What Questions Should I Ask My Healthcare Provider
You may want to ask your provider:
- What type of breast cancer recurrence do I have?
- Has the cancer spread outside the breast?
- What stage is the breast cancer?
- What is the best treatment for this type of breast cancer?
- What are the treatment risks and side effects?
- Should I look out for signs of complications?
A note from Cleveland Clinic
Most breast cancer recurrences respond well to treatments. You may be able to try new drugs or combination therapies in development in clinical trials. Your healthcare provider can discuss the best treatment option based on your unique situation.
Last reviewed by a Cleveland Clinic medical professional on 03/24/2021.
What Is Breast Cancer
The breast is made up of millions of cells. Breast cancer develops when a single cell or group of cells begin to multiply out of control and forms a tumour. The breasts consist of fatty tissue and lobules that are connected to the nipple by ducts. Breast cancer usually starts in cells that line a duct or lobule. Sometimes cells can break away and travel to other parts of the body, starting new tumours. You can find out more about the breasts and the lymphatic system here.
What Are The Types Of Breast Cancer Recurrence
If you develop cancer in the opposite, untreated breast , you receive a new breast cancer diagnosis. This isnt the same as breast cancer recurrence.
When breast cancer returns, it may be:
- Local: Cancer returns in the same breast or chest area as the original tumor.
- Regional: Cancer comes back near the original tumor, in lymph nodes in the armpit or collarbone area.
- Distant: Breast cancer spreads away from the original tumor to the lungs, bones, brain or other parts of the body. This is metastatic cancer, often referred to as stage 4 breast cancer.
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Incidence And Survival Rates
Breast cancer is the most frequently diagnosed cancer among women in 140 of 180 countries worldwide. Between 2008 and 2012 breast cancer incidence increased by 20 per cent, while mortality has increased by 14 per cent. In the US, it is estimated that there are currently 3.1 million breast cancer survivors.
Overall survival rates for breast cancer vary world wide, but in general survival rates have improved. This is because the majority of breast cancer cases are diagnosed at an earlier and localised stage, and improved surgery and adjuvant tailored treatment regimes are available. In many countries the five-year survival rate for women diagnosed with Stage I/II breast cancer is 8090 per cent. If it has reached the distant stage the survival rate falls to 24 per cent. The five-year prevalence of breast cancer per 100,000 is 665 in Western Europe, 745 in North America, and 170 in Eastern Asia.
Why People Are Getting Covid
Were seeing more reinfections now than during the first year of the pandemic, which is not necessarily surprising, Dr. Esper says.
The CDC says cases of COVID-19 reinfection remain rare but possible. And with statistics and recommendations changing so quickly and so frequently, that rare status could always change, as well.
Dr. Esper breaks down the reasons behind reinfection.
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What Are Cancer Survival Statistics
A key part of making a prognosis is looking at survival rates. These are numbers researchers collect over many years in people with the same type of cancer. These numbers are based on large groups of people. For breast cancer, there are two main measurements:
Breast cancer survivalrates reflect the percentage of women who are alive 5 years or longer after their diagnosis. This means the numbers are based on women who were found to have breast cancer at least 5 years ago. Advances in diagnosing and treating cancer have led to steadily improving survival rates, so the outlook for women diagnosed today is likely better.
Relative survival rates donât take into account the cause of death. Theyâre a measure of the percentage of people with cancer who have lived for a certain time after diagnosis, compared with people who did not have cancer.
Breast Cancer Subtypes Hormonal And Her2 Status And Survival Rates
Many research studies over the years have shown that Estrogen-positive breast cancers have better survival rates than all of the Estrogen-negative subtypes.
Progesterone-positive breast cancer also appears to have improved survival rates in comparison to progesterone-negative cases.
For ER+ sub-types survival rates were significantly better than all other subtypes. For example, at stage 1b,
ER+ PR+ HER2- 5-year survival rates were 98.6%ER+ PR- HER2+ 5-year survival rates were 97.3%
The subtype triple negative breast cancer had the worst survival rates over all three stages. At stage I the 5-year survival rate was 92.9% and at stage III 48.9%.
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What Are My Chances Of Surviving Breast Cancer
The five-year relative survival rate for localized breast cancer has increased from 72 percent in the 1940s to about 93 percent for stage 0, 88 percent for stage I, 81 percent for stage IIA, 74 percent for IIB, 67 percent for IIIA, 41 percent for IIIB, 49 percent for IIIC and 15 percent for stage IV. Survival after a diagnosis of breast cancer continues to decline beyond five years. Ten-year survival and beyond is also stage-dependent, with the best survival observed in women with early stage disease.
