This study examined the prevalence of breast cancer with various combinations of ER/PR/HER2 receptor status in conjunction with five-year survival statistics. The study was based on data from the California Cancer Registry. Women who were African American, Hispanic, of low socio-economic status, under 50 at diagnosis, and/or with stage IV undifferentiated tumors were more likely to have breast cancer with an ER-negative subtype (ER-/PR-/HER2+ or ER-/PR-/HER2- (triple negative)). Stage III and stage IV tumors and poorly differentiated and undifferentiated tumors were also more likely to be hormone receptor negative than earlier stage and less aggressive disease. Survival was found to vary from 96% for hormone receptor-positive/HER2 negative breast cancer (ER+/PR+/HER2-) to 76% for hormone receptor-negative breast cancer (including both ER-/PR-/HER2+ and triple negative).

Other recent studies clarify breast cancer prognosis picture

The current study results show that relatively new treatments for HER2 overexpressing breast cancer (primarily Herceptin) have been effective in increasing survival for women with HER2+ tumors. The study also highlights the survival disadvantage of ER- disease. However, longer-term studies have found that the relative protection conferred by ER+ breast cancer compared to ER- tumors disappears over time. The reasons for this are far from clear.

Breast cancer tends to develop resistance to anti-estrogen treatments (tamoxifen and aromatase inhibitors) over time. Some breast cancer changes ER or PR status as it metastasizes. One Chinese study found that all types of breast cancer tend to have two periods of heightened recurrence: at two years after breast cancer surgery and at approximately nine and one-half years. This gives some credence to the hypothesis that some women might harbor breast cancer cells capable of metastasis and also capable of remaining dormant and unaffected by the early years of intensive breast cancer treatment (possibly breast cancer stem cells). These cells may also be different in how they express hormone receptors.

The question for breast cancer survivors is what to do to reduce the risk of recurrence and metastasis. Based on the available evidence, such women should eat a wide variety of the foods on our recommended list and limit or avoid those on our avoid list, in addition to paying particular attention to the foods discussed in the articles we have produced on different types of breast cancer. The overall goal is to bathe our normal cells with nutrients that promote healthy DNA and cell division. In addition, any new breast cancer cells that do arise or that leave dormancy are to find themselves in an environment that promotes their death and inhibits their proliferation and migration. We do not recommend taking phytoestrogen supplements or bioidentical hormones to reduce the risk of hormone receptor-positive breast cancer. Neither has been demonstrated to be safe and effective; in fact, they may turn out to promote breast cancer growth under some circumstances.