Will 30% of Early Stage (1-IIIA) go on to metastasize??
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Well, that's why I said "normally" or something like that....
Muska, it would make a HUGE difference whether your cancer is fast or slow growing as chemo ONLY works on fast growing cells. It would have been a waste for me to have gotten chemo 7 years ago! They are testing a whole bunch of different ways now to see if you "need" chemo or not. Stats wouldn't apply to AorB, just lump it all in one.
I still think early stage patients are UNDER treated.
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Barbe many are. I agree. I'm still pissed you didn't get hormone suppression therapy. I do think that is changing but earlier stage might still be getting 5 years. While the studies aren't out yet my Onc is pushing for 10 on me because she considers me high risk as I said earlier even though I'm node negative. So those with tumor less than 5cm and no nodes might not be pushed for 10 years right now.
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hi barbe,
How can you tell if a cancer is fast growing or slow growing? Mine is grade 2 but it was 1.4 cm and it never really grew in like 5 months. What is considered fast growing?
Thanks:)
Vicki
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Pathology labs look at the rate of cancer cell division (mitotic rate) to determine how fast it is growing.
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I've discussed this thread with my MO. My stats are all over the place and like many. I don't fit neatly into one box. I've reviewed the published data, my lifemath scores and all sorts of other numbers I come across. His response resonated with me. "Your numbers are your numbers." In other words, while I scour the internet looking for peace of mind, I really cannot compare my case with someone else's.
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Isn't that how they get the statistics they give us?
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WW I don't "believe" in stats! Why. You've already blown the odds by getting cancer in the first place. Now I've blown them again by recurring! Stats are NO guarantee in anything but false hope or false despair....
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Barbie I agree Early breast caners are under treated. We should be told about metastic breast cancer right away so we can select to opt for chemo or not with the full information. not just asked to make a decision on chemo, with out knowing that we could be told we now have stage 4 cancer and are terminal and wishing we had taken more treatment in the beginning.
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Stats are an aggregate of what happened to a given group. Stats are not an individual predictor of what will happen to you. Additionally, if stats show a very small risk of something, someone will fall in that group. No one should mistake stats for individual predictive tools or a guarantee of anything. If you do you may end up being quite disappointed or worse.
I do feel that statistics have value but never view them as predicting my personal future
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phaila grade 2 is moderate rate. Grade 1 is slow growing and grade 3 is fast growing.
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Muska,
I think the study does not address the grade, aggressiveness, and severity of early stage breast cancer. Just looking at stages oversimplifies the nature of cancer. Basically breast cancer is split into 4 molecular subtypes: Luminal A (ER/PR+ and low growth rate), Luminal B (ER/PR+ and fast growth rate or triple positive breast cancer), HER2 breast cancer (HER2+ and ER/PR-), and triple negative. http://ww5.komen.org/BreastCancer/SubtypesofBreast...
In the past, staging was the best determinant of prognosis in breast cancer. However, 40,000 women and men are still dying of breast cancer per year. That stat has been the same since the 1970s. Now, molecular characteristics are helping determine the best treatment plans. That is why Oncotype Dx and Mammaprint have been to develop to see who will best benefit from chemotherapy.
I hope that explanation helps!
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The topic of "40,000 deaths per year from mbc" is often discussed on this forum.
Kayb, you are right about there being progress in breast cancer survival. The 1990s was a decade where herceptin was introduced, extending the lives of many women with Her2+ bc and it was also the decade where antiestrogen/aromatase inhibitors began being used to extend the lives of women with estrogen postive mbc. Still, there is no cure. We don't really even know how to prevent breast cancer.
As someone with bc metastesis, I don't want to see the statistics misrepresented or skewed to try to drum up support for mbc funding. Let the statistics speak for themselves honestly.
40,000 deaths a year is still too many. According to this website, an estimated 246,660 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S. this year. That does not include diagnosis of non invasive (in situ) cases. More than 2.8 million women in the U.S. have a history of bc. Since bc knows no borders, these numbers grow when you include the rest of the world's population. So, to find a cure? Yes, worthwhile for many. Many.
