Dcis Can Happen At Any Age
âDCIS can happen to anybody, anytime,â says Dr. Meyers, but itâs usually diagnosed in women over 40, the age at which many women begin getting mammograms. According to the American Cancer Society, DCIS rates increase with age, and peak around age 70 to 79.
Women diagnosed with DCIS under age 50 have a higher rate of recurrence or of an invasive cancer, and therefore more aggressive treatment is usually recommended, says Dr. White. Those over 50, on the other hand, can take comfort in knowing that a diagnosis does not raise their risk of early death.
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Sobrevida De Pacientes Con Cncer De Mama Avanzado Positivo Para Receptores De Estrgenos
- 1Departamento de Hematología-Oncología. Escuela de Medicina. Pontificia Universidad Católica de Chile, Santiago, Chile.
- 2Departamento de Cirugía Oncológica y Maxilofacial. Escuela de Medicina. Pontificia Universidad Católica de Chile, Santiago, Chile.
- 3Departamento de Anatomía-Patológica. Escuela de Medicina. Pontificia Universidad Católica de Chile, Santiago, Chile.
- 4Departamento de Radiología. Escuela de Medicina. Pontificia Universidad Católica de Chile, Santiago, Chile.
- 5Centro de Cáncer. Pontificia Universidad Católica de Chile, Santiago, Chile.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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What Are The Symptoms Of Breast Cancer Recurrence
You may experience different signs of breast cancer recurrence depending on where the cancer forms.
Local breast cancer recurrence may cause:
- Breast lump or bumps on or under the chest.
- Nipple changes, such as flattening or nipple discharge.
- Swollen skin or skin that pulls near the lumpectomy site.
- Thickening on or near the surgical scar.
- Unusually firm breast tissue.
- Biopsy of the site of suspected recurrence.
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What Is Worse Triple Negative Or Triple Positive Breast Cancer
Triple-negative breast cancer is usually more aggressive, harder to treat, and more likely to come back than cancers that are hormone receptor-positive or HER2-positive. The symptoms, staging, diagnosis, and survivorship care for triple-negative breast cancer are the same as other invasive ductal carcinomas.
Cancer Alters Your Life And It Never Really Leaves You
For those beginning their cancer journey, Carol has two bits of advice. Definitely dont put off getting anything suspicious checked. She doubts she would have found the cancer early if she werent seeing Dr. Khoo regularly. Lastly, know that cancer never leaves you. Post-cancer PTSD and anxiety is real, even after treatment ends, and thats OK.
Because El Camino Health knows that the emotional toll may continue long after cancer treatment ends, theyve developed the Survivorship Program to support patients like Carol who may have questions or fears about whats happening with their mind, body or emotions.
Now at age 33, Carols life is basically back to normal, although she still struggles with the possibility that she may not be able to have more children through natural means.
As much as cancer sucked, states Carol, I truly appreciate the many new perspectives it gave me: A glimpse of the lives of the doctors and nurses providing care. The depths of empathy of everyone on a cancer journey. And it forced me to jump off the never-ending achievement treadmill with no regrets. Life is such a gift!
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Understanding Breast Cancer Survival Rates
Prognosis varies by stage of breast cancer.
Non-invasive and early stage invasive breast cancers have a better prognosis than later stage cancers .
Breast cancer thats only in the breast and has not spread to the lymph nodes has a better prognosis than breast cancer thats spread to the lymph nodes.
The poorest prognosis is for metastatic breast cancer , when the cancer has spread beyond the breast and nearby lymph nodes to other parts of the body.
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What Is The Relative Survival Rate Of Breast Cancer
A relative survival rate compares women with the same type and stage of breast cancer to women in the overall population. For example, if the 5-year relative survival rate for a specific stage of breast cancer is 90%, it means that women who have that cancer are, on average, about 90% as likely as women who dont have that cancer to live
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Treatments And Recurrence: Early And Late
Treatments also play a role in both early and late recurrences. While chemotherapy can significantly reduce the risk of recurrence in the first five years, it has much less influence on the risk of late recurrence.
Hormonal therapy reduces the risk of recurrence in the first five years , but can also reduce the risk of late recurrences. It is this reduction in risk that has led to recommendations to extend hormonal therapy for people at high risk beyond five years.
Extending hormonal therapy from five years to 10 years has been shown to reduce the risk of late recurrence, but the risk of recurrence needs to be weighed against the side effects of continued therapy.
A 2019 study found that people with luminal A tumors continued to have significant benefit from tamoxifen therapy for 15 years post-diagnosis.
The addition of bisphosphonates to an aromatase inhibitor in post-menopausal women with early-stage breast cancer may improve survival, but it’s too early to determine the effect on late recurrences. Bisphosphonates reduce the risk of bone metastases, but the most common sites of distant late recurrence are the brain, liver, and lungs.