Survival Rates For Stage Iv Breast Cancer
Stage of breast cancer at diagnosis is one of the most important prognostic factors. Above is a bar chart from the National Cancer Institute statistics for 2012. As we can see, the 5-year survival rate for women diagnosed with Stage IV breast cancer was 22%.
Remember, these figures are still quite dated as it takes 5 years to determine survival rates and treatment is improving all the time.
A recent study found that 37% of women survived for three years after a Stage IV breast cancer diagnosis, although some women do survive longer.
However, although the 5-year survival rates are much higher for earlier stages of breast cancer at diagnosis, there is no predicting which cases will progress to metastatic breast cancer in the future.
Although it is important to be realistic regarding the survival of metastatic breast cancer, each individual situation is unique and ultimately, statistics are meaningless.
There is a small subcategory of people with Stage IV breast cancer who beat the odds and live for years. However, it is difficult to predict who will fall into this group.
All that is known is that people in this group have secondary spread to the bones. Furthermore, cancer is often estrogen positive and responds to hormone treatments.
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Relative Survival Rate By Stage
The survival rates by stage are based on the stage at the time of diagnosis. Youâve probably been given a number and letter for your cancer stage. Here, the terms localized, regional, and distant are used instead of numbers and letters. Hereâs what they mean and the 5-year relative survival rates for each:
- Localized breast cancer is only in the breast. This includes stage IA , some IIA , and some IIB . The 5-year relative survival rate is 99%.
- Regional breast cancer has spread to nearby tissue or lymph nodes. This includes stage IB , some IIA , some IIB , and all stage III . The 5-year relative survival rate is 86%.
- Distant breast cancer has spread to other parts of the body. This includes stage IV, pronounced âstage 4â). The 5-year relative survival rate is 28%.
De Novo Metastatic Breast Cancer And Recurrent Breast Cancer
It is important to understand the two types of Stage IV Breast Cancer and the differences between them:-
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Survival Rates And Mortality Rates
Survival depends on mortality. You start with 100 percent of the people in the group.
100 percent mortality rate = survival rate
Say, the mortality rate in the group of people is 5 percent. Survival would be 95 percent .
Similarly, the number of people in a group who survive depends on the number of people who die. Say, 500 people are in the group and 1 person dies. This means 499 people survived .
I May Not Feel Like A Fighter Theres No Final Victory
The language used to describe cancer and its treatment is often the language of war: fighting cancer, battling cancer, being a warrior. But those words may not resonate with women who have metastatic breast cancer.
Sendelbach recalls using fighting words when she was first diagnosed with stage 1 breast cancer. I was 30 years old, and I was in fight mode, she says. I was like, Hell yeah, I can kick cancers ass and so on. When she was diagnosed with stage 4, though, she realized there would be no end in sight, no final victory for her.
Theres not a finish line, she says, so to be in fight mode doesnt really work. There has to be an end in sight to stay in that place.
For her, metastatic breast cancer is something she deals with day to day. She describes her journey as a marathon, not a sprint. If you have to stop sometimes to walk and take water breaks, she says, you should. If you try to run as fast as you can all the time, its inevitable that youre going to fail.
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Unique Challenges For Young Adults
Breast cancer in young adults is just different. We are at a different phase of our lives and encounter unique challenges compared to older persons. These challenges may significantly impact our quality and length of life. Some of the unique challenges and issues young adults face:
- The possibility of early menopause and sexual dysfunction brought on by breast cancer treatment
- Fertility issues, because breast cancer treatment can affect a womanâs ability and plans to have children
- Many young women are raising small children while enduring treatment and subsequent side effects
- Young breast cancer survivors have a higher prevalence of psychosocial issues such as anxiety and depression13
- Questions about pregnancy after diagnosis
- Heightened concerns about body image, especially after breast cancer-related surgery and treatment
- Whether married or single, intimacy issues may arise for women diagnosed with breast cancer
- Challenges to financial stability due to workplace issues, lack of sufficient health insurance and the cost of cancer care
Lifestyle Factors And The Survival After Breast Cancer
In this report from our Continuous Update Project the worlds largest source of scientific research on cancer prevention and survivorship through diet, nutrition and physical activity we analyse global research on how certain lifestyle factors affect how likely it is that a person will survive after developing breast cancer. This webpage forms part of WCRF/AICRs 2018 Third Expert Report Diet, Nutrition, Physical Activity and Cancer: a Global Perspective.
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Cancer Cure And All Clear
Many people who have cancer want to know if theyre cured. You may hear words like cure and all clear in the media.
