What Is The Chance I Could Die In The Next 5 Years
The average 5-year survival rate for all people with breast cancer is 89%. The 10-year rate is 83%, and the 15-year rate is 78%. If the cancer is located only in the breast , the 5-year survival rate is 99%. More than 70% of breast cancers are diagnosed at an Early Stage.
All survival statistics are primarily based on the stage of breast cancer when diagnosed. Some of the other important factors are also listed below that affect survival.
Stage 0 breast cancer can be also described as a pre-cancer. If you have DCIS you can be quite confident you will do well. DCIS does not spread to other organs. What can be concerning is when an invasive cancer grows back in the area of a prior lumpectomy for DCIS. This type of local recurrence does carry a risk to your life. Luckily, this does not happen frequently. Also, be aware that those who have had DCIS in the past are at a higher risk for developing an entirely new, invasive breast cancer. Take our video lesson on Non-Invasive DCIS to learn more.
Stage I invasive breast cancer has an excellent survival rate. The chance of dying of Stage I breast cancer within five years of diagnosis is 1 to 5% if you pursue recommended treatments.
Stage II breast cancer is also considered an early stage of breast cancer. There is a slightly increased risk to your life versus a Stage I breast cancer. Altogether, the risk of Stage II breast cancer threatening your life in the next 5 years is about 15%.
Rationale For Neoadjuvant Endocrine Therapy For Er
The PEPI score was also tested in the ACOSOG Z1031 trial to determine whether it could be used to assist decisions for neoadjuvant endocrine therapy vs. chemotherapy and identify patients with low risk of recurrence. The Z1031 trial tested 16 to 18 weeks of aromatase inhibitor in postmenopausal stage II or III ER-positive patients. Patients with a Ki67 of > 10% at 4 weeks of AI were declared endocrine therapy resistant and went on to neoadjuvant chemotherapy. Patients with a PEPI score of 0 exhibited a 5-year risk of relapse of 3.6% without chemotherapy, and confirmation is being sought in the ALTERNATE trial .
Prospective validation of the PEPI 0 and mPEPI 0 biomarker as a surrogate for 5-year RFS in the ALTERNATE trial would allow comparison of different NET strategies and agents and identify patients who do not need chemotherapy- a de-escalation strategy. Thus, neoadjuvant hormonal therapy is also a pathway to de-escalation because although higher-risk patients in the ALTERNATE trial were offered postoperative chemotherapy, many of these patients who received neoadjuvant hormonal therapy were able to avoid postoperative adjuvant chemotherapy. Therefore, in the ALTERNATE trial, postoperative chemotherapy served as a backstop for those patients who were candidates for it, whereas lower-risk patients avoided it.
Feeling Unwell Or Tired
Many women do not feel as healthy after chemo as they did before. There is often a residual feeling of body pain or achiness and a mild loss of physical functioning. These changes may be very subtle and happen slowly over time.
Fatigue is another common problem for women who have received chemo. This may last a few months up to several years. It can often be helped, so its important to let your doctor or nurse know about it. Exercise, naps, and conserving energy may be recommended. If you have sleep problems, they can be treated. Sometimes fatigue can be a sign of depression, which may be helped by counseling and/or medicines.
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When To Call Your Healthcare Provider
If you have any of these symptoms while taking Adriamycin, call your healthcare provider:
- Fever of 100.5 degrees F or higher
- Pain or redness at your injection site
- Bloody urine or reddish sweat
- Unusual bruises or persistent bleeding
- Persistent cough, sore throat, pneumonia
- Allergic symptoms, such as shortness of breath, swelling of feet or ankles, rash, swollen throat or tongue
Expectations And What To Avoid
Radiation therapy should not cause pain or discomfort during the procedure. However, minor side effects are common in the days or weeks afterward. Before beginning radiation therapy, an individual should schedule a consultation with their doctor to work out the details.
People should also take some precautions while they are receiving radiation therapy. For example, they should avoid direct sun exposure by using sunscreen and covering up areas of bare skin when outside.
Also, taking antioxidant supplements, such as vitamins A, C, D, and E, can interfere with radiation therapys effectiveness. People should, therefore, focus on eating a well-balanced diet so that their body can absorb the nutrients and vitamins it needs from food.
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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.
Understanding Her2+ Status And Survival
Doctors use three markers to help define breast cancers and guide treatment. One of those is the HER2 protein. The other two are hormone receptors . When a cancer has none of these, doctors call it triple negative. Until recently, there wasnt much information about how these markers changed survival rates for breast cancer.
