Hormone Receptor Status And Her2 Status
Triple negative IBC are hormone receptor-negative and HER2-negative. Triple negative IBC and IBC that are hormone receptor-positive and HER2-negative tend to have a worse prognosis than other IBC .
Hormone receptor-negative breast cancers, such as triple negative IBC, can be treated with chemotherapy, but they cant be treated with hormone therapy.
HER2-positive breast cancers can be treated with chemotherapy and with trastuzumab and other HER2-targeted therapies. So, women with HER2-positive IBC tend to have better survival than women with HER2-negative IBC .
When Should I Call My Doctor If I Am Concerned About Inflammatory Breast Cancer
If you notice any changes to your breast, even if you do not feel a lump, you should contact your doctor immediately. With further testing, your doctor can determine whether IBC may be a concern.
Last reviewed by a Cleveland Clinic medical professional on 10/27/2018.
References
- American Cancer Society. Accessed 11/1/2018.Inflammatory Breast Cancer.
- Breastcancer.org. Accessed 11/1/2018. Inflammatory Breast Cancer.
- The IBC Network Foundation. Accessed 11/1/2018.What is Inflammatory Breast Cancer?
- National Breast Cancer Foundation. Accessed 11/1/2018.Inflammatory Breast Cancer .
- National Cancer Institute. Accessed 11/1/2018.Inflammatory Breast Cancer.
Recurrence Of Metastatic Breast Cancer
Metastatic breast cancer is considered a chronic disease, so it doesnt go away and recur.
But in recent years, people under age 50 have seen a particularly strong decline in death rates due to breast cancer, according to the Centers for Disease Control and Prevention .
These declines are due in part to improved screening and treatment for the disease.
There are a few general facts that are helpful to know about breast cancer outlook:
- Breast cancer is the most common cancer diagnosis in the United States, according to the
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Screening For Breast Cancer
Women in the UK aged between 50 and 70 are invited to have a routine mammography every three years. This is gradually being extended to women aged 47-73.
Mammography is a special X-ray test and aims to detect breast cancer at an early stage when treatment is most likely to be curative. Read more about breast screening.
Genetic testing and mammography screening may also be offered to younger women with a strong family history of breast cancer. See your doctor if you feel this applies to you.
What Tests And Exams Do Health Care Professionals Use To Diagnose Inflammatory Breast Cancer
Mammography and imaging tests
Screening mammography has made it possible to detect many breast cancers before they produce any signs or symptoms. However, inflammatory breast cancer produces symptoms, so in the case of this cancer, the mammogram may be used to evaluate the breast when symptoms are present or to determine the location for a breast biopsy. Due to the rapid spread of the cancer, this cancer is sometimes found between the routine mammogram exams. Other imaging tests, including MRI, ultrasound, PET scans, and CT scans may be used to evaluate the breast if inflammatory breast cancer is suspected. A bone scan to look for spread to the bones may also be performed if a diagnosis of inflammatory breast cancer is confirmed.
Definitive diagnosis
The diagnostic guidelines for inflammatory breast cancer require that the following factors are present:
- A rapid onset of erythema , edema , and a peau d’orange appearance and/or abnormal breast warmth, with or without a lump that can be felt
- These symptoms have been present for less than six months.
- The redness covers at least one-third of the breast.
- A biopsy from the affected breast reveals invasive cancer.
Specialized testing on breast cancer samples
Certain laboratory tests are typically performed on all breast cancer tumor samples to help determine the optimum treatment. These include:
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Survival Rate By Stage
Breast cancer stage describes how far cancer has spread in your body. Different stages of breast cancer have different survival rates.
The SEER database does not use the American Joint Committee on Cancer TNM system for cancer stages that you may see on your pathology report. Instead, the SEER database uses stages known as localized, regional, and distant:
- Localized means there is no evidence that cancer has spread beyond the breast.
- Regional means that cancer was found in nearby lymph nodes or structures outside the breast.
- Distant means the cancer has traveled to remote parts of the body such as bones, liver, or lungs.
Here are the SEER relative 5-year breast cancer survival rates, from the American Cancer Society website:
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SEER stage |
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*These rates are based on women who were diagnosed between 2009 and 2015.
Its important to know that the survival rate for your type of breast cancer may be different than whats represented in this chart. Here are some reasons why:
- The numbers in this chart represent women diagnosed and treated at least 5 years ago. As treatments improve, survival rate numbers can change.
- The numbers you see here do not factor in certain cancer characteristics such as grade, hormone-receptor status, or HER2 status.
- These numbers also dont consider how well a cancer treatment may be working in your body.
Dilemmas Of Stage Iv Breast Cancer
Indeed, there are many serious and personal questions involving stage IV breast cancer. So, overall survival is less likely, and gains from intensive breast cancer treatment are unfortunately rather modest. A serious consideration is, therefore, quality of life during the course of treatment.
These decisions tend to be a dynamic process, based on individual cases, between patients and physicians. Respect needs to be given to the expectations for treatment, the status of the disease and the patient wishes.
