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What Is The Prognosis For Breast Cancer

What Is A 5

Prognosis for 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 for at least 5 years after being diagnosed.

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.

How Long Does It Take For Stage 1 Breast Cancer To Develop Into Stage 2

It is not possible to determine exactly how long it will take for newly diagnosed breast cancer to progress from stage 1 to stage 2. It can happen within months if it is an aggressive high-grade tumor, or it can take longer. It’s important to know that stage 1 breast cancer could have already been present for a while before being detected, so it may progress quickly.

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Locally Advanced Breast Cancer Prognosis

If breast cancer has come back and spread to the tissues and lymph nodes around the chest, neck and under the breastbone, there may be an increased risk of cancer cells spreading to other areas of the body.

This means the overall prognosis can be harder to predict.

Treatments such as chemotherapy, hormone and targeted therapies are given for locally advanced breast cancer because they work throughout the whole body.

Will I Die Of Breast Cancer

Metastatic Breast Cancer Infographic

This is a difficult question to answer early in your cancer care but it is still worth asking. Many people just diagnosed with cancer have no idea how much of a risk to their life their unique situation poses. Most breast cancers carry a low risk of recurrence, especially early-stage cancers. The answer is usually reassuring.

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Where To Find Cancer Statistics

NCI collects and reports on cancer statistics through its SEER Program, which stands for Surveillance, Epidemiology, and End Results. From the Cancer Stat Facts page on the SEER web site, you can find answers to the most commonly asked questions about cancer statistics for many cancer types. You can also browse the latest SEER Cancer Statistics Review.

How Is Breast Cancer Recurrence Managed Or Treated

Your treatment depends on the type of cancer recurrence, as well as past treatments. If cancer develops in a reconstructed breast, your surgeon may want to remove the breast implant or skin flap.

Treatments for local and regional breast cancer recurrence may include:

  • Mastectomy: Your surgeon removes the affected breast and sometimes lymph nodes.
  • Chemotherapy:Chemotherapy circulates in blood, killing cancer cells.
  • Hormone therapy:Tamoxifen and other hormone therapies treat cancers that thrive on estrogen .
  • Immunotherapy:Immunotherapy engages your bodys immune system to fight cancer.
  • Radiation therapy: High-energy X-ray beams damage and destroy cancer cells.
  • Targeted therapy: Treatments target specific cancer cell genes or proteins.

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Reproductive Factors And Steroid Hormones

Late age at first pregnancy, nulliparity, early onset of menses, and late age of menopause have all been consistently associated with an increased risk of breast cancer. Prolonged exposure to elevated levels of sex hormones has long been postulated as a risk factor for developing breast cancer, explaining the association between breast cancer and reproductive behaviors.

Clinical trials of secondary prevention in women with breast cancer have demonstrated the protective effect of selective estrogen receptor modulators and aromatase inhibitors on recurrence and the development of contralateral breast cancers. Use of SERMs in women at increased risk for breast cancer has prevented invasive ER-positive cancers. These data support estradiol and its receptor as a primary target for risk reduction but do not establish that circulating hormone levels predict increase risk.

A number of epidemiologic and pooled studies support an elevated risk of breast cancer among women with high estradiol levels. The Endogenous Hormones and Breast Cancer Collaborative Group reported a relative risk of 2.58 among women in the top quintile of estradiol levels.

A meta-analysis by the Collaborative Group on Hormonal Factors in Breast Cancer of 58 international studies that included 143,887 postmenopausal women with invasive breast cancer and 424,972 without breast cancer concluded the following about menopausal HRT and breast cancer :

How Are Breast Tumors Tested For Her2

What is the survival rate for breast cancer | Norton Cancer Institute

Women newly diagnosed with invasive breast cancers should be tested for HER2.

A biopsy or surgery sample of the cancer is usually tested with either immunohistochemical stains or Fluorescent in situ hybridization .

See Testing Biopsy and Cytology Specimens for Cancer and Understanding Your Pathology Report: Breast Cancerto get more details about these tests.

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Advanced Stage At Presentation

Several studies raised the notion that young breast cancer patients tend to present with more advanced stages than older women . A retrospective cohort from Denmark of 10,356 women diagnosed before 50 years reported that patients aged â¤35 years at diagnosis were at higher risk of being node positive compared with patients between 35 and 50 years . A study of 732 non-metastatic breast cancer patients from Mount Sinai Medical Center, New York showed that patients younger than 36 years had larger tumors , and were more likely to be diagnosed with stage II or III cancer .

Symptoms Of Metastatic Breast Cancer

The symptoms of stage 4 breast cancer depend on the location of the cancer and where it has spread in your body.

