Lumpectomy Plus Radiation Therapy And Local Recurrence
For women who have lumpectomy plus radiation therapy, the chance of local recurrence in 10 years is about 3-15 percent .
The risk of local recurrence depends on tumor characteristics, including biomarkers .
It also depends on whether or not the tumor margins and the lymph nodes in the underarm area contain cancer cells. The chance of local recurrence is lower when :
- Tumor margins do not contain cancer
- Lymph nodes do not contain cancer
Chemotherapy, hormone therapy and/or HER2-targeted therapy can lower the risk of breast cancer recurrence for people treated with lumpectomy plus radiation therapy .
What Is Stage 1 Breast Cancer
This breast cancer is the earliest stage of invasive breast cancer. In stage 1, the tumor measures up to 2 cm and no lymph nodes are involved. At this stage, the cancer cells have spread beyond the original location and into the surrounding breast tissue.
Because a stage 1 tumor is small, it may be difficult to detect. However, breast self-exams and routine screening are always important and can often lead to early diagnosis, when the cancer is most treatable.Stage 1 breast cancer is divided into two categories:
Stage 1A: The tumor measures 2 cm or smaller and has not spread outside the breast.
Stage 1B: Small clusters of cancer cells measuring no more than 2 mm, are found in the lymph nodes, and either there is no tumor inside the breast, or the tumor is small, measuring 2 cm or less.
At stage 1, TNM designations help describe the extent of the disease. For example, there may or may not be cancer cells in the lymph nodes, and the size of the tumor may range from 1 cm to 2 cm. Most commonly, stage 1 breast cancer is described as:
- T: T1, T2, T3 or T4, depending on the size and/or extent of the primary tumor
- N0: Usually, cancer has not spread to the lymph nodes.
- M0: The disease has not spread to other sites in the body.
Stage 1 breast cancer survival rate
The survival rate for stage 1A breast cancer may be slightly higher than for stage 1B. However, all women with stage 1 breast cancer are considered to have a good prognosis.
Where Does Breast Cancer Spread To
Breast cancer cells seem to prefer to settle into:-
- long bones in the arms and legs
- ribs
- skull
With an osteolytic metastasis, the cancer kind of eats away at the bone, creating holes.
With an osteoblastic bone metastasis, the bone mineral density actually increases, but this can cause the bones to fracture more easily. This requires a little more explanation. Breast cancer metastases tend to be lytic when they are untreated, and then they become densely sclerotic as they respond to treatment.
Even if no treatment is given yet, an osteoblastic metastasis from breast cancer generally indicates that the persons own body is trying to fight cancer with some success.
A CT scan may also be used to check for metastasis to the lungs or liver. A CT scan is essentially an X-ray linked to a computer. The breast cancer doctor injects a contrast dye agent into the bloodstream and this makes any cancer cells in the liver and chest easier to see.
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What Are The Chances Of Breast Cancer Returning
Each persons risk of breast cancer recurrence is different and depends on many factors, such as the size, type, grade and features of the cancer and whether the lymph nodes were affected.
Your treatment team can tell you more about your individual risk of recurrence if you want to know this.
The risk of breast cancer recurring is higher in the first few years and reduces as time goes on.
However, recurrence can happen even many years after treatment, which is why its important to be breast and body aware, and report any changes to your treatment team or GP.
In the UK, the number of people surviving breast cancer has risen greatly over the past decade and most people diagnosed with primary breast cancer will not have a recurrence.
Cancers Linked To Radiation Treatment
Lung cancer: The risk of lung cancer is higher in women who had radiation therapy after a mastectomy as part of their treatment. The risk is even higher in women who smoke. The risk does not seem to be increased in women who have radiation therapy to the breast after a lumpectomy.
Sarcoma: Radiation therapy to the breast also increases the risk of sarcomas of blood vessels , bone , and other connective tissues in areas that were treated. Overall, this risk is low.
Certain blood cancers: Breast radiation is linked to a higher risk of leukemia and myelodysplastic syndrome . Overall, though, this risk is low.
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Keeping Personal Health Records
You and your doctor should work together to develop a personalized follow-up care plan. Be sure to discuss any concerns you have about your future physical or emotional health. ASCO offers forms to help keep track of the cancer treatment you received and develop a survivorship care plan when treatment is completed. At the conclusion of active treatment, ask your doctor to provide you with a treatment summary and a survivorship care plan.
This is also a good time to talk with your doctor about who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the care of their family doctor, another health care professional, or a specialized survivorship clinic. This decision depends on several factors, including the type and stage of cancer, side effects, health insurance rules, and your personal preferences.If a doctor who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan forms with them and with all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you throughout your lifetime.
