Risk Factors
Women with more aggressive cancers at the time of original diagnosis are generally at higher risk for developing metastatic disease. Here are some characteristics of aggressive forms of breast cancer:
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Lymph node involvement
The greater the lymph node involvement at diagnosis, the greater the risk of metastasis.
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Tumor size
Larger tumor size at diagnosis increases risk of metastasis.
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Histologic grade
This refers to the difference between cancer cells and normal cells when examined under a microscope. The higher the grade, the higher the risk of metastasis.
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Nuclear grade
This refers to the rate at which cancer cells divide and multiply. Cancer cells with high nuclear grade are higher risk.
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Hormone receptors
Breast cancers that are estrogen-receptor negative multiply more rapidly but often respond well to chemotherapy.
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HER2/neu
Breast cancer cells that overexpress the HER2/neu protein multiply more rapidly, but respond well to targeted therapy (such as Trastuzumab, a treatment that blocks this receptor).
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Lack of expression of any receptor (Triple-Negative Breast Cancer)
These tumors are typically more aggressive, fast growing and have no specific target or molecular therapy. However, these tumors usually divide rapidly, and may respond to chemotherapy. Triple-negative breast cancers may recur earlier than other breast cancers, but rarely recur after five years.
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BRCA Mutation
Your physician may recommend a PARP inhibitor if you have a BRCA mutation.
