Breast Cancer Prognosis: Fear Hope And Understanding Survival Rates
Following a breast cancer diagnosis, its natural to wonder about your prognosis. Prognosis refers to the overall outlook of a disease how well it generally responds to treatment and how it may affect your life expectancy. A prognosis cant predict the future for any one individual. Its important to discuss your cancer prognosis with your doctor to better understand the road ahead.
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.
A 2021 study reported that Black and Hispanic women actually met U.S Preventative Services Task Force breast cancer screening guidelines at a higher rate than white women.
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.
The Tnm System For Staging Breast Cancer
The AJCCs addition of the letters T, N, and M for anatomic breast cancer staging adds more information to a breast cancer diagnosis. Heres what they mean:
- T : The tumor grade shows a higher number for a larger size or density.
- N : Nodes refers to lymph nodes and uses the numerals 0 to 3 to give information about how many lymph nodes are involved in the cancer.
- M : This refers to how the cancer has spread beyond the breast and lymph nodes.
The AJCC also added clarifications in staging for ER, PR, and HER2 expression and also genetic information.
Ultimately, this means someone diagnosed with stage 3 breast cancer can receive more information from their breast cancer staging than ever before.
No matter the stage, the best source of information about your individual outlook is your own oncology team.
Make sure you understand your breast cancer stage and subtype so that you can better understand treatment options and individual outlook.
Getting the right treatment and the support you need can help you navigate the challenges of being diagnosed with stage 3 breast cancer.
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What Is Stage 3 Triple Negative Breast Cancer
Typically, triple-negative breast cancer patients will receive a combination of surgery, radiation therapy, and chemotherapy.
Research shows that survival rates are higher when chemotherapy is used to shrink the tumor before surgery. Doing chemotherapy before surgery usually means fewer cancer cells in the body at the time time of surgery. This makes it less likely for cancer cells to spread to other areas of the body during the surgery.
Another option to treat triple-negative breast cancer is using drugs that inhibit the poly ADP-ribose polymerase enzyme. Particularly in patients that also test positive for BRCA mutation, PARP inhibitors make it harder for the cancer cells to survive.
Finally, a combination of immunotherapy and chemotherapy may treat advanced triple-negative breast cancer that tested positive for the PD-L1 protein. Immunotherapy helps the patients immune system work harder to fight the cancer cells, in this case also fighting the PD-L1 protein.
If you or someone you know has been diagnosed with triple-negative breast cancer, request an appointment to meet with one of our breast cancer specialists located in the Denver area, Colorado Springs, Boulder, and other areas throughout the Colorado Front Range. We are also happy to quickly schedule a second opinion to help you with making the cancer treatment decision youre confident in.
Triple Negative Breast Cancer Clinical Trial
Ongoing clinical trial tried to investigate effectiveness and safety of different possible treatment for future use and also has several clinical trials in the pipeline. The patient can also enroll their name in these trials to get novel therapies and also assist in research by providing the data to the research team. The different research aim is different, some are investigating new therapies to treat the patient, whereas some drugs may use in preventive therapy. Name registration for a clinical trial is the first step to enrolling name to the research3,4.
References
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The Tnm Staging System
The breast cancer staging system, called the TNM system, is overseen by the American Joint Committee on Cancer . The AJCC is a group of cancer experts who oversee how cancer is classified and communicated. This is to ensure that all doctors and treatment facilities are describing cancer in a uniform way so that the treatment results of all people can be compared and understood.
In the past, stage number was calculated based on just three clinical characteristics, T, N, and M.
The T category describes the original tumor:
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HER2 status: are the cancer cells making too much of the HER2 protein?
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Oncotype DX score, if the cancer is estrogen-receptor-positive, HER2-negative, and there is no cancer in the lymph nodes
Adding information about tumor grade, hormone-receptor status, HER2 status, and possibly Oncotype DX test results has made determining the stage of a breast cancer more complex, but also more accurate.
In general, according to experts, the new staging system classifies triple-negative breast cancer at a higher stage and classifies most hormone receptor-positive breast cancer at a lower stage.
You also may see or hear certain words used to describe the stage of the breast cancer:
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Distant: The cancer is found in other parts of the body as well.
The updated AJCC breast cancer staging guidelines have made determining the stage of a cancer a more complicated but accurate process. So, the characteristics of each stage below are somewhat generalized.
Want To Learn More About Your Breast Cancer Treatment Options Were Here For You
Whether you just received your diagnosis or youre looking for new treatment options, were here to help.