The next section in this guide is Survivorship. It describes how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to choose a different section to read in this guide.
How Could Someone Be A Breast Cancer Survivor At Diagnosis
Breast cancer needs time to grow. So, if a breast mass shows up on a mammogram or is detected during a monthly breast self-exam, you have already been living with it for some time.
A such, surviving this period of time is what prompts many people to consider diagnosis the point at which you can be called a breast cancer survivor.
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How Is Metastasis Found
Metastasis is most often found when people report symptoms.
These may include:
- Seizures
- Yellowing of the skin or whites of the eyes
Dont panic if you have signs or symptoms like fatigue, weight change or bone pain. These are common problems for many people. Most often, they dont mean the breast cancer has spread. For example, bone pain may be a sign of arthritis or muscle strain. And, many people have fatigue for a number of reasons.
However, discuss any signs or symptoms you have with your health care provider to find out the cause. Its always OK to get a second opinion, especially if you feel your health care provider isnt listening to your concerns.
Stage Iv Breast Cancers May Be Recurrences Following Initial Treatment
Up to 5% of initial breast cancer diagnoses are of the most advanced or metastatic stage. However, this number has significantly reduced with the implementation of widespread breast cancer screening programs.
Metastatic breast cancer can appear to be a rapid deterioration of a disease that has been present for some time undetected.
But metastatic breast cancer can also be the result of a recurrence of breast cancer after successful initial treatment. Sometimes the terms local and regional recurrence indicate a return of breast cancer to the original tumor site or elsewhere in the breast or contralateral breast.
If the cancer returns in other areas of the body it is a distant metastasis or distant recurrence.
For more detail on Stage IV survival rates, recurrence rates and treatment please see our new post HERE.
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Who Is A Cancer Survivor
According to Roswell Parks , MSPH, PhD, Director of Cancer Screening and Survivorship, both the National Cancer Institute and Roswell Park clinically define a person as a cancer survivor from the day of their cancer diagnosis onward, for as long as they are alive.
But if you ask most cancer patients, they will tell you they did not in any way feel like a survivor the day they learned they had cancer. I surely did not. Instead, I felt scared and in disbelief. While my doctor gave me hope by telling me my cancer had been caught early and my prognosis was good, I was afraid of how I would respond to chemotherapy, and whether it would work. But on that day, I also vowed to do my best to get through the treatment and fight hard to survive.
Fast forward four months, when I finished the last of 18 weeks of aggressive chemotherapy treatments. Although I felt battered, Id reached what Dr. Reid calls the operational definition of a cancer survivor. Its fair to say that many patients consider themselves to be survivors the day they finish their treatments. That definition quite literally rings true for many, who celebrate the end of treatment by ringing the Victory Bell at Roswell Park.
Signs Of Breast Cancer Recurrence
The signs of cancer recurrence depend on where the cancer resurfaces. You might not see or feel any signs of a local recurrence, and, if you do, it will probably be a slight change in or around your breast or underarm area. More often than not, your provider might find evidence of a local recurrence during a physical exam or mammogram.
A distant recurrence will typically produce some symptoms, but because many of those breast cancer symptoms are common to other health problems, it can be hard to tell if theyre due to a distant recurrence or something else. Have an open conversation with your cancer care team about any symptoms youre having, especially if they last more than two weeks.
Pay special attention to these symptoms, which could signal a cancer recurrence:
- Blood in your urine or stools
- Any new lumps or areas of swelling
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Breast Cancer Recurrence Risk Lingers Years After Treatment Ends
Steady rates of recurrence in women with estrogen receptor-positive disease could influence decisions about long-term therapy.
Even 20 years after a diagnosis, women with a type of breast cancer fueled by estrogen still face a substantial risk of cancer returning or spreading, according to a new analysis from an international team of investigators published in the New England Journal of Medicine.
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Standard treatment for estrogen receptor-positive, or ER-positive, breast cancer includes five years of the endocrine-based treatments tamoxifen or aromatase inhibitors, both of which are taken daily as a pill.
Researchers from the Early Breast Cancer Trialists Collaborative Group analyzed data from 88 clinical trials involving 62,923 women with ER-positive breast cancer. The patients all received endocrine therapy for five years and were free of cancer when they stopped therapy.
Over the next 15 years, however, a steady number of these women saw their cancer spread throughout the body, as late as 20 years after the initial diagnosis.
Even though these women remained free of recurrence in the first five years, the risk of having their cancer recur elsewhere from years five to 20 remained constant, says senior study author Daniel F. Hayes, M.D., Stuart B. Padnos Professor of Breast Cancer Research at the University of Michigan Rogel Cancer Center.
