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:
There are three grades of invasive breast cancer:
- Grade 1 looks most like normal breast cells and is usually slow growing
- Grade 2 looks less like normal cells and is growing faster
- Grade 3 looks different to normal breast cells and is usually fast growing
Sometimes the grade given to a cancer after a biopsy can change after surgery. This is because after surgery theres more tissue for the pathologist to look at, which can give them more detailed information about the cancer.
Treatments For Stage 4 Breast Cancer
The following are treatment options for ductal carcinoma and lobular carcinoma. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.
Stage 4 means that the breast cancer has spread to other parts of the body. It is also called advanced breast cancer, or metastatic breast cancer. Treatments cannot completely cure metastatic breast cancer, but they can control it very well, sometimes for many years. Doctors may offer one treatment until it stops working and then give another one.
The treatments offered for stage 4 breast cancer depend on the hormone-receptor status and the HER2 status of the cancer cells. They will also depend on where the cancer has spread, if it is causing any symptoms and your overall health.
The Types Of Radiotherapy
The type of radiotherapy you have will depend on the type of breast cancer and the type of surgery you have. Some women may not need to have radiotherapy at all.
Types of radiotherapy include:
- breast radiotherapy after breast-conserving surgery, radiation is applied to the whole of the remaining breast tissue
- chest-wall radiotherapy after a mastectomy, radiotherapy is applied to the chest wall
- breast boost some women may be offered a boost of high-dose radiotherapy in the area where the cancer was removed however, this may affect the appearance of your breast, particularly if you have large breasts, and can sometimes have other side effects, including hardening of breast tissue
- radiotherapy to the lymph nodes where radiotherapy is aimed at the armpit and the surrounding area to kill any cancer that may be in the lymph nodes
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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.
What Is Stage 0 Lcis
Lobular carcinoma in situ at Stage 0 generally is not considered cancer. Although it has carcinoma in the name, it really describes a growth of abnormal but non-invasive cells forming in the lobules. Some experts prefer the name lobular neoplasia for this reason because it accurately refers to the abnormal cells without naming them as cancer. LCIS, however, may indicate a woman has an increased risk of developing breast cancer.
If you have been diagnosed with LCIS, your doctor may recommend regular clinical breast exams and mammograms. He or she may also prescribe Tamoxifen, a hormone therapy medication that helps prevent cancer cells from growing.
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What Is Stage 3 Breast Cancer
Also known as locally advanced breast cancer, the tumor in this stage of breast cancer is more than 2 inches in diameter across and the cancer is extensive in the underarm lymph nodes or has spread to other lymph nodes or tissues near the breast. Stage 3 breast cancer is a more advanced form of invasive breast cancer. At this stage, the cancer cells have usually not spread to more distant sites in the body, but they are present in several axillary lymph nodes. The tumor may also be quite large at this stage, possibly extending to the chest wall or the skin of the breast.
Stage 3 breast cancer is divided into three categories:
Stage 3A: One of the following is true:
- No tumor is found in the breast, but cancer is present in axillary lymph nodes that are attached to either other or other structures, or cancer may be found in the lymph nodes near the breast bone, or
- The tumor is 2 cm or smaller. Cancer has spread to axillary lymph nodes that are attached to each other or other structures, or cancer may have spread to lymph nodes near the breastbone, or
- The tumor is 2 cm to 4 cm in size. Cancer has spread to axillary lymph nodes that are attached to each other or to other structures, or cancer may have spread to lymph nodes near the breast bone, or
- The tumor is larger than 5 cm. Cancer has spread to axillary lymph nodes that may be attached to each other or to other structures, or cancer may have spread to lymph nodes near the breastbone.
Available Cancer Treatment Options
The current survival rate for cancer patients is about five years after that period, your cancer will either worsen. Five years is the typical survival rate for most cancer types, that doesnt mean that it cant come back after that period its just that the odds are very low.
To make a decisive decision, speak with your medical care professional to discuss what treatment options are available for your specific cancer.
People Also Ask
Q: What type of cancer is curable?A: several forms of cancer are curable, including lung cancer, prostate cancer, breast cancer, pancreatic cancer, and colon cancer. Curing depends heavily on early diagnosis, the earlier you catch cancer, the higher your survival odds are.
Q: How long can you live with cancer? A: the most common cancer survival rate period is five years once you reach this point, your cancer has pretty much reached its peak. If you have not experienced any fatal symptoms yet, you likely wont again. However, that doesnt mean that the odds of cancer growing back is completely gone.