Histopathologic And Immunohistochemical Evaluation
ER and PgR status were determined using the Allred scoring system . IHC was used to assess HER2 status those scoring 2+were submitted for fluorescence in situ hybridization to confirm HER2 receptor status. The Elston-Ellis modification of Scraff-Bloom-Richardson grading system was applied to grade tumour specimens in accordance to the Nottingham Histologic Score system . D2-40 staining was used to evaluate tumour lymphatic invasion, CD34 was used for vascular invasion and S-100 , ,and a broad spectrum keratin stain was used for perineural invasion . Ki-69 was evaluated using MIB1 antibody testing . Nottingham prognostic indices were graded in accordance with the original scoring system as described by Galea et al. . Molecular subtypes were defined in accordance with Goldhirsch et al. at the 2013 St. Gallen international expert consensus .
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Progress In Treating Her2
HER2-positive and triple-negative breast cancer are among the most aggressive forms of breast cancer and traditionally have had lower survival rates than other types of the disease. However, early detection with routine screening has contributed to improved survival for both in recent years. Further, treatment advancesall available at Regional Cancer Care Associates , one of the nations largest networks of cancer specialists with locations in New Jersey, Maryland, and Connecticutalso have helped improve outcomes in HER2-positive cancer. Meanwhile, intensive research and emerging therapeutic strategies are offering new hope for women with triple-negative breast cancer.
Four RCCA medical oncologists recently explained what drives the development of these breast cancers, how they are treated, and how women can play an important and potentially life-saving role in identifying the cancers in their earliest stages, when they can be treated most effectively.
Aileen Chen, MD, a board-certified medical oncologist practicing with RCCA in Freehold and Holmdel, NJ says, Its an exciting time in the fight against breast cancer. Next-generation sequencing technology is detecting genetic mutations that we can treat with targeted therapies in many forms of the disease. This has enhanced our ability to practice personalized medicine by customizing a patients treatment based on her molecular and genetic profiles.
Local Breast Cancer Recurrence
Breast cancer can return to the same area where it first appeared, Lange says. In this case, your doctor will base a treatment approach on how the first cancer was addressed.
If the original tumor was treated with lumpectomy and radiation, many patients may then need a bigger surgery, such as mastectomy, for the purpose of local control, she explains. If the original tumor was treated with mastectomy, then local resection of the recurrence should be considered. This is often followed by radiation therapy to the resection site.
Lange says an oncologist will evaluate a patient with recurrent breast cancer. Based on characteristics of the cancer cells and how they are behaving, the oncologist might recommend chemotherapy, hormonal therapy or a combination of treatments. For some patients, clinical trials of new therapies may be available.
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Brca1 Inherited Gene Mutations And Tnbc
Most breast cancers related to a BRCA1 inherited gene mutation are both triple negative and basal-like .
TNBC may also be related to a BRCA2 inherited gene mutation .
The National Comprehensive Cancer Network recommends people diagnosed with TNBC at age 60 or younger get genetic testing .
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Can You Predict Cancer Survival
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.
Types Of Recurrent Cancer
There are three types of recurrent breast cancer:
Local recurrence: When cancer returns to the same part of the breast as the initial diagnosis, the disease is classified as a local recurrence.
Regional recurrence: This type is diagnosed when the breast cancer is found in nearby lymph nodes and/or the chest wall.
Distant recurrence: Also called metastatic breast cancer, this occurs when cancer cells travel away from the original tumor in the breast to other parts of the body through the lymphatic system or bloodstream. Common metastatic areas include the bones, liver and lungs. Even when a metastatic breast tumor spreads to a different part of the body, it contains the same cancerous cells that developed in the breast.
Risk Factors For Overall Recurrence
There are several risk factors that raise the risk of recurrence overall . These include:
- Tumor size: Larger tumors are more likely to recur than smaller ones both early and late.
- Positive lymph nodes: Tumors that have spread to lymph nodes are more likely to recur at any time than those that have not.
- Age at diagnosis: Breast cancer recurrence is more common in younger people.
- Treatments received and response to treatments: Both chemotherapy and hormonal therapy reduce the risk of recurrence in the first five years.
- Tumor grade: More aggressive tumors are more likely to recur than less aggressive tumors , especially in the first five years.
There are also factors that do not appear to affect the risk of recurrence. Recurrence rates are the same for women who have a mastectomy or lumpectomy with radiation and are also the same for women who have a single vs. double mastectomy.
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Survival Differences Among Patients With Triple
The 8th edition of the AJCC staging system was recently introduced. This newer version combines the conventional anatomic stage and the newly developed prognostic stage to more precisely determine prognosis. The prognostic stage incorporates various biologic factors such as ER, PR, HER2 expression, and histological grade and reflects the differences in disease prognosis according to the expression statuses of these markers. Applying the newer prognostic staging system might advance the cancer stage from a conventional anatomic stage, according to the HR and HER2 status. Therefore, we compared OS among triple-positive, luminal A, and HER2-enriched breast cancer at each conventional anatomic stage using the KBCS dataset.
