Treatment options for HER2-negative breast cancer include surgery, hormone therapy, radiation therapy, targeted therapy, chemotherapy, and immunotherapy.
Treatment for HER2-negative breast cancer will depend on factors such as hormone receptor status, cancer stage, and your age and overall health.
The goal of treatment for HER2-negative breast cancer can vary based on the extent of your cancer. It may focus on eliminating the cancer and preventing it from recurring.
However, if the cancer has spread more widely, treatment may focus on slowing its growth and preventing it from spreading to additional tissues.
Read on to learn more about treatments for HER2-negative breast cancer.
Doctors may recommend surgery as the first treatment for breast cancer. The goal is to remove as much of the cancer as possible.
The type of surgery you receive can depend on factors such as the size and location of your cancer and your personal preferences.
There are two types of breast cancer surgery for HER2-negative breast cancer:
- A lumpectomy involves removing the cancer and some surrounding healthy tissue. This is also called breast-conserving surgery.
- A mastectomy involves removing your entire breast.
Some mastectomies and lumpectomies also involve removing the lymph nodes under your arm. This is called a sentinel lymph node biopsy.
As with any surgery, there are possible side effects of surgery for breast cancer. Speak with a doctor for more information so you can make an informed decision about your treatment plan.
Many HER2-negative breast cancers have hormone receptors for estrogen, progesterone, or both. In fact, an estimated
HR-positive breast cancers are treatable with hormone therapy, so doctors may recommend this for HR-positive/HER2-negative breast cancer. The drugs for this treatment can prevent estrogen from binding to its receptors or reduce the amount of estrogen your body makes.
Because binding of hormones to receptors can promote breast cancer growth, hormone therapy can reduce growth.
It may be suitable:
- before surgery to shrink a tumor
- after surgery to help get rid of remaining cancer cells and prevent the cancer from returning
- as a main component of treatment if you cannot have surgery or choose not to have it
A doctor can provide more information about whether they recommend hormone therapy, what side effects may develop, and what to expect from the treatment.
Radiation therapy is a type of cancer treatment that uses high energy radiation to help kill cancer cells.
The main type of radiation therapy for breast cancer is external beam radiation. During external beam radiation therapy, a machine outside your body delivers the radiation.
Another type of radiation therapy for breast cancer is brachytherapy, or internal radiation therapy. It involves placing a device containing small amounts of radiation inside your body.
You typically receive radiation therapy after breast-conserving therapy.
Radiation therapy may also be suitable as palliative treatment for metastatic breast cancer to help shrink a tumor in order to ease pain, lower the risk of a bone break, or reduce pressure on nerves.
If a doctor recommends radiation therapy, they can advise on the type that will be the most suitable, as well as what the treatment involves and the possible side effects.
While targeted therapy is often suitable for the treatment of HER2-positive breast cancer, it can also be used for HER2-negative breast cancer.
Targeted therapy for breast cancer focuses on specific markers found on or in cancer cells. You
- before surgery to shrink a tumor
- after surgery to help get rid of remaining cancer cells and prevent the cancer from returning
- as a main component of treatment if you cannot have surgery or choose not to have it
There are several targeted therapy drugs that may be used for HER2-negative breast cancer, including:
- CDK4/6 inhibitors such as abemaciclib (Verzenio), palbociclib (Ibrance), and ribociclib (Kisqali)
- the mTOR inhibitor everolimus (Afinitor)
- the PI3K inhibitor alpelisib (Piqray)
- the AKT inhibitor capivasertib (Truqap)
Cancers with BRCA mutations may be suitable for treatment with olaparib (Lynparza) or talazoparib (Talzenna).
An antibody-chemotherapy conjugate called sacituzumab govitecan (Trodelvy) is also an option for treating HR-positive/HER2-negative breast cancers and triple-negative breast cancer.
The side effects that you have with targeted therapy can depend on the specific drug.
