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.
Read Also: What Is Stage 3a Breast Cancer
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.
Stage 3 Diagnostic Criteria
While we talk about stage 3 cancers as one monstrous thing, their diagnosis differs drastically based on cancer type. Generally, a stage 3 cancer diagnosis requires one or more of three features:
- Tumor growth beyond a specific size
- Spread to a specific set of nearby lymph nodes
- Extension of the tumor into nearby structures
Once diagnosed, a cancer stage never changes. Even if the doctor re-stages the cancer diagnosis, or it recurs , they keep the initial staging diagnosis.
The doctor will add the new staging diagnosis to the initial stage and differentiate it with letterslike c for clinical, p for pathological , or after treatments .
Some stage 3 cancers are subdivided to give a more precise classification. These sub-stages will differ based on the specific cancerous organ. For example, stage 3 breast cancer has three subcategories:
- The tumor is smaller than 5 centimeters but has spread to 4-9 nodes.
- The tumor is larger than 5 cm and has spread to 1 to 9 nodes.
3B: The tumor is any size but has invaded the chest wall or breast skin and is swollen, inflamed, or has ulcers. It may have also invaded up to 9 nearby nodes
3C: The tumor can be any size but has spread to either: 10 or more lymph nodes, nodes near the collar bones, or lymph nodes near the underarm and the breast bone
Also Check: Is Stage 3a Breast Cancer Curable
What Does A Breast Cancer Diagnosis Mean
You may have received a diagnosis for breast cancer, or maybe you know someone who has received a diagnosis. What does that mean, exactly? Are there any similar threads that run through a breast cancer diagnosis? Some, but each breast cancer is unique to the person, as is each specific treatment protocol. Breast cancer is not a one-size-fits-all disease.
Before diagnosis, I thought all breast cancers were the same. I have since learned otherwise.
Breast cancer. When you hear those words, either by your own diagnosis or by the diagnosis of someone you know or love, its devastating. Thats it.
Your initial reactions run through you, knocking over any amount of sense you thought you had, with no regard for your sanity. You tell yourself to calm down, to try and think, damnit! Yet, the moment swallows you and from that moment on, you know that youll never forget where you were or what you were doing.
I. Have. Breast. Cancer.
What the hell does that mean? Do I have early stage? Late stage? Has it spread? Is it encapsulated? Is it common? Is it aggressive? Do my breasts have to be cut off? Do I need chemotherapy? How about radiation? Do I get to keep most of my lymph nodes? Will I lose my hair? Will I be sick? Will I get to live after I endure the medical community and their science? What is my prognosis? Will it come back? If it does come back, does that effect my survival rate?
What the hell does my particular diagnosis mean?!
This much I know for sure.
Adoption Of The Prognostic Stage
For the 8th edition, the AJCC committee created the prognostic staging protocol. This integrates biomarkers into the TNM staging system, making use of the results from large cohort studies, which shows that not only pathologic stage, but also different biomarkers could affect survival . The biomarkers indicate tumor grade, hormone receptor status, and HER2. Multigene panel status is also incorporated into the staging system in limited sub-groups. The 8th edition defines clinical and pathologic prognostic stages that combine anatomic staging with tumor grade, hormone receptor status, and HER2 status .
Clinical Prognostic Stage is assigned to all patients regardless of type of therapy given.
ER = estrogen receptor-negative, ER+ = ER-positive, G = grade, HER2 = HER2 negative, HER2+ = HER2-positive, mi = micrometastasis, PR = progesterone receptor-negative, PR+ = PR-positive, Tis = in situ
Pathologic Prognostic Stage is assigned to patients who received surgery as initial treatment.
Additionally, pT1, pT2, pN0, M0, ER+, and HER2 cancers are assigned as Pathologic Prognostic Stage group IA when Oncotype DX recurrence score is less than 11.
Also Check: Tubular Cancer Of The Breast
What Does It Mean To Have Stage 3 Breast Cancer
Stage 3 cancer means the breast cancer has extended to beyond the immediate region of the tumor and may have invaded nearby lymph nodes and muscles, but has not spread to distant organs. Although this stage is considered to be advanced, there are a growing number of effective treatment options.
This stage is divided into three groups: Stage 3A, Stage 3B, and Stage 3C. The difference is determined by the size of the tumor and whether cancer has spread to the lymph nodes and surrounding tissue.
