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.
References
Predictors For Breast Cancer Survival Rates
It has to be remembered that every single breast cancer patient has itsown , unique scenario. Thus, prognosis and breast cancer survival rates are a rough guide ONLY.
However, there are consistent predictors for breast cancer survival rates and these include:-
- The stage of breast cancer at the time of diagnosis
- The Grade of the breast cancer
- A patients age at diagnosis
Stage 1b Breast Cancer Means One Of The Following Descriptions Applies:
Lymph nodes have cancer evidence with small clusters of cells between the approximate size of a pinprick to the approximate width of a grain of rice .
AND EITHER No actual tumor is found in the breast.
OR The tumor is smaller than the approximate size of a peanut .
Similar to stage 0, breast cancer at this stage is very treatable and survivable. When breast cancer is detected early, and is in the localized stage , the 5-year relative survival rate is 100%.
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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.
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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Treatment Options For Stage 3 Cancer
In general, regimens for stage 3 cancers typically start with either surgery or treatment to shrink the tumor before surgery, such as chemotherapy, radiation, or a combination of both.
Stage 3 breast cancer treatment: The first step is typically either chemotherapy or surgery.
Called neoadjuvant chemotherapy, because its given before other treatment, this may help shrink a tumor enough that breast-conserving surgery is possible. If it doesnt shrink enough, the patient may need a mastectomy instead. HER2-positive cancers may also be treated with targeted drugs before surgery.
After surgery, depending on the type of breast cancer, your treatment may continue with radiation. Chemotherapy and/or targeted drugs may be part of your treatment plan after surgery as well.
Stage 3 lung cancer treatment: This is highly dependent on how large the tumor is and which lymph nodes are affected. Generally, treatment begins with chemotherapy and/or radiation. You may have chemotherapy and radiation at the same time, or you may have them one after another. Surgery may follow this treatment if your care team thinks the remaining cancer may be successfully removed. After surgery, additional chemotherapy and/or radiation may be part of your treatment plan.
If chemotherapy, radiation or surgery arent appropriate options, immunotherapy drugs may be.
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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Survival Outcomes Among Human Epidermal Growth Factor Receptor 2
Amsalu Degu
1Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy and Health Sciences, United States International University-Africa, Nairobi, Kenya
Academic Editor:
Abstract
1. Introduction
Cancer is a combination of diseases distinguished by unlimited growth and spread of malignant cells . Among the many forms of cancer diagnosed globally, breast cancer is the primary type of cancer that affects most women . Breast cancer is a significant public health concern globally, accounting for 1,960,682 new cases and 611,625 deaths .
Cancer is becoming an issue of concern for many Kenyans today, with its prevalence rising rapidly over the past few years. It is the third major cause of death after infectious and cardiovascular diseases in Kenya . In 2020, breast cancer accounted for 16.1% of total cancer cases in Kenya .
HER2-positive breast cancer is a highly aggressive, fast-growing type of cancer that accounts for about 20% of breast cancers . Prior to the advent of HER2-directed therapies such as trastuzumab, HER2-positive breast cancer was associated with poorer outcomes and higher mortality rates than other breast cancer subtypes . The advent of trastuzumab, as well as other HER2-directed therapies, has significantly changed the treatment paradigm for patients with HER2-positive disease and dramatically improved outcomes .
2. Methods
2.1. Study Design, Setting, and Period
2.2. Target Population
2.3. Eligibility Criteria
2.3.1. Inclusion Criteria
3. Results
Nac Regimens And Surgical Methods
Three different NAC regimens were used: ED , FEC and EC . For the pts who underwent EC and most of the pts who underwent FEC, a further four cycles of D were then administered. Each chemotherapy regimen was administered every three weeks for four cycles however, this interval was prolonged by at least one week if the pt did not recover from the adverse effects. Subsequent to the completion of the four cycles of NAC, we evaluated the clinical responses and performed surgery within 23 weeks. The surgical methods included Pateys procedure in three pts, mastectomy in 16 pts and lumpectomy in three pts. All pts underwent level I+II ALN dissection. In addition, the three pts who received Pateys procedure underwent level III lymph node dissection.
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What Does Stage 3 Mean
Because stage 3 breast cancer has spread outside the breast, it can be harder to treat than earlier stage breast cancer, though that depends on a few factors.
With aggressive treatment, stage 3 breast cancer is curable however, the risk that the cancer will grow back after treatment is high.
Doctors further divide stage 3 cancer into the following stages:
Hormone Receptor Status Influences Breast Cancer Survival Rates
The hormone receptor status of a breast tumour is not usually included in formal discussions of prognosis.
Each breast tumour will potentially have a different hormone receptor status. When a breast cancer tumour tests positive for the hormones estrogen and progesterone, it implies two things:-
Therefore, due to improvements in treatments, overall survival rates will be higher for hormone receptor positive breast tumors than for those that are hormone negative.
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Drug Treatment Before Surgery
You might have chemotherapy as a first treatment to shrink the cancer down.
You might have hormone therapy first if your cancer cells have hormone receptors. But you usually only have this if chemotherapy isnt suitable.
If your cancer cells have particular proteins called HER2 receptors you might also have a targeted cancer drug called trastuzumab .
These treatments might shrink the tumour enough to allow your surgeon to remove just the area of cancer. This is called breast conserving surgery or a wide local excision.
If the cancer doesnt shrink enough, you need to have the whole breast removed . You may be able to have a new breast made . Do speak to your surgeon about this.
Before your surgery the lymph nodes in the armpit are checked for cancer cells.
You usually have radiotherapy to the breast after surgery.
