhibitors) may have a better survival rate than those who do not receive these therapies.

It’s also important to note that while ER-positive breast cancer is generally considered to be more treatable than ER-negative breast cancer, it is still a serious disease that requires appropriate treatment and follow-up care.

What foods to avoid with estrogen-positive breast cancer?

While there is no specific diet that can cure estrogen-positive breast cancer, a well-planned diet that is rich in nutrients and low in processed foods may help to reduce the risk of recurrence and improve overall health. Some foods that may be beneficial for women with estrogen-positive breast cancer include:

Fatty fish: Fatty fish such as salmon, tuna, and mackerel are high in omega-3 fatty acids, which have anti-inflammatory properties and may help to reduce the risk of recurrence.
Leafy greens: Leafy greens such as spinach, kale, and collard greens are rich in antioxidants and other nutrients that may help to reduce inflammation and improve overall health.
Cruciferous vegetables: Vegetables such as broccoli, cauliflower, and Brussels sprouts contain compounds that may help to prevent the growth of cancer cells.
Berries: Berries such as blueberries, raspberries, and strawberries are high in antioxidants and may help to reduce the risk of recurrence.
Whole grains: Whole grains such as brown rice, quinoa, and whole-wheat bread provide fiber, vitamins, and minerals that may help to support overall health.

On the other hand, some foods that may exacerbate estrogen-positive breast cancer include:

High-fat dairy products: High-fat dairy products such as whole milk, cheese, and butter may promote the growth of cancer cells.
Refined carbohydrates: Refined carbohydrates such as white bread, sugary snacks, and sweetened beverages may promote insulin resistance and inflammation.
Processed meats: Processed meats such as hot dogs, sausages, and bacon may contain preservatives and other chemicals that can promote cancer growth.
Fried foods: Fried foods may contain acrylamide, a chemical that has been linked to an increased risk of breast cancer.
High-sodium foods: Foods high in sodium may increase blood pressure and contribute to inflammation.

It’s important to note that while diet can play a role in reducing the risk of recurrence and improving overall health for women with estrogen-positive breast cancer, it is not a replacement for standard medical treatment. Women with estrogen-positive breast cancer should work closely with their healthcare provider to develop a personalized treatment plan that takes into account their individual needs and health status.

Here are some specific dietary recommendations for women with estrogen-positive breast cancer:

Eat a variety of whole foods: Focus on whole, unprocessed foods like fruits, vegetables, whole grains, lean proteins, and healthy fats.
Limit processed and high-sodium foods: Avoid or limit foods that are high in added sugars, saturated fats, and sodium.
Choose healthy fats: Opt for healthy fats like avocado, nuts, seeds, olive oil, and fatty fish.
Limit dairy products: Choose low-fat or non-dairy alternatives like almond milk or soy milk instead of high-fat dairy products.
Watch your sugar intake: Limit added sugars to less than 10% of your daily calories.
Stay hydrated: Drink plenty of water throughout the day to help flush out toxins and keep your body hydrated.

Remember to consult with your healthcare provider before making any significant changes to your diet. They can help you develop a personalized plan that takes into account your individual needs and health status.