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23

NCCN Guidelines for Patients

®

:

Breast Cancer – Locally Advanced (STAGE III)

Version 1.2017

every 100 cancer cells stain positive, the cancer is

called hormone receptor–positive. If fewer cancer

cells stain positive for hormone receptors, the cancer

is called hormone receptor–negative.

HER2 test

HER2 (

h

uman

e

pidermal growth factor

r

eceptor

2

)

is a receptor within the membrane of breast cells. As

shown in

Figure 8

, it extends from within the cell

through the membrane to outside of the cell. When

activated, it causes breast cancer cells to grow and

divide.

Normal breast cells have two copies of the gene

that makes HER2. In contrast, some breast cancers

have cells with more than two copies. This causes

too many HER2 receptors to be made. Other breast

cancers have cells with only two

HER2

gene copies

but still too many HER2 receptors are made.

With too many HER2 receptors, breast cancer cells

grow and divide fast. However, there are drugs to

stop these cancer cells from growing. Due to high

costs and the side effects of these drugs, it is very

important to have tests that correctly show HER2

status.

IHC is used to learn the amount of HER2 receptors.

An IHC score of 3+ means that the cancer cells have

many HER2 receptors. Another test of HER2 is ISH

(

i

n

s

itu

h

ybridization). ISH counts the number of

copies of the

HER2

gene. If the cancer cells have too

many

HER2

genes or receptors, the cancer is called

HER2 positive.

Blood tests

Blood tests may be done to check for health

problems before starting treatment. For a blood test,

a needle will be inserted into your vein to remove a

sample of blood. The needle may bruise your skin

and you may feel dizzy from the blood draw. Your

blood sample will then be sent to a lab where a

pathologist will test it.

Complete blood count

A CBC (

c

omplete

b

lood

c

ount) measures the number

of blood cells in a blood sample. It includes numbers

of white blood cells, red blood cells, and platelets.

Cancer and other health problems can cause low or

high counts.

Comprehensive metabolic panel

Chemicals in your blood come from your liver, bone,

and other organs. A comprehensive metabolic panel

often includes tests for up to 14 chemicals. The

tests show if the level of chemicals is too low or

high. Abnormal levels can be caused by cancer or

other health problems. Your doctor may use this test

to check how well your organs are working before

treatment.

2

Treatment planning

Blood tests