  • If breast cancer has spread to your bones, you may notice a sudden new bone pain. Breast cancer most commonly spreads to your ribs, spine, pelvis, or arm and leg bones.
  • If it has spread to your brain, you may experience headaches, vision or speech changes, or memory problems.
  • Breast cancer that has spread to your lungs or liver usually causes no symptoms.

The main treatments for stage 4 breast cancer are targeted drug therapies that destroy cancer cells wherever they are in your body.

These treatments may include:

  • hormone therapy, which stops or slows the growth of tumors by preventing your body from producing hormones or interfering with the effect of hormones on breast cancer cells
  • chemotherapy, where drugs given orally or through an IV travel through your bloodstream to fight cancer cells
  • immunotherapy, which uses drugs that stimulate your immune system to destroy cancer cells
  • a combination of these therapies

In some cases, surgery or radiation therapy may be used to treat stage 4 breast cancer.

The following are the common treatment options for different types of stage 4 breast cancer.

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How Is Prognosis Estimated

Prognosis is estimated by looking at what has happened over many years to large groups of people diagnosed with a similar cancer. However, everyones situation is different so no one can say for certain what will happen to you. Also, treatments and survival rates are constantly improving, which affects the accuracy of estimates for people being treated today.

Prognosis is described in different ways. It may be put into words or numbers. Its often expressed as a five- or ten-year survival rate. This is an estimate of how many people are likely to be alive five or ten years following their diagnosis.

A 90% five-year survival rate means that 90 out of 100 people diagnosed with breast cancer are likely to be alive five years after their diagnosis. It doesnt mean these people will only live for five years it just states how many people are likely to be alive at that point.

Cancer Research UK has general statistics on five- and ten-year breast cancer survival rates on their website. Remember, these statistics are based on large groups of patients and cannot predict what will happen in your individual case.

Enhancing Healthcare Team Outcomes

Secondary Breast Cancer

After the treatment of breast cancer, long-term follow-up is necessary. There is a risk of local and distant relapse, and hence an interprofessional team approach is necessary. The women need regular mammograms and a pelvic exam. Also, women with risk factors for osteoporosis need a bone density exam and monitoring for tumor markers for metastatic disease. For those who are about to undergo radiation therapy, a baseline echo and cardiac evaluation are necessary. Even though many types of integrative therapies have been developed to help women with breast cancer, evidence for the majority of these treatments is weak or lacking.

Outcomes

Over the past four decades, the survival rates of most breast cancer patients have improved. Of note is that the presence of breast cancer has gradually slowed down over the past decade, which may be due to earlier detection and improved treatments. The prognosis for patients with breast cancer is highly dependent on the status of axillary lymph nodes. The higher the number of positive lymph nodes, the worse the outcome. In general, hormone-responsive tumors tend to have a better outcome. In breast cancer survivors, adverse cardiac events are common this is partly due to the cardiotoxic drugs to treat cancer and the presence of traditional risk factors for heart disease. The onus is on the healthcare provider to reduce the modifiable risk factors and lower the risk of adverse cardiac events. [Level 5)

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Clinical Data And Tumor Characteristics

The surgeon identifying the cases and constructing the database also collected data regarding date of diagnosis, menopausal status, height, weight, parity, laterality, tumor location, and distant metastases through medical records and the Swedish Cancer Registry. Information concerning tumor size, histological type, and ALNI was retrieved from histopathological examinations. Tumor type was classified using a modification of the World Health Organization classification as proposed by Linell et al. . ALNI was divided into positive, negative, or unknown if no axillary dissection had been performed.

Living With Stage : The Breast Cancer No One Understands

Leer en español.

Editor’s note: We’re bringing back this piece from October 2014 for Metastatic Breast Cancer Awareness Day and to honor Jody Schoger, featured in the story. Schoger died of metastatic breast cancer in May. Want to learn more about MBC? Look for our tweets at the Northwest Metastatic Breast Cancer Conference this Saturday at Fred Hutch.

A no-nonsense Texan of 60 years, Jody Schoger* has a very no-nonsense way of educating people about her metastatic breast cancer.

âSomeone will say, âWhen are you done with treatment?â and Iâll tell them, âWhen Iâm dead,ââ said Schoger, a writer and cancer advocate who lives near Houston. âSo many people interpret survivorship as going across the board. That everybody survives cancer now. But everybody does not survive cancer.â

An estimated 155,000-plus women in the U.S. currently live with âmets,â or metastatic breast cancer. This type of cancer, also called stage 4 breast cancer, means the cancer has metastasized, or traveled, through the bloodstream to create tumors in the liver, lungs, brain, bones and/or other parts of the body. Between 20 and 30 percent of women with early stage breast cancer go on to develop metastatic disease. While treatable, metastatic breast cancer cannot be cured. The five-year survival rate for stage 4 breast cancer is 22 percent median survival is three years. Annually, the disease takes 40,000 lives.

