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The Spectrum of Breast Cancer: A Detailed Examination of Its Various Forms

Breast cancer, one of the most prevalent cancers worldwide, manifests in various forms, each with unique characteristics and treatment pathways. Among these forms, Luminal A and Luminal B breast cancers are notably significant due to their hormone receptor status and impact on treatment strategies. This article delves into these subtypes, clearly understanding their nature and management. 

Luminal A and B Breast Cancer: Key Characteristics and Differences 

Breast cancer subtypes are primarily categorised based on hormone receptors and the human epidermal growth factor receptor 2 (HER2) presence. Luminal A and B breast cancers are hormone receptor-positive, expressing estrogen and progesterone receptors. Still, they differ in growth kinetics and HER2 expression, leading to different management strategies. 

  

Luminal A Breast Cancer: The Common Yet Less Aggressive Type 

Luminal A breast cancer is the most commonly diagnosed subtype, characterised by high expression of hormone receptors and low levels of HER2 and Ki-67, a marker that indicates cell proliferation. This subtype is known for its slower growth rate and generally favourable prognosis. 

  

Treatment Approaches for Luminal A Breast Cancer 

  • Hormonal Therapy: The cornerstone of Luminal A treatment, hormonal therapies such as Tamoxifen or aromatase inhibitors (like letrozole, anastrozole and exemestane), block estrogen receptors or reduce estrogen production, respectively
  • Surgical Options: Depending on the tumour size and patient preference, surgery may involve breast-conserving surgery (lumpectomy) or mastectomy
  • Radiation Therapy: Often recommended following surgery to eliminate residual cancer cells and reduce the risk of recurrence
  • Chemotherapy: Less commonly used but may be recommended in cases with higher risk features

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Luminal B Breast Cancer: More Aggressive and Complex 

Luminal B breast cancer, while also hormone receptor-positive, typically shows higher levels of Ki-67, indicating a faster growth rate. This subtype may also be HER2-positive, influencing treatment decisions and overall prognosis. 

  

Treatment Strategies for Luminal B Breast Cancer 

  • Combination Therapy: Given the more aggressive nature of Luminal B, a combination of hormonal therapy and chemotherapy is often necessary. 
  • HER2-Targeted Therapies: Drugs like trastuzumab or pertuzumab are essential for treating HER2-positive Luminal B cancers. They effectively target and inhibit the HER2 protein. 
  • Surgical and Radiation Therapy: Similar to Luminal A, these treatments are tailored based on the tumour's characteristics and extent of spread. 

 

Prognosis and Outcomes 

While Luminal A breast cancer generally has a better prognosis due to its less aggressive behaviour, Luminal B's prognosis can vary significantly based on HER2 status and response to treatment. Early detection and tailored therapeutic approaches are crucial in improving outcomes for both subtypes. 

   

Understanding the spectrum of breast cancer, particularly the nuances between Luminal A and B subtypes, is crucial for effective treatment and management. Advances in targeted therapies and personalised medicine continue to improve the outlook for individuals diagnosed with these condition.

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References

  1. Science Direct. Luminal A Breast Cancer. 27 September 2024 Retrieved from https://www.sciencedirect.com/topics/medicine-and-dentistry/luminal-a-breast-cancer   
  2. Mayo Clinic. Breast Cancer. 27 September 2024 Retrieved from https://www.mayoclinic.org/diseases-conditions/breast-cancer/symptoms-causes/syc-20352470  
  3. Susan G. Komen. Molecular Subtypes of Breast Cancer. 27 September 2024 Retrieved from https://www.komen.org/breast-cancer/diagnosis/molecular-subtypes/  

Topics: Health & Wellness, Women's Health, General Practice / Family Medicine

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OT&P Healthcare

OT&P Healthcare is a Premium Private Healthcare Practice in Hong Kong. Our priority is to help individuals to enhance and optimise their health by providing easy access to a wide range of excellent practitioners and information, supported by management systems and technology that ensure quality of service and value. Our Mission is to provide pre-eminent private healthcare in Hong Kong. We aim to be the best in class fully integrated healthcare service, providing a circle of care for all our patients' needs.

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