What I Wish People Knew About Metastatic Breast Cancer
Women with metastatic breast cancer think about fighting cancer very differently than women who don’t have a stage 4 diagnosis. If you have advanced cancer, these women understand what youre going through.
The term metastatic breast cancer describes breast cancer that has spread beyond the breast to the bones, liver, brain, or another organ. Even if the cancer is found in another organ, its still referred to as breast cancer and is treated as such.
While metastatic breast cancer is terminal and cannot be cured, because of improved treatments more women are living longer than ever with it. Even so, a lack of information and many misconceptions about this diagnosis persist.
What Survival Rate Really Means With Cancer
Survival rate is defined as the percent of people who survive a disease such as cancer for a specified amount of time, but may be presented in a number of different ways. Survival rates does not indicate if a cancer is cured or if treatment is completed. Survival rates are also statistics looking at a broad range of people. They do not necessarily predict how an individual with a particular subtype of cancer will do. Learn about the common definitions describing survival with cancer, and the limitations of statistics.
What Are The Survival Rates For Younger Women With Breast Cancer
Overall survival from breast cancer has increased in recent years. The most recent data shows that about 90 per cent of women aged between 40 and 69 years at diagnosis will be alive five years after their diagnosis. However, for women younger than 40 years, survival is lower because their breast cancers are often larger at diagnosis and more aggressive. Of younger women diagnosed with breast cancer, about 82 per cent of those aged 20 to 29 years and 84 per cent of those aged 30 to 39 years will be alive five years after diagnosis.
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Plans Have To Be Flexible
My energy is unpredictable, says Sendelbach. I literally never know how Im going to feel from one day to the next. Its so hard to make plans because if I say yes to something thats two weeks away, the day of, I could wake up and feel absolutely horrible.
When someone with metastatic breast cancer declines an invitation or cancels at the last minute, its most likely not because they dont want to be there. Says Sendelbach, We physically cant do it.
Silberman agrees. Ive been going through for a long time, she says, and Ive had friends drop away. Because of MBC and my treatments, its hard for me to be reliable.
What About Breast Cancer In Men
The stages of breast cancer relate to how much the cancer has grown and how far its spread. Generally, the earlier breast cancer is diagnosed and treated, the higher the chances for long-term survival.
|Stage 0||This is a precancerous stage with no invasive cancer cells.|
|Stage 1||The tumor is small and localized to the breast. There may be a small amount of cancer in nearby lymph nodes.|
|Stage 2||The tumor is still localized to the breast but is larger and may have spread to several nearby lymph nodes.|
|Stage 3||This stage includes cancers that have spread to the skin, chest wall, or multiple lymph nodes in or near the breast.|
|Stage 4||This is metastatic breast cancer, meaning its spread to one or more distant parts of the body, most commonly to the bones, lungs, or liver.|
The stages of breast cancer are based on the following factors:
- whether the lymph nodes contain cancer cells
- whether the cancer has metastasized, meaning its spread to other, more distant parts of the body
Since 2018, the following factors have also been used to determine breast cancer stage:
- whether the cancer cells have hormone receptors and need estrogen or progesterone to grow
- whether the cancer cells have the HER2 protein that helps them grow
- tumor grade, meaning how aggressive the cells look under the microscope
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Clinicopathologic Features Biology And Prognosis
The comparison of clinicopathologic and prognostic features of breast cancer arising in younger women with those in their older counterparts has been the subject of published studies for decades.27–29 Traditionally, breast cancer arising in a younger host is characterized by a more aggressive phenotype. Among 185 premenopausal women carrying a diagnosis of invasive breast cancer, referred for surgery at the European Institute of Oncology from April 1997 to August 2000, those aged less than 35 years had a higher percentage of ER-negative , progesterone receptor -negative , vascular or lymphatic invasion and pathologic grade 3 tumors compared with women aged 35-50 years.30 Differences in tumor size, lymph node involvement, and Her2/neu status between younger and older women diagnosed with breast cancer have been less clear.30–33
Metastatic Breast Cancer Is Terminal
Metastatic breast cancer cant be cured and it is terminal. One thing I didnt know when I was first diagnosed is that breast cancer can only kill you if you have metastatic breast cancer, says Rosen, who explains that if your cancer remains in the breast, the tumor can be removed, but metastatic means it has spread outside the breast.
MBC is almost like a different disease than early-stage breast cancer, adds Ann Silberman, 60, from Sacramento, California, who was diagnosed in 2009. We are going to die. Our concerns are much different from those of a person who has a treatment that will be over . Someone in an earlier stage may worry about losing their hair which is understandable but they will return to their normal life at some point.
People with metastatic breast cancer expect to be on treatment for the rest of their lives. I dont think everyone understands that, Silberman says. I still get, When will your treatment be over? Well, its never going to be over.
