Treatment Of Stage Iii Breast Cancers
Sometimes large breast cancers invade into muscles or attach to major arteries, veins or nerve trunks, which makes them impossible to surgically remove completely.
So, for these patients, the treatment usually starts with radiation or chemo to try to shrink it first, before surgery. But even a large tumor that has not attached itself onto muscle can, sometimes, be completely removed. There is no direct relationship between tumor size and whether or not it may be treated surgically or not.
Obviously, Stage 3 breast cancers that surgeons can completely remove do tend to have a significantly better prognosis than inoperable stage 3 breast cancers. However, some breast tumors, particularly those that are ER-positive, respond very well to chemotherapy. So well, in fact, that they actually downstage.
So, it is difficult to predict the overall prognosis for stage 3 breast cancer, as it will vary from individual to individual. If the response to chemotherapy is favorable, the overall survival rate is around 72%.
Determining The True Stage Of Breast Cancer
All the diagnostic tests and scans up to this point have been critical for helping your doctors understand your disease. But the exact stage of cancer cant be determined until surgery happens which is sometimes referred to surgical staging or pathological staging.
Breast surgery is usually the first step in Stages 0-2, and sometimes Stage 3 breast cancer. Surgery allows your surgeon to see whats happening inside your body. It also allows them to remove cancerous tissues which is an important step in preventing the cancer from spreading and determining next steps for your treatment.
If surgery cant be done right away or at all, a clinical stage is given instead based on diagnostic imaging test results, biopsy pathology results, and a physical exam.
Certain Breast Cancer Subtypes Have A Better Statistical Prognosis
In general, tubular, mucinous and medullary breast carcinomas have a better prognosis than the other sub-types.
The table below gives a very general approximation of the survival rates that may be associated with the different breast cancer subtypes.
However, please bear in mind that these figures are a rough generalization only and survival will always be determined by the individual characteristics of each breast cancer and each patient.
Nonetheless, the relative aggressiveness of the different breast cancer subtypes can be interpreted from the table.
and is almost always near 100% curable.)
|breast cancer sub-type|
|Inflammatory breast carcinoma||65% 35%|
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Age At The Time Of Diagnosis Affects Breast Cancer Survival Rates
It has always been known that curiously, young women have a poorer prognosis than older ones
Indeed, one cohort study examined 4,453 women with breast cancer between 1961 and 1991 who were all treated at the same center.
This study found that both ends of the age spectrum fared less well. So, women under the age of 40 years at diagnosis and those over 80 years had a statistically poorer prognosis.
However, for younger women, this may be due to the fact that they often present with higher-grade tumors that tend to be more aggressive and less likely to be hormone receptor-positive. This means that breast cancer may not respond as well to treatment.
So, it is important to bear in mind other factors discussed in this post, such as stage, grade and hormone receptor status play an important role in prognosis.
What Can I Expect While Living With Metastatic Breast Cancer
Your care team will monitor you every few months to check if the cancer is responding to treatment, and also to see if you are having any side effects. The process of restaging the cancer includes:
- History/physical exam.
- Blood tests.
- Imaging tests, including CTs and bone scan or PET scan.
Before your scans or tests, its normal to feel anxiety. It may help to bring a friend or family member to the appointment with you.
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What Is Stage 0
Stage 0 is the least invasive stage of breast cancer and usually detected early in patients, according to the American Cancer Society. In this stage, cancer cells or non-cancerous abnormal cells are only in the part of the breast in which they formed and haven’t spread.
“At this stage of breast cancer, we tell patients not to be too worried. Stage 0 is extremely treatable and we ask people not to shed a tear over the diagnosis just yet,” said Cruz.
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Survival Rates Of Stage 4 Breast Cancer
Unfortunately, cancer cells often become more difficult to treat and may develop drug resistance once they spread. According to the Australian Institute of Health and Welfare , the 5-year survival rate for women whose breast cancer is metastatic at first diagnosis is 32%, compared to the 91% on average for all breast cancer patients.
Factors affecting survival rate of metastatic breast cancer
Survival rates can provide an estimate of what percentage of patients with the same stage of breast cancer are still alive after a certain period of time . However, they cannot predict how long any specific individual with breast cancer will live. The length of survival time for people with metastatic breast cancer can vary significantly from person to person, but there are a number of factors which can influence this including:
- Response to treatment
- The extent and location of metastases
- The presence of other health issues not related to cancer
- The specific subtype of breast cancer . This is very important, as some types of cancer can be more aggressive than others and respond differently to treatment.
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What Investigations Are Necessary For Staging Breast Cancer
Breast cancer staging almost always involves a bone scan, as breast cancer is highly prone to metastasize to the bones.
During this test, medics inject a small amount of a radioactive substance into the bloodstream, where it eventually collects in the bones. A radiation scanner is then able to detect accumulations of tracer substance in the bones.
If breast cancer spreads beyond the breast, 25% of the time it goes into bones first.
How Quickly Do Breast Cancer Tumors Grow From Stage To Stage
Cancer cells divide and multiply quickly in such a way that as a tumor gets bigger, it divides and grows even faster. The average doubling time for breast cancer tumors is between 50 and 200 days. Breast cancer tumor growth rate is impacted by hormonal factors, such as hormone receptor status and HER2 status.
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What Doesn’t Affect Survival
Just as there are factors associated with a better or worse prognosis, there are some factors that do not appear to make a big difference. These are generally less understood by the general public:
- Aggressiveness of treatment
- Having a positive attitude
The goal of treatment for metastatic breast cancer is often very different than that of early-stage disease, and this can raise anxiety among patients and loved ones of patients. With early-stage breast cancer, the goal is usually to be aggressive in order to reduce the risk that the cancer will come back.