Overall survival among luminal A, triple-positive, human epidermal growth factor receptor 2 -enriched and triple-negative breast cancer subtypes in the Korean Breast Cancer Society cohort , according to the 7th edition of the American Joint Committee on Cancer staging system for breast cancer. OS was estimated using Kaplan-Meier survival analysis. Stage I, stage II, stage III, and stage IV.
How Life Expectancy And Relapse Differ From Positive Tumors
Questions about the survival rate and recurrence rate are very common when someone is diagnosed with triple-negative breast cancer . While prognosis is, on average, poorer than with hormone receptor or human epidermal growth factor receptor 2 positive tumors, triple-negative breast cancer is a very heterogeneous disease. On a positive note, and unlike hormone-positive tumors that commonly recur late , late recurrence is less common with triple-negative tumors. The recent approval of immunotherapy only for triple-negative disease is also optimistic.
We will look at factors that may affect survival or recurrence as well as the statistical rates of both. We will also look at life expectancy with stage 4 triple-negative breast cancers and recent case reports of a few long-time survivors.
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Questions To Ask Your Doctor About Her2
- What are my treatment options?
- What is the best course of treatment for my cancer, and why?
- Whats the overall goal of treatment in my case?
- When should I start treatment?
- Can I still work and manage my regular activities during this time?
- How often will I be coming in to see you for treatment?
- Will I be coming here for all my visits and treatments, or going elsewhere?
- What short-term side effects and long-term risks are associated with my treatment?
- What are the next steps if the desired treatment doesnt work?
- How likely is it for my cancer to come back in the future? What symptoms should I be aware of?
- What is the cost of my treatment?
- What should I discuss with my insurance company?
Survival Of Breast Cancer Based On Stage
Statistics are given below for the overall survival rates for breast cancer based on certain stages of disease development.
I made this page many years ago, when there was nothing like this data available on the internet. Recently this page has been up-dated with the most recent statistics that we can find. Prognosis will be even better than the numbers here suggest because modern targeted treatments have improved a lot.
Breast cancer staging is determined by many factors and these include:-
- The presence and size of a tumor
- Whether the tumor is node negative or positive, this means whether lymph nodes are involved or not
- If the cancer has metastasized beyond the breast
If breast cancer is diagnosed and it is determined that there is no metastasis to the lymph nodes then the chances of survival are extremely good.
Once breast cancer has spread to the lymph nodes the mode of treatment tends to shift to the chemotherapy medicines, and the odds of survival are somewhat lower.
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Clinicopathological Characteristics Of Patients
Among 491,913 patients originally identified from SEER database, cases of 33,339 TP-FBCs and 336 TP-MBCs from 2010 to 2017 were included in our study. According to the percentage of TP-FBC/TP-MBC to total FBC/MBC at each year , we firstly showed the trends of the subsets in 8 years . Generally, the subtype of TPBC was more prevalent in males than that in females with the exception of 2012.
Clinical pathological characteristics of TP-MBC compared with TP-FBC were summarized in Table . TP-MBC patients are significantly older than TP-FBC , patients older than 65years account for almost half in TP-MBC. TP-MBC had less Asian/pacific islanders , more ductal carcinoma , higher clinical stage as well as T stage , N stage , M stage . However, there was no significant difference in tumor grade and surgery status between TP-MBC and TP-FBC.
Table 1 Clinical pathological characteristics of TP-MBC compared with TP-FBC
In Table , data of distant organ metastasis in TP-MBC and TP-FBC was shown. Compared with TP-FBC, TP-MBC patients had higher proportions of bone metastasis and lung metastasis . Significant difference was not found in the brain metastasis or liver metastasis between TP-MBC and TP-FBC.
Table 2 Comparison of distant organ metastasis patterns in TP-MBC and TP-FBC
How Long After Breast Cancer Treatment Do Recurrences Occur
The risk of recurrence for all breast cancers was highest in the first five years from the initial cancer diagnosis at 10.4%. This was highest between the first and second years after the initial diagnosis. During the first five years after the initial diagnosis, patients with oestrogen receptor positive breast cancer had lower rates of recurrence compared with those with ER negative disease. However, beyond five years, patients with ER positive disease had higher rates of recurrence.
The late recurrence or relapse of breast cancer refers to cancers that come back after five years, but may not return for 10 years, 20 years, or even more. For people who have estrogen receptor-positive tumours, the cancer is actually more likely to recur after five years than in the first five years.
In contrast to the common belief that surviving for five years after cancer treatment is equivalent to a cure, with hormone-sensitive breast tumours there is a steady rate of recurrence risk for at least 20 years after the original diagnosis, even with very small node-negative tumours.
An awareness of the risk of late recurrence is important for a number of reasons. People are often shocked to learn that their breast cancer has come back after say, 15 years, and loved ones who dont understand this risk are often less likely to be supportive as you cope with the fear of recurrence.
- The long bones of the arms and legs
Symptoms and Detection