Q: Can stage 1 cancer be cured?A: yes, stage 1 cancer is one of the most curable forms of cancer however, often, it doesnt require immediate treatment.
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Types Of Stage 1 And 2 Breast Cancer
The most common types of invasive breast cancers are named after the area of the breast where they begin. Types of early breast cancers include:
- Invasive ductal carcinoma IDC means that the cancer originated in the milk ducts of the breast, and has spread into the surrounding breast tissue. IDC is the most common type of breast cancer, accounting for 80% of all breast cancers.
- Invasive lobular carcinoma ILC means that the cancer originated in the milk-producing lobules of the breast, and has spread into the surrounding breast tissue. ILC is the second most common type of breast cancer, and accounts for 10% of breast cancers.
- There are also other less common forms of invasive breast cancer, such as inflammatory breast cancer and Pagets disease of the nipple. For more information on the various types of invasive breast cancer, including the less common forms, please visit Types of Breast Cancer page.
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Selection Of Patients With Metastatic Breast Cancer For Potentially Curative Treatment
Currently, potentially curative treatment is generally considered in patients with metastatic breast cancer only if the disease is oligometastatic. Multiorgan involvement is usually considered a contraindication to potentially curative treatment except in patients with indolent lesions, like bone metastases, whose other sites of disease can be controlled locally with surgery and/or radiation.
Studies to date suggest that in addition to oligometastatic disease, there are several other features common to the patients who are most likely to benefit from a potentially curative approach: young age, good performance status, adequate body functional reserve, long disease-free interval before recurrence , and low systemic tumor load .
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How Is Stage 4 Breast Cancer Treated
The aim of treatment is to improve the quality and length of life of people with stage 4 breast cancer. Each person will be treated differently based on the disease characteristics and the intended goals of treatment.
Most treatments aim at decreasing the tumor burden and stabilizing the disease. In general, stage 4 cancer treatmentsalthough they may extend life in a significant number of peopleare considered palliative . This is because only a handful of people treated at this stage are cured of their disease.
Stage 4 Breast Cancer Survivor Stories
Following are stories from two survivors of breast cancer, told in their own narrative.
“I am Kathy from Littleton, Colorado. I had been a successful hairstylist till the March of 2013. I was used to the occasional back ache as I did most of my work standing up, but one day the backache was so bad I had to go to the hospital to get some relief. After getting an MRI, I received the news that I had stage four breast cancer that had metastasized in my bones. My stage 4 breast cancer life expectancy was only two months. When looking for treatment, I found the University of Colorado Anchutz Cancer Center. For a year I went through chemotherapy once a week, three biopsies and three rounds of radiation. After two years, I am still battling my cancer while living a healthy life. My doctors call this a miracle as I go to the gym five days a week, work for various cancer awareness organizations and recently started a new business.”
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Can The Cancer Stage Change
Once diagnosed, a cancers stage never changes. Even if the patient improves or gets worse, their cancer is the same as when diagnosed.
Once diagnosed with stage 4 cancer, you will always have stage 4 cancer. That doesnt mean that you cannot sustain a long period of disease-free survival.
Part of the reason for this is statisticalstages help scientists track and reevaluate survival statistics and treatment protocols. But they also let doctors track the efficacy of treatments for your stage.
Doctors use cancer stages to compare patients with similar diagnoses, to more easily study the effectiveness of treatments, to track a persons cancer progression, and as a way to estimate survival rates for specific cancers.
Part of the confusion regarding staging status arises from the fact the disease is sometimes re-staged. Re-staging determines if there has been a progression or remission of the disease.
If cancer is re-staged or recurs , doctors keep the initial staging diagnosis and add a new stage to the patients diagnosis. New staging diagnoses get differentiated with letterslike c for clinical, p for pathological , or y for after treatment.
For instance, stage 2 breast cancer that suddenly spreads to the lungs is stage 2 breast cancer with lung metastases rather than stage 4 breast cancer. Similarly, if stage 4 breast cancer meets the definition of remission after treatment, they describe it as stage 4 breast cancer with no evidence of disease.
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Regional Recurrence Within Three Years Carries A Less Favorable Prognosis But Overall Survival Statistics Are Still Good
Generally speaking, if the breast cancer returns regionally lymph nodes) within the first five years following original treatment, the overall likelihood of survival is thought to be somewhat poorer.