Chemotherapy involves drugs that interfere with the growth and division of cancer cells.
You may receive chemotherapy for HER2-negative breast cancer:
- before surgery to shrink a tumor (neoadjuvant chemotherapy)
- after surgery to help get rid of remaining cancer cells and prevent the cancer from returning (adjuvant chemotherapy)
- as a main component of treatment if you cannot have surgery or choose not to have it
The type of chemotherapy drug you receive can depend on your individual situation. Sometimes, a combination of chemotherapy drugs may be suitable.
Chemotherapy drugs have broad activity that can also affect healthy cells in your body that grow and divide at a faster rate. As a result, chemotherapy can lead to a range of side effects.
Your doctor can provide more information about the possible side effects, as well as whether they recommend chemotherapy and what drugs it will involve.
Immunotherapy is a type of cancer treatment that helps your immune system better respond to cancer.
Immunotherapy is often a potential treatment option for triple-negative breast cancer. This is breast cancer that is HR-negative and HER2-negative.
You may receive immunotherapy:
- before surgery to shrink a tumor
- after surgery to help get rid of remaining cancer cells and prevent the cancer from returning
- as a main component of treatment if you cannot have surgery or choose not to have it
Your doctor can advise on whether they recommend immunotherapy, what the treatment involves, and what side effects may develop.
There’s no alternative treatment that can effectively treat HER2-negative breast cancer. However, some complementary treatments may be suitable for use along with conventional treatment and may help ease symptoms and improve quality of life.
According to the
If you’re interested in trying out a complementary treatment, be sure to talk with your doctor about the potential benefits and risks before starting.
Here are some examples of questions you may want to ask your care team as you prepare for treatment for breast cancer:
- What type(s) of treatment are you recommending for my cancer and why?
- What is the overall goal of my treatment?
- When will I start my treatment?
- How long will my treatment last in total? How long will each treatment session last?
- Where will I receive my treatment?
- What side effects should I be aware of? Is there anything I can do to help prevent or reduce them?
- When should I contact you about treatment side effects? When should I go to the hospital instead?
- Will this treatment have any long-term effects? If so, what are they? Is there anything I can do to help prevent them?
Where to find support if you’re having treatment for HER2-negative breast cancer
If you’ve recently received a diagnosis of HER2-negative breast cancer, you might want to look into some of these resources for support:
- the
American Cancer Society’s patient programs and servicesTrusted Source and Cancer Survivors Network - BreastCancer.org and its discussion forum for connecting people with breast cancer
- the Susan G. Komen Foundation and its financial assistance program
- Living Beyond Breast Cancer and its three private support groups on social media and funding opportunities for people needing additional financial support
The first-line treatment for HER2-negative breast cancer depends on factors such as the tumor size and HR status.
Some people who have larger tumors undergo chemotherapy first. Treatment can often involve surgery followed by another treatment.
If surgery is not an option, treatments doctors recommend can include:
- chemotherapy
- targeted therapy
- immunotherapy
- radiation therapy
Hormone therapy may also be an option for HR-positive/HER2-negative breast cancer.
In January 2023, the Food and Drug Administration (FDA) approved elacestrant (Orserdu) for estrogen receptor-positive HER2-negative advanced or metastatic breast cancer that has ESR1 mutations.
In October 2024, the FDA approved inavolisib (Itovebi) with palbociclib and fulvestrant for the treatment of HER2-negative breast cancer and other types of breast cancer.
Treatments for HER2-negative breast cancer can include surgery, radiation therapy, hormone therapy, chemotherapy, targeted therapy, and immunotherapy.
The type of treatments for HER2-negative breast cancer can depend on many factors, including the cancer’s HR status, stage, and grade, as well as your age, overall health, and personal preference.
If you have questions or concerns about your treatment or outlook, be sure to raise them with your care team. They can provide you with more information about the treatments they recommend, what the treatments involve, and what side effects may develop.