In contrast, with stage 4 disease, the goal is usually to use the minimum amount of treatment possible to control the disease . Studies have found that more aggressive treatment does not improve survival rates but does reduce quality of life.
While having a good attitude may improve your sense of well-being, it has not been shown to affect survival rates. In fact, holding in negative emotions in order to appear positive may be detrimental to your health in general.
Seed And Soil Hypothesis
The “seed and soil” hypothesis states that specific organs harbor metastases from one type of cancer by stimulating their growth better than other types of cancer. This interaction is dynamic and reciprocal, since cancer cells modify the environment they encounter. Tumor embolus = seed and Target organ = soil.
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What Is Stage Iv Breast Cancer
Stage IV is the most advanced stage of breast cancer. It has spread to nearby lymph nodes and to distant parts of the body beyond the breast. This means it possibly involves your organs such as the lungs, liver, or brain or your bones.
Breast cancer may be stage IV when it is first diagnosed, or it can be a recurrence of a previous breast cancer that has spread.
How A Breast Cancers Stage Is Determined
Your pathology report will include information that is used to calculate the stage of the breast cancer that is, whether it is limited to one area in the breast, or it has spread to healthy tissues inside the breast or to other parts of the body. Your doctor will begin to determine this during surgery to remove the cancer and look at one or more of the underarm lymph nodes, which is where breast cancer tends to travel first. He or she also may order additional blood tests or imaging tests if there is reason to believe the cancer might have spread beyond the breast.
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 size of the cancer tumor and whether or not it has grown into nearby tissue
- whether cancer is in the lymph nodes
- whether the cancer has spread to other parts of the body beyond the breast
Numbers or letters after T, N, and M give more details about each characteristic. Higher numbers mean the cancer is more advanced. Jump to more detailed information about the TNM system.
Jump to a specific breast cancer stage to learn more:
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How To Handle Emotions
Coping with the many symptoms that can occur with stage 4 breast cancer can be frustrating and discouraging, and people sometimes wonder if they will have to feel poorly the rest of their lives. Anxiety and depression are also severe for some people with advanced disease.
Fortunately, palliative care team consults are now offered at many cancer centers. While hospice is a form of palliative care, palliative care can be helpful even with early, curable tumors. Working with a palliative care team to address physical and emotional issues frees you up to work with your oncologist on issues that treat your cancer specifically.
While the research is also young, it appears that those people who receive palliative care consults not only have a better quality of life with advanced cancer, but they may actually live longer, too.
You May Not Know Im Sick By Looking At Me
I may look perfectly healthy, but Im sick, says Silberman. Treatment is hard. I sleep a lot. I still travel, but its difficult. I just visited a friend in Utah for four days, and it wore me out for two weeks.
Just because someone doesnt look like she has advanced-stage cancer, she can be very sick. It can be an invisible illness, says Silberman. You tell somebody you have cancer, but if you have hair, sometimes they dont believe you.
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Stages Of Breast Cancer: Stage Iiib
A stage IIIb breast cancer is one in which the tumor may be of any size but it has grown into the chest wall or the skin of the breast. A stage IIIb designation also applies if there is evidence of either
- axillary lymph node metastasis
- internal mammary node metastasis
presenting in such a way as to suggest that total surgical removal is not possible.
There is a unique type of breast cancer, inflammatory breast cancer, that causes the breast to appear red and swollen. This is because the cancer cells block some of the lymphatic vessels. Inflammatory breast cancers tend to have a poorer prognosis and are generally stage IIIb at least.
Research Into Advanced And Metastatic Breast Cancer
As metastatic breast cancer remains the leading cause of death from breast cancer, NBCF is committed to funding a broad spectrum of research that helps to further understand breast cancer metastasis, develop improved treatment options and enhance patient quality of life for those with metastatic breast cancer.
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Predictors For Breast Cancer Survival Rates
It has to be remembered that every single breast cancer patient has itsown , unique scenario. Thus, prognosis and breast cancer survival rates are a rough guide ONLY.
However, there are consistent predictors for breast cancer survival rates and these include:-
- The stage of breast cancer at the time of diagnosis
- The Grade of the breast cancer
- A patients age at diagnosis
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.
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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
- the skin
Examples Using The Full Staging System
Because there are so many factors that go into stage grouping for breast cancer, it’s not possible to describe here every combination that might be included in each stage. The many different possible combinations mean that two women who have the same stage of breast cancer might have different factors that make up their stage.
Here are 3 examples of how all of the factors listed above are used to determine the pathologic breast cancer stage:
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Precancer Or Noninvasive Cancer
Some physicians use the terms precancer and noninvasive cancer interchangeably when referring to stage 0 breast cancer, whereas others simply call it cancer. There is great debate over this, but generally, DCIS is considered cancer, while LCIS isn’t .
Aside from clinical perspectives that shape their opinion on the proper terminology to use, some physicians consider how hearing “cancer” will affect a patient.
Learning that your condition is “precancerous” may make you worry that it will inevitably progress to cancer and that it must be treated as such . On the other hand, people told that they have a “noninvasive cancer” often lump their condition in with more advanced cases of the disease. In fact, some doctors refer to LCIS as lobular neoplasia simply because it sounds less frightening.
Don’t be mistaken: Both DCIS and LCIS are concerning because they have the potential to invade beyond their well-contained sites. Both carcinomas have the cellular appearance of cancer and both might eventually grow and spread beyond their original clumps. But, they also might not. So far, doctors can’t say which direction any particular case will go.
While stage 0 breast cancer should be taken seriously, the lower the stage number, the easier the disease is to treat.
Remember that all of these names for stage 0 breast cancer are just different ways to refer to the same thing. Don’t get hung up on terms when deciding on treatment.