If youve just been diagnosed with breast cancer, your next stop will be to meet with a nurse navigator or breast surgeon, depending on your initial diagnosis, and start building your treatment plan. We offer cancer care clinic locations across the Twin Cities and western Wisconsin, so get started by selecting a location to make an appointment at.
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What Is A 5
A relative survival rate compares women with the same type and stage of breast cancer to women in the overall population.For example, if the 5-year relative survival rate for a specific stage of breast cancer is 90%, it means that women who have that cancer are, on average, about 90% as likely as women who dont have that cancer to live for at least 5 years after being diagnosed.
Survival Rates And Prognosis
The outlook for breast cancer is often described in terms of relative survival rates.
Relative survival rates are an estimate of the percentage of people who will survive their cancer for a given period of time after diagnosis. Survival among people with cancer is compared to survival among people of the same age and race who have not been diagnosed with cancer.
Five-year relative survival rates tend to be lower for triple-negative breast cancer than for other forms of breast cancer.
According to the American Cancer Society, the overall 5-year relative survival rate for TNBC is . However, an individuals outlook depends on many factors, including the stage of the cancer and the grade of the tumor.
Your healthcare professional will be able to give you a more precise outlook based on:
- the stage of your TNBC
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What Is Breast Cancer
Breast cancer occurs when cells in the breast become abnormal and grow out of control.
What Are Symptoms of Breast Cancer?
The American Cancer Societys warning signs and symptoms of breast cancer include:
- Swelling or thickening of the breast
- Irritation or dimpling of the breast skin
- Pain in any area of the breast
- Nipple turning inward
- Changes in the size or shape of the breast
- Skin changes on the breast: redness, scaliness, flaky skin, or thickening of the nipple or breast skin
- Nipple discharge that is not breast milk, including blood
- Lump in the underarm area
- Not all lumps in the breast are cancerous more than 80% are benign
- It is impossible to tell by feel only whether a lump is cancerous or not
- See a doctor if you notice any breast changes or lumps
How Does Staging Relate To Types Of Breast Cancer
In addition to cancer stage, doctors will determine the tumor grade and subtype.
Tumors are graded on a scale of 1 to 3, based on how abnormal the cells appear compared to normal cells. The higher the grade, the more aggressive the cancer, meaning that it tends to be growing quickly.
The subtype is important because treatment and outlook will vary depending on which subtype of breast cancer that you have. Subtypes include:
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What Are The Stages Of Invasive Ductal Carcinoma
Invasive ductal carcinoma is usually described through a numeric scale ranging from 1 to 4 . Specifically, the invasive ductal carcinoma stages are:
- Stage 1 A breast tumor is smaller than 2 centimeters in diameter and the cancer has not spread beyond the breast.
- Stage 2 A breast tumor measures 2 to 4 centimeters in diameter or cancerous cells have spread to the lymph nodes in the underarm area.
- Stage 3 More extensive cancer is found, but it is confined to the breast, surrounding tissues and lymph nodes.
- Stage 4 The breast cancer has metastasized to lymph nodes beyond the underarm area or to distant sites, such as the lungs, liver, bones or brain.
Survival Statistics For Breast Cancer
Survival statistics for breast cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular persons chances of survival.
There are many different ways to measure and report cancer survival statistics. Your doctor can explain the statistics for breast cancer and what they mean to you.
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How Do Physicians Assign Breast Cancer Stages
In general, breast cancer stages are established based on three key variables: the size of a tumor, the extent of lymph node involvement and whether the cancer has spread to other areas of the body. This information may be obtained through a combination of clinical examinations, imaging studies, blood tests, lymph node removal and tissue samples . If, based on the initial test results, a physician believes that the cancer may have spread to other parts of the body, further testing may be ordered, such as a bone scan, positron emission tomography scan or liver function test.
Diagnosis Of Invasive Lobular Carcinoma
The earlier youre diagnosed with ILC and start treatment, the better your outlook. As with other types of cancer, early stages of ILC are likely to be treated more easily with fewer complications. This typically but not always leads to a complete recovery and low recurrence rates.
But compared with the much more common IDC, early diagnosis of ILC can be a challenge. Thats because the growth and spread patterns of ILC are more difficult to detect on routine mammograms and breast exams. ILC tumors are likely to have multiple origins, and they grow in single-file lines rather than a lump.
The first step in a diagnosis of ILC is a breast examination. Your doctor will feel your breast for a thickening or hardening of the tissue. Theyll also look for any swelling in the lymph nodes under your arms or around your collarbone.