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I am one whose breast cancer did not behave as expected. My 1.9 cm, grade 2, node negative, low oncotype tumor did not seem to be taken too seriously once I finished treatments. After I felt my lump that recurred, I had to insist on it being biopsied. They were "sure" it was scar tissue because I was so "low risk". They were all floored that it returned. I am glad I found my recurrence before it had the opportunity to get into the nodes, but know that I am at very high risk to be stage 4 eventually. I do think early detection helps in catching things before they've spread too far, but it still is no guarantee, and that is not clearly conveyed at all.
I am glad that metastatic BC is getting more attention, but I think there needs to be more funding directed at treating ALL breast cancer. We need better treatments and hopefully cures for stage 4, but we also need to learn WHY some early cancers recur and some don't, and then focus ways on trying to have BC not recur at all. It all needs more research dollars. Hopefully the moonshot is getting us in the right direction.
The definitions of luminal A versus Luminal B vary based on which professional journal, etc you use, so they aren't treated differently because there's no agreed upon definition. Many use luminal B as ER+, PR-, HER2- with Ki67 over 15 or 20. There are lots of different criteria. I think the "experts" know there are differences, but they don't know what they all mean yet. They used to think PR really made no difference, but now seem to be learning that may not be the case. With all of the genetic stuff going on now with tumors, I think we are in an exciting time as far as new treatments. I just hope they come soon enough for all of us.
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I'm so sorry kbee
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Oh, it's all good. I'm done with treatment and back to living life again...the new, new normal!
It'd sure be nice though to see them focus more research on the guts of this disease, rather than the pink fluff. One year, a local breast cancer charity distributed magnets with mammogram reminders. I'm ok with that. They then spent a lot of "research dollars" to see if the distribution of their magnets had any effect on the numbers of women getting mammograms. And they brag about how much of their money goes to research. Put that "research money into REAL research that will have an impact on women with the disease. The 30% statistic is misleading though, which is frustrating. Misusing statistics is irresponsible and muddies the water of understanding for everyone. Even as someone who's often on the "wrong" side of statistics, I don't want them skewed in any way.
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Good luck with your new normal KBeee. You're right too about the whole pink campaign, it's out of control. A group of us from the Pinktober Revolution thread on BCO have put this site together: www.pinktobersucks.com
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I will wear the pink ribbon emblems I already have...but all year ‘round, not buy pink promotional items; and will tell anyone who asks that there needs to be more research into a cure (especially for MBC), not “awareness” nor simply early detection. (And that “saving the girls” isn’t always possible--saving the patients is what counts)!
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I think it's important to remember that 80% of all Stage 1, ER./PR+ women who have a simple lumpectomy would never have a recurrence. In other words, only about 20% of earliest stage basic breast cancers recur.
The problem is identifying that 20%. The rest of us are being horribly overtreated. I am 8 years out from diagnosis. I was told that if I had come in a few months earlier, they would have recommended chemo for me, since all women with over a 1 cm tumor were given chemo. Standard of care was changed. And, with the oncotype tests, we are finding that chemo would not help many women who seemed to be a perfect candidate for it. As it stood, my MO said she wouldn't even recommend the oncotype, my Ki was low, grade 1, indolent.
I stopped hormone therapy after 2 years -- doc wanted to switch me to an AI, but with my osteoporosis, I refused,Remember that most women who are fine leave BCO in a couple of years, so the people who comment here are either newbies, or people who have fallen into that difficult 20%
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"Remember that most women who are fine leave BCO in a couple of years, so the people who comment here are either newbies, or people who have fallen into that difficult 20%"
Not sure that's true, there are plenty of people here who aren't stage IV and are looking for answers to issues that concern them at the various points in their treatment. And there are inspirational "long-termers" (at all stages) who continue to offer help to newbies and others. The way things stand, the inconvenient truth is that 20-30 per cent of us know that we won't be on BCO forever.
