How Long Before Recurrence Is Off The Table
Recurrence is a risk for up to 32 years after a first diagnosis of breast cancer, according to a recent study. Your risk of recurrence after 10 years of remission depends on a number of things like:
- The size of the tumor
- The number of lymph nodes with cancer
- Whether cancer is estrogen receptor-positive
In general, once you have a breast cancer diagnosis, even if you are years in remission, its a good idea to be watchful and consult your doctor for regular breast exams and other screenings they think are appropriate. Early detection is the best way to get the best outcome from treatment. Talk to your doctor about the best schedule of checkups for you.
What Type Of Breast Cancer Is Most Likely To Recur
Among patients who were recurrence-free when they stopped endocrine therapy after five years, the highest risk of recurrence was for those with originally large tumors and cancer that had spread to four or more lymph nodes. These women had a 40 percent risk of a distant cancer recurrence over the next 15 years.
Impact Of Late Recurrence
The impact of late distant recurrence cannot be stressed enough. Once breast cancer is metastatic, it is no longer curable. While there are some long term survivors with stage 4 breast cancer , the average life expectancy is currently only around three years.
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Outlook For People With Stage 3 Breast Cancer
Its natural to want to know your outlook, but statistics dont tell the whole story. Your breast cancer type, overall health, and many more factors beyond your control may affect treatment outcomes.
Establishing open communication with your treatment team can help you best assess where you are in your cancer journey.
Support groups can be a great source of comfort as you navigate your diagnosis through your treatment and beyond. Your doctors office or hospital can offer some suggestions and resources in your area.
Keep Reaching Out To Friends And Loved Ones
even if they seem to be retreating from you. I found that the more I felt them retreating, the less I would reach out, thinking they just dont want to deal with this. After some experience, I realize a lot of people just dont know how to help or communicate. You will need your friends and family even if it is just to go shopping with you or to a movie. Dont get caught in the cycle of retreating as they do or you will be very lonely. artistatheart
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Additional Tools For Diagnosing Advanced Breast Cancer
The additional tools below are often used specifically for diagnosing advanced cancer:
Sentinel lymph node biopsy: This procedure removes sentinel lymph node cells during surgery for examination. When breast cancer spreads, it often heads first to the lymph nodes.
Chest X-ray: This detailed image of the chest may help doctors see whether cancer has spread to the bones.
Computed tomography scan: Also known as a CAT scan, this procedure takes detailed pictures of internal areas of the body using a computer linked to an X-ray machine. A dye may be used to help the organs show up more clearly in the images.
Bone scan: This procedure looks for bone metastasis, or cancer cells that have spread to the bone. A small amount of radioactive material is injected into the blood, then detected with a scanner.
Positron emission tomography scan: A PET scan is a detailed imaging tool that uses a radioactive drug, known as a tracer, to search for cancer cells within your body.
Managing Treatment Side Effects
Breast cancer treatments can cause a variety of side effects. Some side effects may be short-lived and resolve on their own. Others may require treatment to manage.
For example, a persons doctor may:
- adjust their medication regimen if they develop side effects from medication
- refer them to a physical or occupational therapist if their physical function declines after treatment
- recommend breast reconstruction surgery if they are dissatisfied with the shape or look of their breast following breast cancer surgery
Breast cancer and cancer treatments may also affect a persons mental health. If they are experiencing mental health challenges, their doctor may prescribe medication, counseling, or a combination of both.
A person should let their doctor know about any changes in their physical or mental health during follow-up appointments, even if they are not certain that the changes are related to breast cancer or cancer treatments. Some treatment side effects may take months or years to appear.
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Breast Cancer May Return Even 20 Years Later Researchers Find
This means women with the most common type of breast cancer, called estrogen-positive or hormone-positive breast cancer, need to think carefully about whether they want to stop taking the pills, even if they cause side-effects, doctors said.
These breast cancers have a lingering smoldering quality and carry substantial risk of late recurrence after five years of therapy, said Dr. Harold Burstein of the Dana Farber Cancer Institute, who was not involved in the study.
Many patients think. OK, I made it to five years. I know Im safe, said Dr. Jennifer Litton, an oncologist at the MD Anderson Cancer Center. But for estrogen-receptor positive breast cancer, its a continued lifelong risk.
Breast cancer is the second-biggest cancer killer of American women, after lung cancer. The American Cancer Society says every year, it’s diagnosed in 200,000 women and a few men, and kills around 40,000.