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Is Stage 4 Breast Cancer Curable
Theres currently no cure for stage 4 breast cancer, but with treatments it can be kept under control, often for years at a time.
People with metastatic breast cancer need to receive treatments for the rest of their lives. If a certain treatment stops being effective, another treatment regimen may be tried.
How Is Invasive Ductal Carcinoma Diagnosed
Same Day Results
At the Johns Hopkins Breast Center, we know how quickly patients want results from a biopsy or scan if there is a suspicion of breast cancer. We follow strict guidelines for biopsies and pathology reports. Most of our patients will receive the probability of cancer immediately following their biopsy procedure and a pathology confirmation within 24 hours.
Learn more about the steps of diagnosis, including:
- Digital mammography
- Biologic targeted therapy
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Coping With Your Prognosis
Even if your healthcare team has told you that your prognosis is very good, its normal to feel worried sometimes about how long youll live. Fear of recurrence or cancer progression is extremely common after a diagnosis.
If youre dealing with anxiety or overwhelmed about your prognosis, youre not alone, and were here for you. Visit our page on coping with a new breast cancer diagnosis for information and tips on navigating different emotions and finding support.
How Survival Rate Is Estimated
Survival rates for all cancers are estimated by looking at data on large numbers of people who have a certain type of cancer. Researchers gather information about the people over periods of time, such as 5 years, 20 years, or longer.
Living Beyond Breast Cancer, like the American Cancer Society, uses U.S. survival rates based on data from the Surveillance, Epidemiology, and End Results Program, known as SEER, of the National Cancer Institute . The NCI works with the North American Association of Central Cancer Registries to gather this information from every state in the U.S. on an ongoing basis.
For breast cancer, the SEER database uses 5-year relative survival rates. A relative survival rate in breast cancer means that women who have the same stage and type of breast cancer are compared to women in the overall population who do not have cancer. For example, if women who have a certain stage and type of breast cancer are found to be about 90 percent as likely as women who dont have that cancer to live at least 5 years after being diagnosed, then the 5-year relative survival rate for the diagnosed women is 90 percent.
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What Are The Symptoms Of Ibc And When Do They Develop
IBC symptoms can develop in three to six months. They are a result of lymph vessels becoming blocked and white blood cells building up. These symptoms include:
- Large patches of redness
- Swelling and warmth on your breast
- Dimpling or a thickness to the skin, giving it the texture and appearance of an orange peel
- Flat, inverted, bruised-looking nipple
- Itching
- Generalized pain
These blockages may also cause the lymph nodes under your arm or around your collarbone to become swollen. If youre pregnant or breastfeeding, some of these symptoms might be mistaken for a common breast infection called mastitis. This is caused by breast tissue inflammation that usually affects people who are lactating, and they may or may not have an infection. You may initially be diagnosed with this condition and sent home with antibiotics. Its important to talk to your doctor if your symptoms dont go away in seven to 10 days.
Breast Cancer Type’ Is Determined By Cell Shape And Appearance
Breast cancers or carcinomas are mainly of epithelial cell origin.
Epithelial cells are the lining of most of our organs and vessels.
However, there are quite a few very rare types of breast cancers which are comprised of non-epithelial cells . Furthermore, a great many breast cancers are actually not pure, but rather a mixture of different types of cells.
In general, there are six types of standard breast carcinomas, and statistically, some of these tend to show a better prognosis than others.
The six most common types of breast cancer are as follows:-
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How Quickly Breast Cancer Develops
You may have heard remarks that cancer has been present for five years before it is diagnosed, and this may sometimes be true.
The actual time it takes for breast cancer to grow from a single cancer cell to a cancerous tumor is unknown, as estimates based on doubling time assume that this is constant throughout the duration of tumor growth.
If doubling time were constant, cancer with a doubling time of 200 days would take 20 years to develop into a detectable tumor, and a doubling time of 100 days would take 10 years to be evident on exam.
In contrast, a breast tumor with a doubling time of 20 days would take only 2 years to develop.
Since the majority of studies have found the average doubling time to be between 50 days and 200 days, it’s likely that most breast cancers that are diagnosed began at least 5 years earlier .
Targeted Therapies And Hormone Therapy
Many inflammatory breast cancers are HER2 positive, so treatment with HER2-targeted therapies can be effective in controlling the tumor. These drugs are usually given along with the other treatments after a diagnosis of IBC. If the cancer is sensitive to estrogen, hormone therapy may also be an option.
Most inflammatory breast cancers are estrogen receptor and progesterone receptor negative, so hormonal therapy with tamoxifen or aromatase inhibitors isn’t commonly used.
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How Fast Breast Cancer Grows
People may wonder about growth or doubling time when considering how long to wait to begin treatment. This growth is also very important to understand if you have a lump and have been advised to simply observe it over time.
Unless your healthcare provider is extremely confident that a lump is benign, it should be evaluated right away rather than waiting.
In general, the growth of breast cancer can be quite variable, but several studies provide at least an estimate of what may be happening.