Cured means theres no chance of the breast cancer coming back. However, its not possible to be sure that breast cancer will never come back. Treatment for breast cancer will be successful for most people, and the risk of recurrence gets less as time goes on. Recurrence, unfortunately, can happen even many years after treatment, so no one can say with certainty that youre definitely cured.
All clear, or in remission which is another term you may have heard used, means theres no obvious sign of cancer at the moment.
If your breast cancer has spread to other parts of your body this will affect your prognosis. Secondary breast cancer can be treated, sometimes for many years, but not cured. Find out more about secondary breast cancer.
In order to be as clear as possible, your treatment team is more likely to talk about your chances of survival over a period of time or the possibility of remaining free of breast cancer in the future.
Health Disparities In Young African Americans
In addition to these unique issues, research has shown that young African American women face even greater challenges.
- African American women under age 35 have rates of breast cancer two times higher than caucasian women under age 35.14
- African Americans under age 35 die from breast cancer three times as often as caucasian women of the same age.14
- Researchers believe that access to healthcare and the quality of healthcare available may explain these disparities. But scientists continue to investigate.
- Research also shows that young African Americans are more likely to get aggressive forms of breast cancer than anyone else.14
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Ways To Reduce The Risk Of Breast Cancer
8 ways to reduce the risk of breast cancer, is among the most common cancers in women. However, noting that survival rates are gradually increasing thanks to early diagnosis and improved new treatment methods
Around 2 million 300 thousand women are diagnosed with breast cancer every year around the world. Neglecting regular health checks due to the pandemic and not applying to a doctor or health institution due to the fear of COVID-19, reduced early diagnosis and led to an increase in advanced cancer cases. Early diagnosis increases the success of cancer treatment. Patients with complaints should not flee from health institutions in order to conduct necessary research on the underlying cause of these complaints, especially if these complaints are increasing. Even if it is a pandemic, if we do not protect our health, if we do not take health seriously, if we do not take the necessary examinations and treatments on time, additional problems and losses arising from these negligence may compete with the damage caused by COVID-19.
Early Detection Saves Lives
Melissa is one of the resource persons in the second episode of Tita Hope Talks: Tackling Access to Cancer Diagnosis and Navigation in the COVID-19 Era, a timely discussion on the importance of early diagnosis in cancer care with or without the pandemic.
An initiative by Hope from Within, a multi-stakeholder cancer advocacy campaign spearheaded by MSD in the Philippines, Tita Hope Talks seeks to remind the public to consult their doctor as soon as they spot something unusual and not to put off preliminary screening.
Hosted by broadcast journalist and health advocate Niña Corpus, Tita Hope Talks gathers experts and health stakeholders to discuss their perspective and provides their insights on various issues surrounding cancer care.
The sessions panel speakers included Dr. Beverly Ho, Disease Prevention and Control Bureau director of the Department of Health Dr. Jorge Ignacio, Cancer Institute director of the UP-PGH Dr. Guia Ladrera, Oncology Department section head of the Lung Center of the Philippines Melissa Ongsue-Lee,VP for sales and marketing of Hi-Precision Diagnostics Amiel Herrera, founder/CEO of Medcheck and Melissa de Leon, president of breast cancer support group Project Pink.
The role of cancer screening in early detection and its impact on survival is well documented in breast, cervical, lung and colorectal cancers.
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Examples Of Rates Versus Numbers
Say, town A has a population of 100,000 and town B has a population of 1,000. Over a year, say there are 100 breast cancer deaths in town A and 100 breast cancer deaths in town B.
The number of breast cancer deaths in each town is the same. However, many more people live in town A than live in town B. So, the mortality rates are quite different.
In town A, there were 10 breast cancer deaths among 100,000 people. This means the mortality rate was less than 1 percent .
In town B, the mortality rate was 10 percent .
Although the number of deaths was the same in town A and town B, the mortality rate was much higher in town B than in town A .
Lets look at another example. In 2021, its estimated among women there will be :
- 100 breast cancer deaths in Washington, D.C.
- 720 breast cancer deaths in Alabama
- 4,730 breast cancer deaths in California
Of the 3, California has the highest number of breast cancers. However, that doesnt mean it has the highest breast cancer rate. These numbers dont take into account the number of women who live in each state. Fewer women live in Alabama and Washington, D.C. than live in California.
Other factors may vary by state as well, such as the age and race/ethnicity of women. So, to compare breast cancer mortality rates, we need to look at mortality rates.
In 2021, the estimated mortality rates are :
- 26 per 100,000 women in Washington, D.C.
- 22 per 100,000 women in Alabama 22
- 19 per 100,000 women in California 20