When you or a loved one receives a breast cancer diagnosis, the first thing that hits is a wave of confusion. You’re suddenly confronted with a stream of medical terminology, subtypes, receptors, and treatment names, and for many, those terms quickly become tangled with fear and outdated information.
One of the most complex and often misunderstood diagnoses is HER2+ breast cancer. This specific subtype has been the subject of rapid scientific advancement over the past two decades.1 Unfortunately, myths still linger, causing unnecessary anxiety and sometimes influencing critical decisions.
NOWINCLUDED was designed to cut through that noise. Drawing on the latest research and deep clinical understanding, we will dismantle the most persistent myths about HER2+ breast cancer, provide a clear breakdown of what this condition is, and shine a critical light on how disparities affect access to its life-saving treatment within our Black and Brown communities.
Our goal is to replace fear with facts and empower you to become a fully informed advocate on your health journey.
What is HER2+ Breast Cancer?
Breast cancer is not a single condition; it is a complex group of conditions. It is classified based on the presence or absence of three key receptors on the surface of the cancer cells: Estrogen Receptor (ER), Progesterone Receptor (PR), and Human Epidermal Growth Factor Receptor 2 (HER2).2
HER2-positive breast cancer is defined by an excessive amount of the HER2 protein on the surface of the cancer cells.2 Imagine the HER2 protein as an “On” switch for cell growth. In a healthy cell, there are a normal number of these switches, which regulate growth appropriately. In HER2+ cancer, however, a genetic error (specifically, gene amplification) results in hundreds or thousands of these extra switches.2 This protein overexpression causes the cancer cells to:
- Divide and grow rapidly.
- Be more aggressive.
- Be more likely to recur without specific intervention.
It is this specific biological characteristic that makes the tumor “positive” for HER2.
Debunking The 3 Most Common Myths
Busting misconceptions is the first step towards feeling informed and empowered. To reduce the anxiety and confusion that often follow a diagnosis, let’s immediately tackle the three most common and harmful myths surrounding HER2-positive breast cancer.
Myth 1:
HER2+ is the deadliest, most aggressive form of breast cancer, and prognosis is poor.
Fact: While historically true, the development of HER2-targeted therapy (such as trastuzumab and pertuzumab) revolutionized outcomes.3 When treated with modern protocols, the survival rates for many people with HER2+ are now comparable to, or even better than, those with hormone receptor-positive cancer.3 The aggressive nature of the HER2-positive subtype is now matched by equally aggressive, highly effective treatment protocols.3
Myth 2:
A HER2+ diagnosis means you must have a major gene mutation (like BRCA) or that your lifestyle caused it.
Fact: HER2 overexpression is an acquired characteristic of the tumor in the vast majority of cases, meaning it’s a random gene change that occurs within the cell and is not inherited. Only a small percentage of breast cancers are linked to inherited mutations.3
While a healthy lifestyle is always important, this specific diagnosis is almost universally due to spontaneous somatic mutations (mutations in the tumor tissue itself).3 HER2 status is found by testing the tumor tissue itself, not through genetic tests that look for inherited genes like BRCA.3
Myth 3:
HER2-Targeted therapies are experimental and should be avoided.
Fact: Drugs like trastuzumab (Herceptin) have been the standard of care for HER2+ breast cancer since the late 1990s and dramatically reduce the risk of recurrence.3
Newer antibody-drug conjugates (ADCs) like T-DM1 (trastuzumab emtansine) and T-DXd (Trastuzumab deruxtecan) are also FDA-approved and provide groundbreaking efficacy, particularly in cases of recurrence.3 These treatments are essential to the HER2+ survival toolkit and are considered first-line therapy.
The Hidden Myth: Unequal Access and Outcomes in Black and Brown Communities
The scientific victory over HER2+ cancer hasn’t translated into equal success for everyone. This is not a failure of biology, but a failure of the system.4 Systemic inequality creates dangerous health gaps, leading to higher mortality rates for Black and Brown women despite effective treatments being available.4
We must confront the invisible barriers that turn a treatable diagnosis into a crisis:
- Delayed Diagnosis & Staging: Black and Brown women are statistically more likely to be diagnosed at a later, more aggressive stage.4 This delay is fueled by limited access to high-quality screening, insurance gaps, and implicit biases that can lead providers to dismiss concerns.4
- The Cardiotoxicity Crossroads: HER2-targeted therapy carries a risk of heart damage (cardiotoxicity).4 Due to historical health inequities, Black women often have higher rates of pre-existing conditions like hypertension (high blood pressure), making them uniquely vulnerable to this side effect.4 Vigilant, specialized cardiac monitoring is therefore non-negotiable but often overlooked.
- Barriers to Completion: Receiving the full, year-long course of targeted infusions is life-saving, yet many Black and Brown people face many logistical and financial obstacles.4 Lack of reliable transportation, inflexible jobs, and high out-of-pocket costs prevent adherence to the demanding treatment schedule, leading to suboptimal care.4
- Research Underrepresentation: The chronic underrepresentation of women of color in HER2+ clinical studies means that new, potentially curing therapies aren’t adequately tested across the population most impacted by disparities.4
The science offers tremendous hope. Now, we must demand that access and equitable care close the survival gap.
Our Call to Action: Be Informed, Be Engaged
Understanding the myths and the facts is essential, but recognizing the disparities demands action. Your HER2 status gives you a clear target; your voice is the tool to hit it.
- Demand Comprehensive Diagnostics: Do not settle for incomplete testing. Ask your physician: “What is my tumor’s exact ER/PR/HER2 status, and are all components being addressed”?
- Prioritize Cardiac Health: If on HER2-targeted therapy, ask specifically: “How frequently will my Ejection Fraction (LVEF) be monitored to check my heart function”?
- Leverage Your Community: Use platforms like NOWINCLUDED’s cancer circle to share resources, find support, and connect with others navigating similar systemic challenges.
The science behind HER2-positive breast cancer offers tremendous hope. Now, we must work together, as patients, advocates, and health professionals, to ensure that this promise of survival is accessible to every member of our community.
References:
- Malhotra, P. (2025). HER2-Positive Breast Cancer: Testing, Treatment, Research. Retrieved from Breast Cancer Research Foundation: https://www.bcrf.org/about-breast-cancer/her2-positive-breast-cancer-treatment-research/
- Cheng, X. (2024). A Comprehensive Review of HER2 in Cancer Biology and Therapeutics. Genes. doi:10.3390/genes15070903
- Sile, E. (2025). 10 Breast Cancer Myths Debunked. Retrieved from Breast Cancer Research Foundation: https://www.bcrf.org/about-breast-cancer/breast-cancer-myths-debunked/
- Chen, L., & Li, C. I. (2016). Racial disparities in breast cancer diagnosis and treatment by hormone receptor and HER2 status. Cancer Epidemiology, Biomarkers & Prevention. doi:10.1158/1055-9965.EPI-15-0293