A Disease No One Gets
Sadly, people donât âgetâ mets. In fact, a recent survey sponsored by Pfizer Oncology shows just how misunderstood it is. Sixty percent of the 2,000 people surveyed knew little to nothing about MBC while 72 percent believed advanced breast cancer was curable as long as it was diagnosed early. Even more disheartening, a full 50 percent thought breast cancer progressed because patients either didnât take the right treatment or the right preventive measures.
âTheyâve built an industry built on four words â early detection equals cure â and that doesnât even begin to define breast cancer,â said Schoger, who helped found Breast Cancer Social Media, a virtual community for breast cancer patients, caregivers, surgeons, oncologists and others. âWomen are blamed for the fate of bad biology.â
The MBC Alliance, a consortium of 29 cancer organizations including the biggest names in breast cancer , addressed this lack of understanding and support as well as what many patient advocates term the underfunding of MBC research in a recently published landmark report.
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What Is Carcinoma In Situ
Some people are diagnosed when the cancerous cells are still totally within a duct or lobule. These are called carcinoma in situ , as no cancer cells have grown out from their original site.
- Ductal carcinoma in situ is the most common type of non-invasive breast cancer and about 1 in 5 new breast cancer cases will be DCIS. A carcinoma in situ is easier to treat and has a better outlook than an invasive cancer.
- Lobular carcinoma in situ results in abnormal cells in the milk producing glands of the breasts. These cells rarely spread outside of the lobules to other parts of the breast or body.
Other Symptoms And Signs Of Breast Cancer
Other signs which may be noticed in the affected breast include:
- Changes in the size or shape of a breast.
- Dimpling or thickening of some of the skin on a part of a breast.
- The nipple turning in .
- Rarely, a discharge occurring from a nipple .
- A rare type of breast cancer, causing a rash around the nipple, which can look similar to a small patch of eczema.
- Rarely, pain in a breast. Note: pain is not a usual early symptom. Many women develop painful breasts and this is not usually caused by cancer.
The first place that breast cancer usually spreads to is the lymph glands in the armpit . If this occurs, you may develop a swelling or lump in an armpit. If the cancer spreads to other parts of the body then various other symptoms can develop.
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Why Breast Cancer Survival Rates Are Going To Be Higher Than The Most Up
It is important to remember that the breast cancer survival rates that are listed on this page are, in reality, going to be higher.
This is because the breast cancer survival rates data is gathered from a large number of people with the disease over a 5 year period. Hence, even the most up-to-date statistics are still going to be a little out of date.
Thus, with the ongoing improvements and advancements in breast cancer screening, research, early detection and advanced tailored treatment, the outcomes at present will be even better than the statistics listed here.
Triple Negative Breast Cancer
With this type of breast cancer, the breast cancer cells dont have ER+ or PR+ receptors. They dont overproduce the HER2 protein, so hormone therapy isnt very effective.
Instead, triple negative stage 4 breast cancer is usually treated with chemotherapy. Radiation therapy may also be an option, depending on the site of metastasis.
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Stages Of Inflammatory Breast Cancer
This type of cancer is usually in one of three stages:
- Stage IIIB: All Inflammatory breast cancers start in this stage since they involve the skin of your breast.
- Stage IIIC: This cancer has spread to lymph nodes around your collarbone or inside your chest.
- Stage IV: The cancer has spread outside your breast and nearby lymph nodes to other parts of your body.
How Is Ibc Treated
Treatment for IBC usually starts out with chemotherapy, followed by surgery and breast cancer radiation therapy.
- Recommendations for chemotherapy cycles average six cycles over a span of four to six months.
- Radiation therapy is generally given five days a week for five to six weeks.
The goal of chemotherapy for breast cancer is to shrink the tumor or tumors as much as possible before surgery so the oncologist can surgically remove as much cancer as possible. If your cancer is HER2-positive, you may also undergo a targeted therapy. If your hormone receptor status was positive, your provider may suggest hormone therapy.
A mastectomy is usually indicated for people with IBC, and if your provider finds cancer in the lymph nodes, these organs may be surgically removed as well. Many people with IBC have radiation therapy following surgery. Its possible to have breast reconstruction, but because radiation therapy is so important in IBC, its recommended to wait until after your radiation is finished.
Consider getting a second opinion or even several opinions to be sure youre comfortable with your surgical team and that youre getting the information you need to make a decision thats right for you.
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Stage Iv Breast Cancers May Be Recurrences Following Initial Treatment
Up to 5% of initial breast cancer diagnoses are of the most advanced or metastatic stage. However, this number has significantly reduced with the implementation of widespread breast cancer screening programs.
Metastatic breast cancer can appear to be a rapid deterioration of a disease that has been present for some time undetected.
But metastatic breast cancer can also be the result of a recurrence of breast cancer after successful initial treatment. Sometimes the terms local and regional recurrence indicate a return of breast cancer to the original tumor site or elsewhere in the breast or contralateral breast.
If the cancer returns in other areas of the body it is a distant metastasis or distant recurrence.
For more detail on Stage IV survival rates, recurrence rates and treatment please see our new post HERE.