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.
What Is The Prognosis For Triple Negative Breast Cancer
Triple negative breast cancer can be more aggressive and difficult to treat. Also, the cancer is more likely to spread and recur. The stage of breast cancer and the grade of the tumor will influence your prognosis. Research is being done currently to create drug therapies that are specific for triple negative breast cancer.
Interested in learning more? i3Health is hosting an upcoming webinar Metastatic Triple-Negative Breast Cancer: Applying Treatment Advances to Personalized Care. Learn more here.
Material on this page courtesy of Johns Hopkins Medicine
Stage 3b Breast Cancer
Stage 3B breast cancer means a tumour of any size that has spread to other tissues near the breast such as skin, muscles, or ribs. At this stage, the tumour may or may not have spread to the lymph nodes. However, the cancer has not spread to other distant parts of the body.
Cancer that has spread to the skin of the breast might be inflammatory breast cancer, a rare form of cancer which can be aggressive and challenging to treat.
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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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Inflammatory Breast Cancer Stages
Inflammatory Breast Cancer Stages are phases defined to help organize the different treatment plans and to understand the Inflammatory Breast Cancer Prognosis better. Inflammatory Breast Cancer Staging has been adapted to meet the specific characteristics of the disease progress. IBC is typically diagnosed in following three stages:
Inflammatory Breast Cancer- Stage 3A
IBC Stage 3A is when patient has less than one complete breast affected.
Inflammatory Breast Cancer- Stage 3B
The whole breast is affected, might have spread to issues near the breast, such as the skin or chest wall, including the ribs and muscles in the chest. The cancer may have spread to lymph nodes within the breast or under the arm. In Stage IIIB, the cancer has spread to areas like the breast skin or chest wall. This might also include the ribs and muscles in the chest. Also, the cancer would have spread to lymph nodes that are within the breast or under the arms.
Inflammatory Breast Cancer- Stage 3C
In Stage IIIC the cancer would have been spread to the lymph nodes under the collar bone and also near the neck. In this stage too, the cancer would have spread to lymph nodes within the breast or under the arm. This stage, the cancer affects the tissues near the breast.
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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Breast Cancer Survival Rates According To The Stage Of The Cancer
Breast cancer stage of course refers to the spread and size of cancer at diagnosis. Stage zero means the breast cancer is still in situ or contained. Whereas, stage IV means that the cancer has metastasised to other body regions. The stage of cancer at diagnosis affects prognosis.
The statistics below are taken from the from the SEER database of the National Cancer Institute between the years 1975 to 2010.
The 5 year survival rate means that within 5 years around 93 people out of 100, diagnosed with Stage II breast cancer, will still be alive.
Stage 3 Lung Cancer Symptoms
Early stage lung cancer may produce no visible symptoms. There may be noticeable symptoms, such as a new, persistent, lingering cough, or a change in a smokers cough . These symptoms may indicate that the cancer has progressed to stage 3.
Other symptoms may include:
- trouble breathing, being winded or short of breath
- pain in chest area
- bone pain
The five-year survival rate refers to the percentage of people who are alive five years after theyre first diagnosed. These survival rates can be divided by the stage of a particular cancer type at the time of diagnosis.
According to the American Cancer Society data derived from a database of people diagnosed with lung cancer between 1999 and 2010, the five-year survival rate for stage 3A NSCLC is about 36 percent. For stage 3B cancers the survival rate is about 26 percent. For stage 3C cancers the survival rate is about 1 percent.
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Stage 3 Breast Cancer Treatment Options
Treatment for stage 3 breast cancers typically involves a combination of surgery along with chemotherapy to shrink the tumor before surgery and radiation after surgery to treat the chest wall and/or lymph nodes. Lymph nodes will also likely be removed during surgery.
Targeted therapies, including hormone therapy, can also be used depending on your cancers specific characteristics.
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What Tumor Factors Threaten My Life More
There are important tumor biology factors not well reflected in survival statistics by breast cancer stage. Below we list a few important factors that carry a higher risk to life beyond just the stage of cancer. You must ask your surgeon or medical oncologist to explain your receptor status and give you a copy of your biopsy pathology report.
Triple Negative Receptor breast cancer
Triple negative breast cancer is considered a more aggressive breast cancer. Invariably it does require chemotherapy. If you have triple negative breast cancer the risk of dying is higher than the standard statistics usually quoted for a particular stage of breast cancer . Learn more about Triple Negative Breast Cancer with our video lesson
HER2-Positive breast cancer
HER2-positive breast cancers are also more aggressive tumors. But the good news is that we now have incredibly effective, targeted chemotherapy and immunotherapy for HER2-positive cancers. Our video lesson covers HER2-Positive Breast Cancer in more detail .
Breast Cancer at a Young Age
Women younger than 40 have a higher chance of being diagnosed with a more advanced stage breast cancer. Also, the specific cancer type younger women develop has a higher chance of being more aggressive . As a result, age is a relative risk factor for survival.
Untreated breast cancer
Teaching everyone to be an expert in their own breast cancer care.
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What Is Breast Cancer Staging
Breast cancer staging is the determination of the extent and spread of the cancer. An individual’s health care team uses stages to summarize the extent of the cancer in a standardized way that is recognized by all health care providers. They use this staging to determine the treatment most appropriate for the type of cancer. Cancer staging helps to determine the prognosis, or outlook, of a cancer, including rates of recurrence and survival rates.