Five-year overall survival after an isolated chest wall recurrence is 68% and after intra-breast recurrence it is 81%.
In one 2010 medical research study, the ten year overall survival rate was estimated at 84% for women without recurrence. However, this figure goes down to 49% for women with a locoregional recurrence and 72% for women with a second primary tumour.
A large 2015 study examined the impact of the time of the disease free interval on survival rates. For women with a locoregional recurrence that happened in the first 18 months, the ten year overall survival rate is around 30%. The overall 10 year survival rate for those whose recurrence happened within 3 years goes up to 50%. Furthermore, for those who suffered a recurrence after 3 years the ten year overall survival rate increases to 70%.
This recent study clearly demonstrates that the longer the time span since the primary prognosis and treatment to the recurrence, the better the long-term prognosis.
The rate of distance breast cancer metastasis and overall survival is most favorable for women in which the recurrence occurred locally and after five years.
However, women with a same-breast recurrence within five years have a distant metastasis rate of about 61%, which are slightly poorer odds.
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Many Women Live For Decades With Metastatic Breast Cancer
A stage 4 diagnosis is not an instant death sentence, says Renee Sendelbach, 40, from Austin, Texas, who was diagnosed seven years ago, when she learned that her breast cancer had moved into her lungs, bones, and lymph nodes.
Ive had metastatic breast cancer for five years and Im still kicking, says Susan Rosen, 53, from Franklin, Massachusetts.
According to a 2017 article in the journal Cancer Epidemiology, Biomarkers & Prevention, 34 percent of women diagnosed with metastatic breast cancer have been living with the disease for five years or longer.
The goal of treatment is to keep patients on their feet as long as possible so that they can continue to do what they want to do, says Gretchen Kimmick, MD, associate professor of medicine at the Duke Cancer Institute in Durham, North Carolina.
In recent years, treatment for breast cancer has vastly improved, largely because doctors are able to more accurately target therapy to the type of breast cancer a woman has. The discovery of the HER2 protein and medicines that block it has revolutionized treatment for women with cancers that overexpress this protein, Dr. Kimmick says. This cancer was pretty deadly two decades ago, and now we are starting to debate if weve cured it in some women.
What Is Metastatic Cancer
In metastasis, cancer cells break away from where they first formed , travel through the blood or lymph system, and form new tumors in other parts of the body. The metastatic tumor is the same type of cancer as the primary tumor.
Cancer that spreads from where it started to a distant part of the body is called metastatic cancer. For many types of cancer, it is also called stage IV cancer. The process by which cancer cells spread to other parts of the body is called metastasis.
When observed under a microscope and tested in other ways, metastatic cancer cells have features like that of the primary cancer and not like the cells in the place where the metastatic cancer is found. This is how doctors can tell that it is cancer that has spread from another part of the body.
Metastatic cancer has the same name as the primary cancer. For example, breast cancer that spreads to the lung is called metastatic breast cancer, not lung cancer. It is treated as stage IV breast cancer, not as lung cancer.
Sometimes when people are diagnosed with metastatic cancer, doctors cannot tell where it started. This type of cancer is called cancer of unknown primary origin, or CUP. See the Carcinoma of Unknown Primary page for more information.
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Stage 4 Cancer Prognosis
After a stage 4 cancer diagnosis, its normal to want to learn more about survival rates. Survival rate estimates for patients with cancer vary based on several factors, including:
- Type of cancer
- Overall health before beginning cancer treatment
- Grade of the cancer
Although the overall prognosis may be poor based on cases with previous patients and older treatments, many patients with stage 4 cancer can live for years.
A few factors to keep in mind:
- Many treatments are available to help fight cancer.
- Your bodys response to treatment may differ from that of others.
- Youll be able to share decision-making with your care team at each stage of treatment.
Advanced cancer treatments may be used to help treat symptoms, slow the cancers growth and improve quality of life. Additionally, having the appropriate support for you and your family can make a big difference.
Mortality Rates Versus Number Of Breast Cancer Deaths
Sometimes its useful to have an estimate of the number of people expected to die from breast cancer in a year. This numbers helps show the burden of breast cancer in a group of people.
Numbers, however, can be hard to compare to each other. To compare mortality rates in different populations, we need to look at mortality rates rather than the number of breast cancer deaths.
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