Skill Checkup: A 64-Year-Old Woman With a Breast Mass and Back and Hip Pain

Maurie Markman, MD


September 08, 2021

Correct Answer: B. HR-positive/HER2-negative

According to the National Cancer Institute, HR-positive/HER2-negative is the most common breast cancer subtype, accounting for about 68% of breast cancers, based on 2014-2018 cases. This is nearly seven times higher than the rate of triple-negative breast cancer and the rate of HR-positive/HER2-positive, which each account for 10% of cases. HR-negative/HER2-positive accounts for about 4% of cases, and in the rest of cases, the receptor status is unknown.

Triple-negative breast cancer is considered to be more aggressive and tends to have a poorer prognosis than other types of breast cancer, mainly because there are fewer targeted medicines that treat triple-negative breast cancer. Studies have shown that triple-negative breast cancer is more likely to spread beyond the breast and more likely to recur after treatment.

HER2-positive breast cancer is more aggressive and more likely to spread than HER2-negative breast cancer. However, in recent years, in de novo metastatic disease, women with the HR-positive/HER2-positive subtype have better survival than those with the HR-positive/HER2-negative subtype (often considered the best prognostic feature). This remarkable change is probably attributable to major advances in HER2-targeted therapies.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.