Additional Markers For Breast Cancer Staging
Additional markers specific to breast cancer will further define your stage, which may be helpful in choosing targeted treatments to fight the cancer.
- ER: The cancer has an estrogen receptor. Estrogen is a hormone, and some cancers have receptors that respond to estrogen.
- PR: The cancer has a progesterone receptor. Progesterone is also a hormone.
- HER2: The cancer makes the protein HER2 .
- G: Grade of cancer refers to how different the cells look from normal. Grade 1 indicates that the cells look fairly normal, while grade 2 cells are growing a little faster, and grade 3 cells look markedly different than normal breast tissue.
These markers, along with the TNM measurements, define your stage.
A cancer recurrence refers to cancer that returns in the same breast, and it requires new staging. This new stage is marked by an R at the end to indicate restaging. If it develops in the other breast, its considered a new cancer.
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Coping With Worries About Recurrence
Nearly everyone who has been treated for cancer worries about it coming back.
At first, every ache or pain can frighten you. But, as time passes, you may come to accept minor symptoms for what they are in most cases warning signs of a cold or flu or the result of over-exerting yourself.
Some events may be particularly stressful the days or weeks leading up to your check-ups, the discovery that a friend or relative has been diagnosed with cancer or the news that someone you met while having treatment is ill again or has died.
We all cope with such anxieties in our own way and there are no easy answers. But keeping quiet about them and not wanting to bother anyone is probably not the best approach.
Just as talking about your diagnosis and treatment may have helped you through the early days, talking about your fears relating to recurrence may help you later on.
Breast Cancer Nows Forum lets you share your worries with other people in a similar situation to you.
You can also read our tips on coping with anxiety and find suggestions in BECCA, our free app that helps you move forward after breast cancer.
What Resources Are Available To Survivors
Even for survivors, there is still important work to be done. In addition to prescribed follow-up appointments, regular screenings or treatments your physician may recommend, supportive care is available for after a cancer-free diagnosis. Survivors can check with their local cancer center for a survivorship program to help guide them in their post-cancer care. Clinical psychologists are available to consult with patients who are dealing with issues affecting their daily life such as survivors guilt, anxiety and depression. Cancer survivors can also seek help from online resources through the American Cancer Society, the National Coalition for Cancer Survivorship, and the Livestrong program.
Youve achieved something extraordinary. Being cancer-free provides fresh perspective and hope for all survivors and their families.
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Breast Cancer May Return Even 20 Years Later Study Finds
Breast cancer can smolder and return even 20 years later unless patients keep taking drugs to suppress it, researchers reported Wednesday.
They were looking for evidence that at least some breast cancer survivors might be able to skip the pills that reduce the risk of the breast tumors coming back, but found that even women with low-risk cancers had a small rate of recurrence 15 and 20 years later.
Ten Lifestyle Changes That May Help
All breast cancer survivors live with the concern about a recurrence or a new cancer. This fear is usually the biggest worry of all. Many women feel that their body has betrayed them and therefore it takes time to trust it again.
Learning how to cope with fears of recurrence is important. Though your body has gone through many changes as a result of a cancer diagnosis and treatment, most women become healthy, strong and optimistic once again.
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Understanding The Difference Between Cure And Remission
Cure means that there are no traces of your cancer after treatment and the cancer will never come back.
Remission means that the signs and symptoms of your cancer are reduced. Remission can be partial or complete. In a complete remission, all signs and symptoms of cancer have disappeared.
If you remain in complete remission for 5 years or more, some doctors may say that you are cured. Still, some cancer cells can remain in your body for many years after treatment. These cells may cause the cancer to come back one day. For cancers that return, most do so within the first 5 years after treatment. But, there is a chance that cancer will come back later. For this reason, doctors cannot say for sure that you are cured. The most they can say is that there are no signs of cancer at this time.
Because of the chance that cancer can come back, your doctor will monitor you for many years and do tests to look for signs of cancers return. They will also look for signs of late side effects from the cancer treatments you received.
How Do You Know Youre In Remission
Tests look for cancer cells in your blood. Scans like X-rays and MRIs show if your tumor is smaller or if itâs gone after surgery and isnât growing back.
To qualify as remission, your tumor either doesnât grow back or stays the same size for a month after you finish treatments.
A complete remission means no signs of the disease show up on any tests.
That doesnât mean your cancer is gone forever. You can still have cancer cells somewhere in your body. Regular checkups will help your doctor make sure the disease isnât active again.
When cancer does come back, itâs called recurrence. Thereâs no way to tell if or when that will happen. This can happen weeks, months, or even years after remission.”add “If and when a cancer comes back varies greatly depending on the cancer type.
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