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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How Does Staging Relate To Types Of Breast Cancer
In addition to cancer stage, doctors will determine the tumor grade and subtype.
Tumors are graded on a scale of 1 to 3, based on how abnormal the cells appear compared to normal cells. The higher the grade, the more aggressive the cancer, meaning that it tends to be growing quickly.
The subtype is important because treatment and outlook will vary depending on which subtype of breast cancer that you have. Subtypes include:
Prognostic Indicators In Stage Iii Breast Cancer Pts Treated With Nac
We compared DFS and OS curves between pts with NIN < 4 and pts with NIN 4, and a greater number of NIN was significantly correlated with poor prognoses. Tausch et al observed that an increased number of involved nodes and an increased ratio of involved to removed nodes were significantly correlated with worse DFS and OS in univariate and multivariate analyses . We compared DFS and OS curves between pts with NIN < 4 and pts with NIN 4 . A high number of NINs was a significant prognostic indicator correlated with DFS and OS . In the current study, the Ki-67 index was indicated to be as an independent prognostic factor for OS . However, achieving pCR subsequent to NAC was not associated with the Ki-67 labeling index . Since the median percentage of Ki-67 was 21.3% , we compared the DFS and OS curves with a cut-off value of Ki-67 at 20% . A high percentage of Ki-67 was suggested as a prognostic indicator correlated with OS , while there was no significant difference between the DFS curves .
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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%.
The Number Staging System
Breast cancer can also be divided into four number stages. We have put these into a table to make them easier to understand. You can .
This information is about stage 1 to 3 breast cancer.
Stage 1 breast cancer is when the cancer is 2cm or smaller. There may be no cancer cells in the lymph nodes in the armpit or tiny numbers of cancer cells are found. Sometimes the cancer cannot be found in the breast, but cancer cells have spread to lymph nodes in the armpit.
Stage 2 breast cancer is when the cancer is up to or bigger than 5cm. It may or may not have spread to the lymph nodes under the arm. Sometimes the cancer cannot be found in the breast. But cancer cells have spread to 1 to 3 lymph nodes in the armpit or near the breast bone.
Stage 3 breast cancer is sometimes called locally advanced breast cancer. The cancer has spread to the lymph nodes in the armpit and sometimes to other lymph nodes nearby. It may have spread to the skin of the breast or to the chest muscle. The skin may be red, swollen or have broken down. Sometimes the cancer cannot be found in the breast or is small but has spread to 4 to 9 lymph nodes in the armpit.
Stage 4 breast cancer is also called secondary or metastatic breast cancer. This is when the cancer has spread to other parts of the body, such as the bones, the liver or lungs. We have separate information about secondary breast cancer.
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What Are Risk Factors For Breast Cancer Recurrence
Anyone with a breast cancer diagnosis can have a recurrence. Your risk of cancer recurrence depends on several factors:
- Age: Women who develop breast cancer before age 35 are more likely to get breast cancer again.
- Cancer stage: Cancer stage at the time of diagnosis correlates with the risk of the cancer being able to recur. Several factors determine cancer stage: tumor size, cancer grade and cancer spread to lymph nodes or other parts of the body. Cancer grade indicates how unusual cancer cells look in comparison to healthy cells.
- Cancer type: Aggressive cancers like inflammatory breast cancer and triple-negative breast cancer are harder to treat. Theyre more likely to come back and spread.
Survival Rate For Patients With Triple
Triple-negative breast cancer is considered aggressive, or fast-growing, but it is treatable. Survival depends on factors such as how advanced the cancer was at diagnosis, your overall health, and your response to treatment.
When assessing survival, researchers use a 5-year marker to make predictions about if cancer will reoccur.
According to the American Cancer Society, if any type of breast cancer is found to be stage 1, the 5-year survival rate is nearly 100%. Stage 2 breast cancer survival is about 93%, stage 3 is 72%, and metastasized or grade 4 breast cancer has about a 22% chance of survival. Keep in mind most triple-negative breast cancers are stage 3 when found.
Its important to note that the survival rates may be higher than this data suggests because new treatments are becoming available through clinical research.
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Evaluation Of Chemotherapy Responses And Toxicities
The clinical response was assessed based on a physical examination, mammography, ultrasonography, MRI and CT according to the Response Evaluation Criteria In Solid Tumors version 1.1 criteria . A clinically complete response was defined as the disappearance of all known lesions a clinically partial response was defined as a 30% reduction in the sum of the longest diameter of the primary lesion progressive disease was defined as a 20% increase in the sum of the LD of the primary lesion and stable disease was defined as neither sufficient shrinkage to qualify for cPR nor sufficient increase to qualify for PD. The efficacy of NAC was examined in the surgical specimens, while the Ki-67 labeling index was examined in the pre-treatment biopsy specimens. The pathological response was assessed based on the histological changes in the invasive area by the Japanese Breast Cancer Society criteria . A pCR was defined as no residual invasive cancer in the breast tissue, regardless of the ALN status, while the grade 0 response indicated no cancerous degeneration. A grade 2 response was defined as 2/3 cancerous degeneration or a small amount of invasive cancer in the specimen, while a grade 1 response was defined as < 2/3 cancerous degeneration in the specimen. The number of involved ALNs was confirmed in the dissected ALN specimen by the pathologist. In addition, toxicities of the NAC were graded by the ECOG common toxicity criteria.
Stage Three Survival Rate
The general five-year survival rate for stage three cancer depends on the type of cancer with which you are infected 2. For example, according to EMedTV.com, the survival rate for stage three lung cancer is 15.5 percent, whereas the survival rate for stage three colon cancer is around 64 percent 2. These figures represent the average percentage of patients who will be alive five years after the date of their diagnosis.
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