Other diagnostic tests may include:
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Is Triple Negative Breast Cancer An Aggressive Form Of Cancer
Its true that triple negative breast cancers can grow quickly. But your prognosis or expected outcome depends on more factors than your cancer subtype. Healthcare providers will also consider your tumors size and whether it has spread to your lymph nodes and other parts of your breast. Its also helpful to know researchers are focusing on ways to slow the spread of TNBC.
How Is Triple Negative Breast Cancer Diagnosed
The first step might be a mammogram to evaluate a suspicious mass or lump in your breast. Based on what they learn, healthcare providers might perform a biopsy to remove breast tissue. Then they examine the tissues cells to determine the cancer subtype. Identifying the cancer subtype is part of the staging process, which is when providers decide how to treat your cancer.
Sometimes providers use the following tests before treatment to check on your tumors size and whether it has spread, or after treatment to monitor response to treatment:
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Subtypes Of Invasive Lobular Carcinoma
The classic, or most common, ILC cells are small. They spread through the breast tissue one by one, in line formation, sometimes branching out like the limbs of a tree. The cells tend to look alike, and they have small nuclei that resemble each other.
Beyond the classic ILC cells, there are also subtypes of ILC cells. These cells do not form in this single-file pattern, which can be seen under a microscope. These subtypes can include:
- Solid: These cells form in large sheet formations, instead of the single-file lines of classic cell formation.
- Alveolar: These ILC cells grow in groups of 20 or more, rather than singly as the classic cells do.
- Tubulolobular: These cells form in small tube-like structures, in addition to the single-file structure seen in classic ILC cells.
There are additional ILC subtypes whose cells do not look like the classic ILC cancer cells. These subtypes include:
- Pleomorphic: These cancer cells are larger than the classic type, and their nuclei do not resemble each other.
- Signet ring cell: These cells are filled with mucus and have a shape that resembles a signet ring.
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Evaluation Of Chemotherapy Responses And Toxicities
The clinical response was assessed based on a physical examination, mammography, ultrasonography, MRI and CT according to the Response Evaluation Criteria In Solid Tumors version 1.1 criteria . A clinically complete response was defined as the disappearance of all known lesions a clinically partial response was defined as a 30% reduction in the sum of the longest diameter of the primary lesion progressive disease was defined as a 20% increase in the sum of the LD of the primary lesion and stable disease was defined as neither sufficient shrinkage to qualify for cPR nor sufficient increase to qualify for PD. The efficacy of NAC was examined in the surgical specimens, while the Ki-67 labeling index was examined in the pre-treatment biopsy specimens. The pathological response was assessed based on the histological changes in the invasive area by the Japanese Breast Cancer Society criteria . A pCR was defined as no residual invasive cancer in the breast tissue, regardless of the ALN status, while the grade 0 response indicated no cancerous degeneration. A grade 2 response was defined as 2/3 cancerous degeneration or a small amount of invasive cancer in the specimen, while a grade 1 response was defined as < 2/3 cancerous degeneration in the specimen. The number of involved ALNs was confirmed in the dissected ALN specimen by the pathologist. In addition, toxicities of the NAC were graded by the ECOG common toxicity criteria.
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What Is Stage Iii Breast Cancer
In stage III breast cancer, the cancer has spread further into the breast or the tumor is a larger size than earlier stages. It is divided into three subcategories.
Stage IIIA is based on one of the following:
- With or without a tumor in the breast, cancer is found in four to nine nearby lymph nodes.
- A breast tumor is larger than 50 millimeters, and the cancer has spread to between one and three nearby lymph nodes.
In stage IIIB, a tumor has spread to the chest wall behind the breast. In addition, these factors contribute to assigning this stage:
- Cancer may also have spread to the skin, causing swelling or inflammation.
- It may have broken through the skin, causing an ulcerated area or wound.
- It may have spread to as many as nine underarm lymph nodes or to nodes near the breastbone.
In stage IIIC, there may be a tumor of any size in the breast, or no tumor present at all. But either way, the cancer has spread to one of the following places:
- ten or more underarm lymph nodes
- lymph nodes near the collarbone
- some underarm lymph nodes and lymph nodes near the breastbone
What Does It Mean To Have Stage 3 Breast Cancer
Stage 3 cancer means the breast cancer has extended to beyond the immediate region of the tumor and may have invaded nearby lymph nodes and muscles, but has not spread to distant organs. Although this stage is considered to be advanced, there are a growing number of effective treatment options.
This stage is divided into three groups: Stage 3A, Stage 3B, and Stage 3C. The difference is determined by the size of the tumor and whether cancer has spread to the lymph nodes and surrounding tissue.
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