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Will I Die Of Breast Cancer
This is a difficult question to answer early in your cancer care but it is still worth asking. Many people just diagnosed with cancer have no idea how much of a risk to their life their unique situation poses. Most breast cancers carry a low risk of recurrence, especially early-stage cancers. The answer is usually reassuring.
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Jul 21, 2022 Â· In the CPS-10 subgroup, the median overall survival was 23.0 months in the pembrolizumabchemotherapy group and 16.1 months in the placebochemotherapy group (hazard ratio for death, 0.73 95% â¦.
Background Compared with surgery alone, postoperative adjuvant radiotherapy improves relapse-free survival of patients with early-stagebreastcancer. We evaluated the long-term overall and disease-free survivalrates of neoadjuvant versus adjuvant RT in early-stagebreastcancer patients. Methods We used the Surveillance, Epidemiology, and End Results database.
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Infinity Pharma Posts 52% Increase In One
Infinity Pharmaceuticals Inc reported an update from its MARIO-3 study of eganelisib in combination with atezolizumab and nab-paclitaxel in front-line metastatic triple-negative breast cancer patients.
Sixty-two patients were enrolled and evaluable for safety, and 57 (were evaluable for efficacy, with a median duration of follow-up of 10.0 months.
Encouraging one-year progression-free survival rates in MARIO-3 1L TNBC study regardless of PD-L1 status.
52% increase in one-year progression-free survival rate in ITT patient population compared to the IMpassion130 benchmark.
No new safety signals were observed during the extended period of treatment, and the MARIO-3 safety profile continued to be consistent with expectations for the three component drugs.
74% of patients were able to remain on treatment with the MARIO-3 TNBC triplet regimen compared to 81% of patients with the IMpassion130 doublet.
Our Advice To Other Women With Metastatic Breast Cancer: Be Nice To Yourself
Give yourself a break! is the advice that Sendelbach offers. Stop negative self-talk about what you should have done but didnt do, she says. If you have MBC, you need to be kind and loving to yourself.
The body has only so much energy to offer per day, and managing metastatic breast cancer requires a lot of it. So it doesnt make sense to try to compare what youre able to do with what your cancer-free friends are accomplishing.
Just getting through the day can be hard, Sendelbach says. Getting rid of those not good enough feelings can lift a huge weight off you.
Pregnancy Diagnosed During Or After Breast Cancer
Studies of pregnancy after a diagnosis and treatment of breast cancer are retrospective and most are case-controlled investigations. Although one study84 showed an increased risk for relapse, most other studies show either no difference in recurrence or a decrease in risk of recurrence.76 Breast cancer survivors and their medical caregivers are advised to fully discuss the risk of recurrence when discussing post-cancer reproductive choices.
For Family And Friends
Caring for a loved one with stage 4 breast cancer has special challenges as well. Fortunately, organizations such as CancerCare now offer support groups design for loved ones who are caring for someone with cancer. In addition to caring for yourself , itÃ¢s helpful to learn about metastatic breast cancer.
Common things that people learn about cancer usually refer to an early-stage disease, and myths about metastatic breast cancer can be painful for those living with advanced disease. For example, one of the things not to say to someone with metastatic breast cancer is, Ã¢When will you be done with treatment?Ã¢
For the most part, people with metastatic breast cancer will require some type of treatment for the rest of their lives.
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Study Design And Data Sources
This is a population-based cohort study. Study participants were identified in Swedens 6 regional breast cancer registries and the National Breast Cancer Registry and followed for outcomes through linkage to the Cancer Registry, the Total Population Register, and the Cause of Death Register. Linkage was conducted using the national registration number, a unique identifier assigned to all Swedish citizens.
Sweden is divided into 6 healthcare regions : North , Uppsala-Örebro , Stockholm-Gotland , West , South-East , and South . Before 2000, each region had a collaborative breast cancer group developing regional treatment guidelines. Since 2000, there are national treatment guidelines with regional adjustments. In 1977-1992, each regional group established a regional registry compiling information on patient and tumor characteristics and planned primary treatment of all newly diagnosed breast cancer patients in the North region, only patients aged younger than 75 years were included in the registry. In 2007, the regional registries were discontinued because the National Breast Cancer Registry was established instead, which includes more than 95% of all newly diagnosed breast cancers patients in Sweden .
The study was approved by the Stockholm Regional Ethics Committee , with jurisdiction for all participating sites. The study protocol has been registered at www.clinicaltrials.gov .
Checking For Cancer Recurrence And Growth
The Surveillance, Epidemiology, and End Results database classifies breast cancer into three stages:
- Localized: This means that the cancer does not appear to have spread outside of the breast.