Stage 2 Breast Cancer
Stage 2 breast cancer is divided into two groups:
- Stage 2A
- Stage 2B
Stage 2A can mean:
No cancer is seen in the breast but cancer is found in one to three lymph nodes under the arm or near the breastbone
The cancer in the breast is 2cm or smaller and cancer is found in one to three lymph nodes under the arm or near the breastbone.
The cancer in the breast is larger than 2cm but smaller than 5cm and no cancer is found in the lymph nodes under the arm.
Stage 2B can mean:
The cancer in the breast is larger than 2cm but smaller than 5cm. Cancer is found in one to three lymph nodes under the arm or near the breastbone
The cancer in the breast is larger than 5cm and no cancer is found in the lymph nodes under the arm.
Also Check: Most Treatable Breast Cancer
Tnm System For Breast Cancer
Doctors also group cancers by the letters T, N, or M. Each of those letters tells you something about your cancer.
âTâ stands for tumor, or the lump of cancer found in the breast itself. The higher the number assigned after it, the bigger or wider the mass.
âNâ stands for nodes, as in lymph nodes. These small filters are found throughout the body, and they’re especially dense in and around the breast. They’re meant to catch cancer cells before they travel to other parts of the body. Here, too, a number tells you whether the cancer has spread to lymph nodes near the breast and, if so, how many.
âMâ stands for metastasis. The cancer has spread beyond the breast and lymph nodes.
Early Locally Advanced And Secondary Breast Cancer
Early breast cancer means the cancer hasn’t spread beyond the breast or the lymph nodes in the armpit on the same side of the body. So, the cancer hasn’t spread to any other part of the body.
Local recurrence means cancer that has come back in the breast, the armpit, or the chest wall after treatment.
Locally advanced breast cancer means the cancer has spread into the surrounding area, such as the lymph nodes, the skin or chest muscle. But it has not spread to other parts of the body.
Secondary breast cancer is also called metastatic breast cancer, advanced breast cancer, or stage 4 breast cancer. It means that the cancer has spread to other parts of the body, such as the liver or bones.
Read Also: Malignant Neoplasm Of Breast Definition
Grading Ductal Carcinoma In Situ
DCIS is also graded on how abnormal the cancer cells look and has a similar grading system to that used for invasive breast cancer .
- Grade 1 or low grade DCIS. The cells are growing slower, and look more like normal breast cells. These cells tend to have estrogen and progesterone receptors .
- Grade 2 or intermediate grade. The cells are growing at a speed of and look like cells somewhere between grades 1 and 3.
- Grade 3 or high grade. The cancer cells look very different from normal cells and are growing faster. These cells tend not to have estrogen and progesterone receptors . High grade DCIS is often more likely to turn into invasive breast cancer.
Necrosis is also noted. If there is necrosis, it means the tumor is growing quickly. The term comedo necrosis may be used if a breast duct is filled with dead and dying cells. Comedo necrosis is often linked to a high grade of DCIS and has a higher chance of developing into invasive breast cancer.
The Breast Cancer Stages: From 0 To 4
The stage of your cancer will appear on your pathology report, a report that details the size, shape and look of the cancer cells under a microscope. . Most cancers, including invasive breast cancer, have four stages.
Stage 0 is abnormal cells that have not spread beyond the ducts or lobules of the breast, such as DCIS or LCIS, respectively.
Stage I cancer is invasive and spreading beyond where it started.
In Stage IA, the cancer is 2 cm or smaller and has not spread into the lymph nodes or outside of the breast.
In Stage IB, small clumps of cancer cells ranging from 0.2 to 2 mm exist in the lymph nodes. There may not be a tumor in the breast, but if there is, it measures no bigger than 2 cm.
Stage II cancer also has two subcategories. Stage IIA describes a cancer that has spread to 1 to 3 lymph nodes under your arms with or without a tumor up to 2 cm large in the breast, or the breast tumor measures 2 to 5 cm without cancer cells in the axillary lymph nodes.
Stage IIB refers to a tumor between 2 and 5 cm along with cancer in 1 to 3 axillary lymph nodes or lymph nodes near the breastbone, or the tumor is larger than 5 cm when no cancer cells exist in the axillary lymph nodes.
In Stage IIIB, the tumor has reached the skin of your breast and/or your chest wall and up to 9 lymph nodes under your arms or near your breastbone.
Inflammatory breast cancer is automatically Stage IIIB or a later stage.