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:
HER2 status: are the cancer cells making too much of the HER2 protein?
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:
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.
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New Medications For Metastatic Breast Cancer
Immunotherapy drugs called checkpoint inhibitors have led to a significant improvement in survival rates for lung cancer and melanoma.
In 2019, Tecentriq became the first immunotherapy drug to be approved for triple-negative breast cancer that is metastatic or locally advanced but unresectable . However, in August 2021, Tecentriq’s manufacturer voluntarily withdrew that indication in the United States.
However, also in 2021, the Food and Drug Administration approved Keytruda for high-risk, early-stage, triple-negative breast cancer. It is used in combination with chemotherapy as a neoadjuvant treatment , and then continued as a single agent as adjuvant treatment .
PARP inhibitors are another class of medication that may alter survival rates in the future, particularly among women who have hereditary breast cancer .
For bone metastases, bone-modifying drugs may be effective in both treating metastases and possibly reducing the development of further metastases in bone.
Finally, for people who have only a single or a few metastases , treating these metastases locally may be an option. While studies are young, treating oligometastases may improve survival or even lead to long-term survival for a minority of people.
What About Breast Cancer In Men
Breast cancer in men is rare less than 1 percent of all breast cancer cases but it can still occur, according to the ACS. A mans risk of getting breast cancer during his lifetime is about
The stages of breast cancer relate to how much the cancer has grown and how far its spread. Generally, the earlier breast cancer is diagnosed and treated, the higher the chances for long-term survival.
|Stage 0||This is a precancerous stage with no invasive cancer cells.|
|Stage 1||The tumor is small and localized to the breast. There may be a small amount of cancer in nearby lymph nodes.|
|Stage 2||The tumor is still localized to the breast but is larger and may have spread to several nearby lymph nodes.|
|Stage 3||This stage includes cancers that have spread to the skin, chest wall, or multiple lymph nodes in or near the breast.|
|Stage 4||This is metastatic breast cancer, meaning its spread to one or more distant parts of the body, most commonly to the bones, lungs, or liver.|
The stages of breast cancer are based on the following factors:
- tumor size
- whether the lymph nodes contain cancer cells
- whether the cancer has metastasized, meaning its spread to other, more distant parts of the body
Since 2018, the following factors have also been used to determine breast cancer stage:
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What Is The Staging For Breast Cancer
Stage I and II breast cancers
- Early-stage localized breast cancer
- Tumor is less than 2 cm in size and is node negative
- Stage II tumors have spread to the axillary lymph nodes and/or a tumor size larger than 2 cm but smaller than 5 cm
Stage III breast cancers
- Locally advanced breast cancer
- Large breast tumors
- Extensive axillary lymph node involvement , nodal involvement of both axillary and internal mammary nodes at diagnosis, or nodal involvement of the soft tissues above or below the collarbone
- A tumor is also considered to be stage III if it extends to underlying muscles of the chest wall or the overlying skin
- Inflammatory breast cancer is at least stage III even if it is small and does not involve lymph nodes
Stage IV breast cancer
- Metastatic breast cancer
- Tumors have spread to areas outside the breast and lymph nodes to the bones, lungs, liver, or other organs
- The primary tumor in the breast may be any size, and there can be any number of affected lymph nodes
How Common Is Triple
About 10 to 20% of breast cancers are found to be triple-negative. However, triple-negative cancer cells are found more often in people under the age of 50. This is about 10 years younger than the average age of 60 or older for other types of breast cancer diagnoses. Triple-negative breast cancer is also found in higher percentages of Black and Hispanic patients and less often in Asian and non-Hispanic patients.
Another population that is more likely to be diagnosed with this type of breast cancer has an inherited mutation of the BRCA gene. About 70% of those with triple-negative breast cancer also test positive for having the BRCA mutation. You may qualify for genetic testing based on your family history. Learn more about genetic testing for breast cancer.
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Is Inoperable Breast Cancer Still Treatable
Although stage 3C breast cancer is defined as either operable or inoperable, an inoperable diagnosis doesnt necessarily mean that it cant be treated.
The term inoperable may mean that all the cancer in the breast and surrounding tissue cant be removed through simple surgery. When breast cancer is removed, a rim of healthy tissue around the tumor, called a margin, is also removed.
For breast cancer to be successfully removed, there needs to be healthy tissue in all margins of the breast, from your clavicle down to a few inches below the breast mound.
It is possible for inoperable breast cancer to become operable following a treatment to shrink the cancer.
Infiltrating/invasive Lobular Breast Carcinoma
Infiltrating lobular carcinoma usually appears as a subtle thickening in the upper-outer breast quadrant.
As the name suggests, these tumours originate mostly in the breast lobules rather than the lining of the breast ducts.
Invasive lobular cancer is a less common type of breast cancer than invasive ductal cancer. This cancer accounts for about 10% of all invasive breast cancer cases.
Prognosis for infiltrating and invasive lobular breast carcinomas will naturally be influenced by tumor size, grade, stage and hormone receptor status..
However, lobular breast cancers, when positive for estrogen and progesterone receptors, tend to respond very well to hormone therapy.
The overall breast cancer survival rates for infiltrating lobular carcinoma, when matched by stage, are a little higher than for ductal carcinoma for the first 5 years.
Survival rates range from about 77% to 93%, but on average, the 5-year survival rate was estimated at about 90%.
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