Most breast cancers are fueled by estrogen, and drugs called hormone blockers are known to cut the risk of recurrence in such cases.
Tamoxifen long was the top choice, but newer drugs called aromatase inhibitors sold as Arimidex, Femara, Aromasin and in generic form do the job with less risk of causing uterine cancer and other problems. The longer women take them, the lower their risk of having the cancer come back.
However, they do cause side-effects.
There Are Good Days And Bad Days
There are days when I say to myself, Ive had enough. I cant take it anymore, says Rosen. But I want to keep on living. I love my life. Overall, I have a great life except for the cancer.
Rosen has a few mantras she uses when things get tough. A lot of the tough times are treatment related, she says. I refer to those as bumps in the road, and , This too shall pass.
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Why Cancer Cells Tend To Spread To The Parts Of The Body They Do
Where a cancer starts is linked to where it will spread. Most cancer cells that break free from the primary tumor are carried in the blood or lymph system until they get trapped in the next downstream organ or set of lymph nodes. This explains why breast cancer often spreads to underarm lymph nodes, but rarely to lymph nodes in the belly. Likewise, there are many cancers that commonly spread to the lungs. This is because the heart pumps blood from the rest of the body through the lungs blood vessels before sending it elsewhere.
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How Serious Is Your Recurrence
The more your cancer spreads from the original tumor, the more serious it is likely to be. Your cancer may be local, regional, or distant:
Local: The cancer comes back in the same breast as the original tumor.
Regional: Here, the cancer returns to the same area as the original tumor, but in a more expanded sense that includes the armpit or collarbone lymph nodes.
Distant: This is what doctors call metastatic cancer or stage IV breast cancer. Here, the cancer shows up far away from the original tumor in places like the bones, lungs, brain, or other areas.
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What Is Breast Cancer Recurrence
Its when your cancer comes back after treatment. It can happen a year after you finish treatment for breast cancer, or 5, 10, even 20 years later. You find another lump, or a shadow appears on your mammogram. Is the cancer back?
Every woman who’s had breast cancer knows that recurrence is possible. Some may do a better job than others at keeping that worry at bay. But sometimes — such as at follow-up visits with the oncologist — it’s hard to avoid.
Survival Rates For Breast Cancer
Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time after they were diagnosed. They cant tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful.
Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. These statistics can be confusing and may lead you to have more questions. Talk with your doctor about how these numbers may apply to you, as he or she is familiar with your situation.
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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.
Breast Cancer Recurrence Risk Lingers Years After Treatment Ends
Even 20 years after a diagnosis, women with a type of breast cancer fueled by estrogen still face a substantial risk of cancer returning or spreading, according to a new analysis from an international team of investigators published in the New England Journal of Medicine.
Standard treatment for estrogen receptor-positive, or ER-positive, breast cancer includes five years of the endocrine-based treatments tamoxifen or aromatase inhibitors, both of which are a taken daily as a pill.
Researchers from the Early Breast Cancer Trialists’ Collaborative Group analyzed data from 88 clinical trials involving 62,923 women with ER-positive breast cancer. The patients all received endocrine therapy for five years and were free of cancer when they stopped therapy.
Over the next 15 years, however, a steady number of these women saw their cancer spread throughout the body, as late as 20 years after the initial diagnosis.
“Even though these women remained free of recurrence in the first five years, the risk of having their cancer recur elsewhere from years five to 20 remained constant,” says senior study author Daniel F. Hayes, M.D., Stuart B. Padnos Professor of Breast Cancer Research at the University of Michigan Comprehensive Cancer Center.
The risk of recurrence was directly tied to the original cancer’s size and characteristics, and to the number of lymph nodes that were cancerous.
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Working Around Side Effects
When it comes to better compliance, Klein said two things must be considered: quality-of-life complaints and real long-term toxicities.
For the nagging quality-of-life issues there are non-hormonal remedies for many of them. You need to first establish that the complaints are related to the medicine. They may be age-related, she explained.
Klein said that postmenopausal women who cant tolerate one AI may do better with a different one. And premenopausal women who cant tolerate tamoxifen have other options as well.
The most serious side effects of tamoxifen are higher risk of uterine cancer and blood clots. AIs can cause accelerated bone loss. Both share all the quality of life issues: vaginal dryness, hot flashes, night sweats, and changes to mood, weight, and sexual desire. Change of life stuff, said Klein.