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Many Factors Can Affect Your Prognosis

Some of the factors that affect prognosis include:

  • The type of cancer and where it is in your body
  • The stage of the cancer, which refers to the size of the cancer and if it has spread to other parts of your body
  • The cancers grade, which refers to how abnormal the cancer cells look under a microscope. Grade provides clues about how quickly the cancer is likely to grow and spread.
  • Certain traits of the cancer cells
  • Your age and how healthy you were before cancer
  • How you respond to treatment

Learn more about Cancer Staging and Tumor Grade.

Stage 4 Survival Rates

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To get a perspective on the difference in survival rates during different stages of cancer, according to the American Cancer Society the rate of survival after diagnosis is:

  • For those at stage 2 there is an expected five-year survival rate of over 90%.
  • For those at stage 3 there is an expected five-year survival rate of 72%.
  • For stage 4 there is an expected five-year survival rate of 22%.

Because the earlier stages of breast cancer have much longer survival rates, early detection and treatment are important.

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The Malm Breast Cancer Database

The study cohort consists of all cases of invasive female breast cancer in Malmö, Sweden, diagnosed between 1 January 1961 and 31 December 1991. They were all treated at the same institution, Malmö University Hospital, and no referrals were made to or from the hospital for patients with breast cancer. All residents in Sweden are registered by a unique 10-digit ID number. Breast cancer patients were identified by review of clinical notes and record-linkage with the Swedish Cancer Registry, forming the basis of the Malmö Breast Cancer Database. This was all completed by one surgeon, who also validated all breast cancer diagnoses by reviewing histological material, X-ray examinations, and medical records . The present study was approved by the regional ethical committee in Lund, Sweden .

Factors Influencing Metastatic Breast Cancer Prognosis

There are several factors that can impact the prognosis of metastatic breast cancer, these include:

  • Age
  • Hormone receptors on cancer cells
  • The type of tissue involved
  • The number of tumors/extent of metastasis
  • A persons overall attitude and outlook on the prognosis

Of course, no factors can accurately predict the exact prognosis for a person with metastatic breast cancer. These statistics are based on many clinical research studies, looking at survival rates for people diagnosed with breast cancer at all stages. But the prognosis of each person is different, regardless of what the statistics indicate.

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Interactive Statistics With Seer*explorer

With SEER*Explorer, you can…

  • Create custom graphs and tables

SEER*Explorer is an interactive website that provides easy access to a wide range of SEER cancer statistics. It provides detailed statistics for a cancer site by gender, race, calendar year, age, and for a selected number of cancer sites, by stage and histology.

Why Were New Measures Added To The Staging System

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The new measures give information on the biology of the tumor that affects prognosis. Adding these measures improved staging.

For example, with breast cancer, a large tumor may have a better prognosis than a small tumor, based on biological measures. In the same way, a small tumor may have a worse prognosis than a large tumor based on these measures.

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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.

Learn more about breast cancer treatment.

Survival For All Stages Of Breast Cancer

Generally for women with breast cancer in England:

  • Around 95 out of every 100 women survive their cancer for 1 year or more after diagnosis
  • Around 85 out of every 100 women will survive their cancer for 5 years or more after diagnosis
  • Around 75 out of every 100 women will survive their cancer for 10 years or more after diagnosis

Cancer survival by stage at diagnosis for England, 2019Office for National Statistics

These statistics are for net survival. Net survival estimates the number of people who survive their cancer rather than calculating the number of people diagnosed with cancer who are still alive. In other words, it is the survival of cancer patients after taking into account that some people would have died from other causes if they had not had cancer.

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Stages Of Breast Cancer

The stages of breast cancer range from 0 to IV .

The highest stage is any cancer with metastases , no matter the size of the tumor, the lymph node status or other factors. This is known as metastatic breast cancer and is the most advanced stage of breast cancer.

Most often, the higher the stage of the cancer, the poorer the prognosis will be.

The table below lists the TNM classifications for each stage of breast cancer for people who have surgery as their first treatment.

When TNM is
IV

*T1 includes T1mi.

**N1 does not include N1mi. T1 N1mi M0 and T0 N1mi M0 cancers are included for prognostic staging with T1 N0 M0 cancers of the same prognostic factor status.

***N1 includes N1mi. T2, T3 and T4 cancers with N1mi are included for prognostic staging with T2 N1, T3 N1 and T4 N1, respectively.

Used with permission of the American College of Surgeons, Chicago, Illinois. The original source for this information is the AJCC Cancer Staging Manual, Eighth Edition published by Springer International Publishing.

What Questions Should I Ask My Healthcare Provider

A Breast Cancer Diagnosis: Now What?

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.

References

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