- With Mayo Clinic internist
Sandhya Pruthi, M.D.
read biographyclose windowBiography of
Sandhya Pruthi, M.D.
Sandhya Pruthi, M.D.
Dr. Sandhya Pruthi, certified by the American Board of Family Practice, has been practicing medicine at Mayo Clinic since 1995 with special interests in breast diseases and women's health.
She is a consultant in the Department of Internal Medicine, Division of General Internal Medicine, and the Breast Diagnostic Clinic. She is an assistant professor of medicine at Mayo Clinic College of Medicine in Rochester, Minn.
The Winnipeg, Manitoba, native stresses education and patient-related research and has been active in both areas since joining Mayo Clinic. She is the primary investigator at Mayo Clinic of several clinical trials evaluating new agents for the prevention of breast cancer and identification of biomarkers for early detection of breast cancer. Her other research and clinical interests include managing the health of women who are at increased risk of breast cancer, breast pain and hot flashes, and developing patient education decision-making tools for breast-related concerns. She is director of the Breast Diagnostic Clinic and is a member of the Women's Health Executive Committee. Dr. Pruthi has been newly elected as a member to the board of directors for the American Society of Breast Disease. She has assisted with a variety of articles for MayoClinic.com.
"Having an opportunity to share information with my patients in the way that will help them to understand and be able to make educated decisions about their own health is very important to me," she says.
"The Web has become a major information site for people, and I want them to get the best and accurate information to be able to make informed choices for themselves, their family members and friends."
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Question
HER2-positive breast cancer: What is it?
A friend of mine has something called HER2-positive breast cancer. Can you tell me what this means?
Answer
from Sandhya Pruthi, M.D.
HER2-positive breast cancer is a breast cancer that tests positive for a protein called human epidermal growth factor receptor-2 (HER2), which promotes the growth of cancer cells. In about one of every three breast cancers, the cancer cells make an excess of HER2 due to a gene mutation. This gene mutation can occur in many types of cancer — not only breast cancer.
HER2-positive breast cancers tend to be more aggressive than other types of breast cancer. They're also less responsive to hormone treatment. However, new treatments that specifically target HER2 are proving to be very effective:
- Trastuzumab (Herceptin). Herceptin, which specifically targets HER2, kills these cancer cells and decreases the risk of recurrence. Herceptin is often used with chemotherapy. But it may also be used alone or in combination with hormone-blocking medications, such as an aromatase inhibitor or tamoxifen. A study published in 2005 found that Herceptin can reduce breast cancer recurrence by as much as 50 percent. Herceptin is usually well tolerated, but it does have some potential side effects, such as congestive heart failure and allergic reaction. This drug is also very expensive.
- Lapatinib (Tykerb). Like Herceptin, Tykerb is a HER2-specific drug. Approved by the Food and Drug Administration in 2007, Tykerb may be effective for HER2-positive breast cancer that doesn't respond to Herceptin. Tykerb is used in combination with the chemotherapy drug capecitabine (Xeloda).
- Certain chemotherapy regimens, such as combinations of anthracycline drugs — doxorubicin (Adriamycin), epirubicin (Ellence).
Breast tissue can be tested for HER2, and routine testing is recommended for most women with breast cancer because the results may affect treatment recommendations and decisions. Whenever breast cancer recurs or spreads, the cancer cells should be tested for HER2.