A recent study looked at the National Cancer Institute data to see if there were differences in survival for women based on these markers. The study shows there are. Overall, women who have HR+ and HER2- breast cancer do best. But in the later stages, those who have the HER2+ type have better survival rates than those with HER2-. Breast cancers that are triple negative have the lowest survival rates. The 4-year survival rates are as follows:
- HR+/HER2-: 92.5%
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How Effective Is Chemotherapy For Cancer
The effectiveness of chemotherapy for cancer has been an issue that has been long debated in the medical community. Some put the effectiveness using the chemotherapy at as little as 2 percent to 4 percent. Others say the results of using chemotherapy for cancer are much higher. In most cases, the only thing the two sides agree on is that the effectiveness of chemotherapy is largely dependent on the stage and type of cancer the patient has.
To understand how effective using chemotherapy for cancer can be, the medical community may use a number of different measurements. One of the most common is the five-year survival rate after diagnosis. In one study published in the journal known as Clinical Oncology, nearly 38 percent of those with testicular cancer, and more than 40 percent of those with Hodgkins Disease, survived five years due to chemotherapy.
Highlights And Future Directions
Another direction for progress will come from ongoing development of more effective strategies for de-escalation of therapy, particularly through measurement of pCR and MRI biomarkers in NAC. For example, improvements in HER2-targeted therapy may result in improved responses, measured by reduction of functional tumor volume and biopsy, such that anthracyclines may be deleted from neoadjuvant platform trial regimens that currently contain anthracyclines. Further progress will likely come from the use of functional biomarkers such as the mPEPI and PEPI score, and genomic assays, in NET. The process of answering these questions, through well designed trials will continue to add to the growing body of information on neoadjuvant strategies in breast cancer, where quantitatively measuring the effects of targeted drug therapy has added so much to what we can offer our patients.
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What Are The Complications Of Breast Cancer Recurrence
Breast cancer that comes back can be harder to treat. The same therapy isnt always effective again. Tumors can develop a tolerance to certain treatments like chemotherapy. Your healthcare provider will try other therapies. You may be able to try drugs under development in clinical trials.
If breast cancer spreads to other parts of the body, your healthcare providers still treat it like breast cancer. For instance, breast cancer cells that move to the lungs cause breast cancer in the lungs not lung cancer. Metastatic breast cancer is more difficult to treat than cancer in only one part of the body.
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.
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Patients Characteristics Over Time
Between January 1981 and December 2008, 48,469 patients were identified in the Institut Curie database. Among these patients, 32,502 women had a previously untreated invasive cancer and met the inclusion criteria. The number of patients increased with time, and their characteristics are detailed in . The proportion of patients between 50 and 65 years of age increased over time. Grade 1 lesions, hormone receptor positive cancers, and non-palpable tumors or tumors less than 2 cm without lymph-node involvement were more prevalent in the most recent periods. The rates of adjuvant chemotherapy, radiotherapy and hormonal therapy increased over time and were applied to a mean of 28.2%, 78.5% and 67.2% of patients, respectively.
Relative Survival Rate By Stage
The survival rates by stage are based on the stage at the time of diagnosis. Youve 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. Heres 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 stage 4). The 5-year relative survival rate is 28%.
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Menstrual Changes And Fertility Issues
For younger women, changes in menstrual periods are a common side effect of chemo. Premature menopause and infertility may occur and may be permanent. Some chemo drugs are more likely to cause this than others. The older a woman is when she gets chemotherapy, the more likely it is that she will go through menopause or become infertile as a result. When this happens, there is an increased risk of bone loss and osteoporosis. There are medicines that can treat or help prevent bone loss.
Even if your periods have stopped while you are on chemo, you may still be able to get pregnant. Getting pregnant while on chemo could lead to birth defects and interfere with treatment. If you are pre-menopausal before treatment and are sexually active, its important to discuss using birth control with your doctor. It is not a good idea for women with hormone receptor-positive breast cancer to take hormonal birth control , so its important to talk with both your oncologist and your gynecologist about what options would be best in your case. Women who have finished treatment can safely go on to have children, but it’s not safe to get pregnant while on treatment.
If you think you might want to have children after being treated for breast cancer, talk with your doctorbeforeyou start treatment. Learn more from our section on fertility concerns for women with cancer.
What Is Stage 0 Dcis
Stage 0 breast cancer, ductal carcinoma in situ is a non-invasive cancer where abnormal cells have been found in the lining of the breast milk duct. In Stage 0 breast cancer, the atypical cells have not spread outside of the ducts or lobules into the surrounding breast tissue. Ductal Carcinoma In Situ is very early cancer that is highly treatable, but if its left untreated or undetected, it can spread into the surrounding breast tissue.