- Regional: This means that the cancer has spread from the breast to nearby lymph nodes or structures.
- Distant: The means that the cancer has spread from the breast to distant parts of the body, such as the bones, liver, or lungs.
Most cases of localized and regional breast cancer are curable with treatment. In some cases, however, breast cancer returns after initial treatment. This is known as breast cancer recurrence.
If breast cancer spreads to distant organs, it is not curable. That said, treatment can help slow the growth of tumors and sometimes shrink them. Tumors may start to grow again if the treatment stops working.
Doctors may prescribe long-term medication and recommend lifestyle changes to help reduce the risk of cancer recurrence or growth.
If someone experiences cancer recurrence or tumors start to grow again, their doctor can help them understand their treatment options. Early diagnosis and treatment are important.
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What Is Considered High Risk For Breast Cancer
High risk for breast cancer is defined as a greater than or equal to 20% lifetime risk, or in other words, a one in five chance of developing breast cancer over a lifetime. We all know someone a coworker, family member such as a mother, sister, daughter or friend that has been diagnosed with this disease.
How Are Cancer Survival Rates Used
Survival statistics may be used to:
Understand your prognosis
The experience of other people in the same situation can give you and your doctor an idea of your prognosis. There may be a good chance your cancer can be treated, considering your overall health and age.
Develop a treatment plan
You also can compare how others responded to treatment with the same type of cancer. This is vital information for you and a doctor to discuss however, no two people will react exactly the same! It is essential to address the treatment plan it is imperative that you choose a regimen that is best for your individual situation.
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Icipants And Study Design
We conducted a retrospective cohort study from a database that included all womendiagnosed with invasive BC and who were 40 years old during the period January2012December 2017 who were treated at the State Cancer Center , inVeracruz, Mexico. The sample size was delimited by 100% of the women withinvasive BC, aged 40 years and who met the rest of the selection criteria froma database with N = 1462 patients. Statistical power will be calculated if nosignificant association is found between the group < 30 years with poorsurvival.
The maximum monitoring time was 60 months, with a prior evaluation at 24 months.Patients were classified as exposed or unexposed according to age < 30 yearsand 30 years. Monitoring included the time interval between the date ofdiagnosis and the date of the last visit or the date of death from any cause.For the rest of the cohort, the monitoring time ended on December 31st, 2017.The selection criteria were women aged 40 years, residing at the state ofVeracruz with a confirmed diagnosis of BC during the period January2012December 2017 who were treated at the CECan and had a complete clinicalrecord. Information was collected from secondary sources, such as medicalrecords and information provided by the Department of Social Work.
Examples Of Mortality Rates Versus Number Of Deaths
Say, town A has a population of 100,000 and town B has a population of 1,000. Over a year, say there are 100 breast cancer deaths in town A and 100 breast cancer deaths in town B.
The number of breast cancer deaths in each town is the same. However, many more people live in town A than live in town B. So, the mortality rates are quite different.
In town A, there were 10 breast cancer deaths among 100,000 people. This means the mortality rate was less than 1 percent .
In town B, the mortality rate was 10 percent .
Although the number of deaths was the same in town A and town B, the mortality rate was much higher in town B than in town A .
Lets look at another example. In 2022, its estimated among women there will be :
- 100 breast cancer deaths in Washington, D.C.
- 730 breast cancer deaths in Alabama
- 4,690 breast cancer deaths in California
Of the 3, California has the highest number of breast cancers. However, that doesnt mean it has the highest breast cancer rate. These numbers dont take into account the number of women who live in each place. Fewer women live in Alabama and Washington, D.C. than live in California.
Other factors may vary by place as well, such as the age and race/ethnicity of women. So, to compare breast cancer mortality rates, we need to look at mortality rates.
In 2022, the estimated mortality rates are :
- 25 per 100,000 women in Washington, D.C.
- 21 per 100,000 women in Alabama 22
- 19 per 100,000 women in California 20
Importance Of Regular Screenings For Breast Cancer
Regular screening can also help improve survival rates by ensuring that breast cancer is detected and treated early.
However, the study also highlighted that not meeting the guidelines was associated with socioeconomic factors like lower income and lack of access to health insurance. Overall, public health agencies are trying to ensure that all women are able to receive timely screening and treatment.
Influence Of Dfti And Other Related Factors On Mortality Risk
A Cox proportional hazards model was used to examine the relationship of patient survival with the relevant variables . The DFTI, hospital level, and hospital ownership were nonsignificant predictors of mortality. ER, PR, and HER2 status were protective factors for mortality risk after other related factors were controlled for. Tumor size, number of involved lymph nodes, and cancer stage also were positively correlated with mortality risk .
Table 2 Influence of DFTIs and other related factors on mortality risk in patients with confirmed breast cancer.