Stage IIIC involves three behaviors of the cancer:
You May Like: Red Mill Baking Soda Cancer
What Does It Mean To Have Stage 1 Breast Cancer
In Stage 1 breast cancer, cancer is evident, but it is contained to only the area where the first abnormal cells began to develop. The breast cancer has been detected in the early stages and can be very effectively treated.
Stage 1 can be divided into Stage 1A and Stage 1B. The difference is determined by the size of the tumor and the lymph nodes with evidence of cancer.
Can Cancer Form In Other Parts Of The Breast
Cancers can also form in other parts of the breast, but these types of cancer are less common. These can include:
- Angiosarcomas. This type of cancer begins in the cells that make up the lining of blood or lymph vessels. These cancers can start in breast tissue or breast skin. They are rare.
- Inflammatory breast cancer. This type of cancer is rare and different from other types of breast cancer. It is caused by obstructive cancer cells in the skins lymph vessels.
- Paget disease of the breast, also known as Paget disease of the nipple. This cancer affects the skin of the nipple and areola .
- Phyllodes tumors. These are rare, and most of these masses are not cancer. However, some are cancerous. These tumors begin in the breasts connective tissue, which is called the stroma.
Recommended Reading: Bob Red Mill Baking Soda Cancer
What Hormones Does Suzanne Somers Use
I use an estrogen cream every day and progesterone cream two weeks a month. Thats why, at 62, I dont require any pharmaceutical drugs. Fugh-Berman: Menopausal hormone therapy DOUBLES the risk of dementia, according to data from the Womens Health Initiative, and increases age-related memory problems, too.
Also Check: Is Er Positive Breast Cancer Hereditary
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:
Read Also: Her2 Negative Cancer
Breast Cancer Metastasis: Secondary Sites
Over the years there have been significant improvements and advancements in the diagnosis and treatment of breast cancer. Indeed, breast cancer is now considered to be a manageable disease.
However, there are still over half a million deaths worldwide from breast cancer and over 90% of these women die of metastasis. Consequently, research into metastasis is of vital importance in overcoming deaths from metastatic breast cancers.
Stage IV or metastatic breast cancer, as mentioned earlier, are cancer cells that have spread from the breast to distant sites around the body. Common secondary sites are:-
- Bone: .
- Lungs
- Liver
Cancer Stage: 5 Important Reasons To Know Yours
Sue Chang, MD, FCAP, is an Assistant Clinical Professor in the Department of Pathology at City of Hope National Medical Center in Duarte, CA.
Not sure what your cancer stage is or what it means? Nows a great time to get informed, as even your health care team is learning new things about cancer staging. The American Joint Committee on Cancer recently released the latest edition of its cancer staging manual with new and updated staging for many types of cancer. Most cancer treatment centers started using the updated manual on January 1, 2018.
Staging is a key component in the development of your treatment plan. The extent of cancer at the time of diagnosiswhere its located, if or where it has spread, and whether its affecting the other parts of the bodyis commonly referred to as the “stage” of cancer.
The cancer staging process is multifaceted. Doctors work together to gather the many pieces of information that go into determining a cancers stage. Findings from procedures and tests such as physical examinations, imaging scans, biopsies, blood tests, and genetic testing are used to assign the stage. The stage is the most accurate snapshot of the cancer at that point in time.
You May Like: What Is Stage 3a Breast Cancer
What Is The Staging Of Triple
Staging is the process of determining the extent of the cancer and its spread in the body. Together with the type of cancer, staging helps determine the appropriate therapy and predict the chances for survival.
To determine if the cancer has spread, medical professionals may use several different imaging techniques, including X-ray, CT scans, bone scans, and PET scans. Staging depends upon the size of a tumor and the extent to which it spread to lymph nodes or distant sites and organs in the body. Examination of lymph nodes removed at surgery and the results of ER, PR, and HER2 tests performed on the tumor tissue also help determine the stage of a tumor. Stage I is the lowest stage, while stage IV is the highest stage and refers to tumors that have metastasized, or spread to areas distant from the breast.
Most doctors specifically adjust breast cancer treatments to the type of cancer and the staging group.
Surgery
Many women with breast cancer will require surgery. Broadly, the surgical therapies for breast cancer consist of breast-conserving surgery and mastectomy .
Radiation therapy
Radiation therapy destroys cancer cells with high-energy rays. Doctors commonly administer radiation therapy to patients after breast cancer surgery, most commonly after lumpectomy.
Chemotherapy
Types of chemotherapy include the following:
Other therapies for triple-negative breast cancer