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Study: More Breast Cancer Patients Can Safely Skip Chemotherapy
A federally funded study has found that many women with the most common type of early stage breast cancer likely do not need chemotherapy after surgery. The study was presented June 3, 2018 at the American Society of Clinical Oncology meeting in Chicago, and simultaneously published in the New England Journal of Medicine. It is likely to change the way many newly diagnosed breast cancer patients are treated.
“With results of this groundbreaking study, we now can safely avoid chemotherapy in about 70% of patients who are diagnosed with the most common form of breast cancer,” said Kathy Albain, MD, a co-author of the study. “For countless women and their doctors, the days of uncertainty are over.”
Chemotherapy For Early Breast Cancer
This summary table contains detailed information about research studies. Summary tables are a useful way to look at the science behind many breast cancer guidelines and recommendations. However, to get the most out of the tables, its important to understand some key concepts. Learn how to read a research table.
Introduction: Chemotherapy after breast surgery improves survival in women with early breast cancer.
A pooled analysis of data from 60 randomized clinical trials showed women of all ages, with or without breast cancer in their lymph nodes, can benefit from adjuvant chemotherapy. Women younger than 50 showed the most improvement in 15-year overall survival.
The benefit of adjuvant chemotherapy depends on each persons prognosis. People with the poorest prognosis get the most survival improvement, while those with the best prognosis get the smallest benefit.
Learn more about chemotherapy.
What Are The Chances Of Breast Cancer Recurrence After Treatment For Stage 2 Breast Cancer
In women who have breast-conserving treatment, the chance of recurrence is about 3-15% in 10 years, depending on tumor characteristics and margins. Distant recurrence in those who had mastectomy is most influenced by axillary lymph node involvement. When axillary lymph nodes are not cancerous, the recurrence rate is 6% in 5 years. When axillary lymph nodes are cancerous, the recurrence rate is 23% in 5 years with mastectomy but no radiation.
Rationale For Neoadjuvant Therapy As A Standard Of Care For Patients With Her2
In summary, for patients meeting KATHERINE trial inclusion criteria who lacked a pCR of the primary tumor or lymph nodes after neoadjuvant HER2-directed therapy, T-DM1 adjuvant therapy was associated with improved invasive DFS with OS to be reported.
For patients attaining a pCR, continuation of the HER2-targeted regimen that led to the pCR makes sense as adjuvant therapy, while failure to attain pCR would prompt a change of the adjuvant regimen to T-DM1. Therefore, determination of pCR status can inform adjuvant therapy to improve outcomes for patients with HER2-positive tumors where neoadjuvant therapy has failed to yield a pCR. Furthermore, effectiveness of T-DM1 as adjuvant therapy after failure to attain a pCR in the HER2-positive subtype has led to novel research strategies that seek to compare neoadjuvant regimens that de-escalate therapy in the HER2 subtype and could include regimens that delete anthracycline. One neoadjuvant trial that tested deletion of anthracycline on some arms was the TRYPHAENA trial, which investigated the role of neoadjuvant pertuzumab in a randomized phase 2 design,. This trial showed low rates of systolic ventricular dysfunction with anthracycline free therapy.
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Possible Side Effects Of Chemo For Breast Cancer
Chemo drugs can cause side effects. These depend on the type and dose of drugs given, and the length of treatment. Some of the most common possible side effects include:
- Hair loss
Chemo can also affect the blood-forming cells of the bone marrow, which can lead to:
- Increased chance of infections
- Easy bruising or bleeding
These side effects usually go away after treatment is finished. There are often ways to lessen these side effects. For example, drugs can be given to help prevent or reduce nausea and vomiting.
Other side effects are also possible. Some of these are more common with certain chemo drugs. Ask your cancer care team about the possible side effects of the specific drugs you are getting.
What Is Stage 0 Lcis
Lobular carcinoma in situ at Stage 0 generally is not considered cancer. Although it has carcinoma in the name, it really describes a growth of abnormal but non-invasive cells forming in the lobules. Some experts prefer the name lobular neoplasia for this reason because it accurately refers to the abnormal cells without naming them as cancer. LCIS, however, may indicate a woman has an increased risk of developing breast cancer.
If you have been diagnosed with LCIS, your doctor may recommend regular clinical breast exams and mammograms. He or she may also prescribe Tamoxifen, a hormone therapy medication that helps prevent cancer cells from growing.