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kbee, you didn't recur, you got a new primary by your stats. Didn't you? Yes, it's still IDC but that ER/PR stats are different. Recurring means the exact same cancer growing again. I'm sorry you got a new kind of cancer...what a bugger breast cancer is, eh??
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the one tumor was in the exact spot as the first. The other was several inches away (but I think it was where the initial needle biopsy went in). Their theory is that first time it was about 85 or90% PR positive. A couple of the cells in the 10% that were PRnegstive got left behind and were unresponsive to chemo and tamoxifen. So they are considering it a recurrence..... Not that it mattered too much. I wondered the same thing though.
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I think some different doctors have different theories, but like metastatic disease, local recurrences can mutate and present with different ER, PR, HER2 signatures. My preference would be that it's all gone now and it's mutating days are ancient history.
Time will tell...............0 -
I'm in the exact same spot as KBee myself, dealing with what I'm being told is a local recurrence but with different receptors. It's hard to find literature on this, and my MO treats it as a new primary because it's different (now TN). I was one of those "early stagers" who stuck around to support others but also understand my own future risks (Onco score of 42).
I never saw this as a possibility. I'm still trying to wrap my brain around this and what it all really means.0 -
Mine came back with the exact rare cancer (Papillary) I got the first time. I'm considered stage IV as per my surgeon, oncologist and radiologist.
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And I'm one of those who have stuck around. Still NED and plan to stay there.
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Many thanks to those who continue to post, even after you have finished your own tx and moved on. I have no empirical data to back this up, but if you search through member names, it seems clear that most become inactive after tx. This is pretty typical for many discussion boards. Once you medical situation or problem is resolved many find there is no need to participate.
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I was dx 4/18/2006 stage 2, IDC, 1/18 node positive, er+100%, pr+100%, Her2neg. Lumpectomy (twice to confirm clear margins) left breast 11 oclock position over my heart, chemo A/C DD, Taxol DD, followed by 35 radiation treatments to my chest and axillary. Then I tried Tamox as I perimenopause but couldn't tolerate it, so I demanded ooph to switch to Femara.
(What I skipped over is that prior to my lumpectomy my preop chest xray showed a lung nodule. MO told me I was now stage 4 without ever sending me to consult a pulmonary specialist. A biopsy was done via my back into my lung nodule and shown as benign fibroma. Long hx of bronchitis and allergies which they ignored when I told them. I found my own pulmonary specialist who was furious when she heard how I was treated. I am very cautious now of some medical professionals ....)
I found this site and the ladies here were far more helpful than my nurses and MO at the time. My sisters here GOT ME through my treatments when my medical team failed to adequately answer my questions. I spent hours researching and reading other patient treatment plans, side effects and simply how to get through with helpful tips. This was back when patients were all treated the same as one size fits all for treatments. A positive node had an automatic protocol for chemo - - even if I went for 2nd opinion it was the SAME McChemo drive through menu. OncoType testing was denied for a positive node patient until the following year 2007 - - and then only some MOs offered it. Most patients had to be informed to even ask for it. BRCA testing was not offered unless you had a convincing family hx of breast or ovarian cancers. MO was not interested in other family cancers, heart dx, strokes, etc.
Back then hardly anyone posted in the Clinical Trials, News Forum. I saw it as a huge gap and need on this site so I started to post any daily news articles I saw. Today it has taken off as the go to site for newbies and us long term patients who are still undergoing some form of treatments or side effects. The way I see it unless someone has walked in our shoes they will never understand the psychological, emotional, physical toll it has cost us. The heartbreak of broken marriages and lost family members. This is why I continue to support this site.
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I too want to thank those out of treatment and NED who post here to help us newer folks. Without you, we'd have no clue. So thank you!
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I agree BB! I think I keep a lot more current on BC developments than my onc can because of this site and in large part to CP!
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One thing that seems consistent is chemo responds best to aggressive cancer.
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