Integrative Subtypes And Late Recurrence
Researchers recently developed a model to identify 11 integrative subtypes of breast cancer with different risks and timing of recurrence, according to the findings of a 2019 study published online in Nature.
Four integrative subtypes were identified that were associated with a high risk of late recurrence . Altogether, these four subtypes accounted for roughly 26% of breast cancers that were estrogen receptor-positive and HER2 negative.
These subtypes included tumors that had an enriched copy number alterations in genes that are thought to drive the growth of cancer , including:
They were also able to identify a subgroup of triple-negative tumors that were unlikely to recur after five years as well as a subgroup in which people continue to be at risk of late recurrence. A Breast Cancer Recurrence Calculator including integrative subtypes has been developed but, at the current time, this is meant for research purposes alone.
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What Are The Chances Of Breast Cancer Recurrence After Treatment For Stage 2 Breast Cancer
In women who have breast-conserving treatment, the chance of recurrence is about 3-15% in 10 years, depending on tumor characteristics and margins. Distant recurrence in those who had mastectomy is most influenced by axillary lymph node involvement. When axillary lymph nodes are not cancerous, the recurrence rate is 6% in 5 years. When axillary lymph nodes are cancerous, the recurrence rate is 23% in 5 years with mastectomy but no radiation.
How Can I Prevent Breast Cancer Recurrence
Healthcare providers dont know why some people experience breast cancer recurrence. A recurrence isnt your fault. You didnt do anything wrong to cause it or fail to do something more to prevent it.
Certain medications may reduce the risk of breast cancer recurrence in people who have early stage breast cancer. For estrogen-receptive breast cancer, hormonal therapies including tamoxifen or aromatase inhibitors block either the activity of estrogen or the bodys production of estrogen. Chemotherapy may also be recommended to reduce risk of breast cancer recurrence.
Early diagnosis may make it easier to treat a recurrence. Follow your healthcare providers recommendations for mammograms and other screenings. You should also perform regular breast self-exams. Get familiar with how your breasts look and feel so you can see your provider quickly if you notice changes. And remember that most breast changes occur for reasons other than cancer.
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Stage : Kim Green Has Lived With Metastatic Breast Cancer For Past 19 Years
Kim Green defies the odds for those living with incurable metastatic breast cancer. Her mother died of metastatic breast cancer at 37, but Green has been living with it for 19 years.
Green has endured more than 60 surgeries since she found a lump in her breast when she was 34 and six months pregnant. Doctors got clean margins after performing a lumpectomy. Shortly afterward she gave birth to her son, born prematurely. She began chemo treatments a week after his birth, followed by a bilateral mastectomy.
Yet, four months after treatment ended, she woke up one morning with a tumor on her neck the size of a golf ball.
When cancer spreads from its original source to another part of the body, its metastatic or stage 4 cancer. There is no cure for metastatic breast cancer, and the median life expectancy is 24 months. The number of metastatic breast cancer patients living longer and well with the disease keeps inching up, doctors say. But ultimately, people die from it.
People with stage 4 breast cancer live longer because of new and better drugs that prolong the time when people feel good. There have been 15 new drugs in the past 15 years, says Dr. Lajos Pusztai, director of Breast Cancer Translational Research at the Yale Cancer Center and professor of medicine at Yale School of Medicine.
Survival For All Stages Of Breast Cancer
Generally for women with breast cancer in England:
- Around 95 out of every 100 women survive their cancer for 1 year or more after diagnosis
- Around 85 out of every 100 women will survive their cancer for 5 years or more after diagnosis
- Around 75 out of every 100 women will survive their cancer for 10 years or more after diagnosis
Cancer survival by stage at diagnosis for England, 2019Office for National Statistics
These statistics are for net survival. Net survival estimates the number of people who survive their cancer rather than calculating the number of people diagnosed with cancer who are still alive. In other words, it is the survival of cancer patients after taking into account that some people would have died from other causes if they had not had cancer.
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Your Journey After Treatment
Today, there are more breast cancer survivors in the United States than any other group of cancer survivors. Three million, to be exact. This staggering number means that in some way, breast cancer has probably touched the lives of at least a couple people you know. And it also means that more and more people are benefiting from early detection and advances in treatment. These days, breast cancer survivors often live long, satisfying, happy lives. Here are a few tips for embracing your new normal and inspiring others along the way.