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Will 30% of Early Stage (1-IIIA) go on to metastasize??

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  • bluepearl
    bluepearl Member Posts: 133
    edited October 2013
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    It now gets worse. 39% of women who get breast cancer go on, within five years, to have another cancer in another place in their bodies. OK. Stats. They can be very misleading when you lump people together. Stage 1 can be anything from a very small 1 mm tumor to a 2 cm tumor. The Grade can be anywhere from 1 to 3. You can have various ER/PR/Her2 readings. OncotypeDX can vary. You can various TYPES of breast cancer. You can have BRAC 1&2. Presence or absence of LVI. All these will influence where you are in that 30%. ...as well as that 39% which would include cancers caused by treatment...ie....uterine cancer and tamoxifen. They also said women with breast cancer are more prone to melanoma and non-melonoma skin cancers as they age. Aren't we all...especially sun whorshippers....so how do you eliminate that behavioral component? Who hasn't had a bad sunburn in childhood? Theresanne is right. Try to stack the deck in your favor but remember the life is a gamble where not all the results are based on planning, but just luck. And the game ends for all of us someday. That means...LIVE today!

  • beesie.is.out-of-office
    beesie.is.out-of-office Member Posts: 1,435
    edited October 2013
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    bluepearl, what the other study that you are referencing said is that the risk to develop another cancer within 5 years after a BC diagnosis is 39% higher than what the risk would be for someone who had not had breast cancer. It did not say that 39% of women develop another cancer.


    In fact, in this study, overall just 5.3% of women who'd had breast cancer developed another cancer. And this 5.3% would include women who have genetic mutations such as the BRCA genes, which significantly increases risk. So that means that for women without these types of genetic mutations, the risk would be lower than 5.3%.


    Edited to add: Just for additional clarity, the study showed that 5.3% of women who had BC developed another cancer, and that was a 39% increase vs. the rate of cancer (excluding breast cancer) among those who did not have BC. So this means that 3.8% of women who didn't have BC developed a different type of cancer; 5.3% is a 39% increase over 3.8%. In total then, only an additional 1.5% of women developed a second type of cancer due to previously having had a diagnosis of breast cancer.


  • rozem
    rozem Member Posts: 749
    edited October 2013
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    thanks for the clarification Bessie - that number freaked me out! im mean honestly, being diagnosed and then having to worry about another cancer.. insult to injury

  • claire_in_seattle
    claire_in_seattle Member Posts: 2,793
    edited October 2013
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    Going to the latest SEER data, there is more good news on this topic. As of the latest update about one month ago, 5 year survival for patients with Stage 0-I is 100%. For Stage II, it's 93%. This marks a significant improvement over previous stats.


    http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-survival-by-stage


    It is only when you get to Stage III that ~30% of patients don't survive 5 years. But 73% for all Stage III represents a quantum leap over ten years ago....I believe by roughly 20 percentage points.


    Things get even better at some major cancer centers. At Seattle Cancer Care Alliance, 89% of Stage III patients who start their treatment there live 5 years. That is jaw-dropping. Stats for Stage II are similar to SEER data.


    Anyway, I can say that unfortunately some of us will have a recurrence, and some of us will get metastatic cancer, but what I see in these numbers is IMMENSE PROGRESS. Is it enough? No. What does annoy me though is unnecessarily scaring women to death with bad (and OLD) data to create headlines.


    I read all the stats when I was first being diagnosed. At that time, the 5 year stats for IIb were something like 75%. I will take >90% any day!!! - Claire

  • bounce
    bounce Member Posts: 215
    edited October 2013
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    blupearl - you nearly gave me a heart attack! Beesie - thank you for clearing things up.


    Theresanne - loved your post - am also eating healthier choices and exercising more. I always use my seat belt. Hell I am even prepared to wrap myself in bubble wrap and wear a crash helmet all day if that makes my odds better. :-)

  • rozem
    rozem Member Posts: 749
    edited October 2013
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    Claire - thanks for that info. I remember my onc telling me that for her2 pos you need to take 10% off the stats so what she told me is about right. 93% of stage 2 - and she told me about 83% for me. Although my BS (who is involved in neoadjuvant trials for her2) says with the widespread use of Herceptin our odds are closer to the her2 - gals now. So yes we are making progress - and yes agreed that we need more research!

  • violet_1
    violet_1 Member Posts: 335
    edited October 2013
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    Claire,  100%!? Now HOW in the HELL could that be true? Not killing the messenger here...just ? the stats...?????

    Vi

  • Momine
    Momine Member Posts: 2,845
    edited October 2013
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    Vi, the stats are for 5-yr relative survival, meaning they do not count deaths from non-cancer causes and they say nothing about what happens 7, 10 and 20 years out.

  • liefie
    liefie Member Posts: 761
    edited October 2013
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    Beesie, I have thanked you before, but want to thank you again for always analysing and explaining these confusing stats for us, and for being so educated about this. You are the voice of reason here, and I always feel way better and more positive after reading your posts. You are truly amazing!

  • violet_1
    violet_1 Member Posts: 335
    edited October 2013
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    M, but it's saying that ZERO % STAGE 1 NEVER EVER GETS RECURRENCE BEFORE 5 YEARS? WE KNOW THAT ISN'T TRUE...?

    I'M CONFUSED HERE. .

    V

    .

  • Annette47
    Annette47 Member Posts: 108
    edited October 2013
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    Violet - they are not saying that 0% get a recurrence, just that they survive past 5 years. So some may have local recurrences or in the few who do have distant metastasis, they are still alive with it at the 5 year mark.

  • violet_1
    violet_1 Member Posts: 335
    edited October 2013
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    Annette,

    Thanks. ..ah...I get it now...sorry...& duh on my part...lol!!!!

    V

  • violet_1
    violet_1 Member Posts: 335
    edited October 2013
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    P.S.

    Apparently, I need more coffeeee!

    Vi

  • LizA17
    LizA17 Member Posts: 102
    edited October 2013
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    As you can see in my signature line, my cancer would be considered aggressive. My Onco has never said anything negative to me. He says thanks to Herceptin and all the other things they have to throw at triple positive cancer, I should be just fine. I'm just happy if I had to have it, that its now and not 15 yrs ago when they didn't have all these tx's available. I choose to look at the glass half full. Sure, I know I could recur and that's scary but if I'm going to be a statistic, I want it to be a good one! Stay strong girls!!

  • violet_1
    violet_1 Member Posts: 335
    edited October 2013
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    And YET...on further thought, I still can't imagine that ZERO percent stage 1's never EVER have died of BC within the 5 year range...ever?

    Vi

  • pupmom
    pupmom Member Posts: 1,032
    edited October 2013
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    Violet, that doesn't sound possible to me either. What are we missing here??

  • beesie.is.out-of-office
    beesie.is.out-of-office Member Posts: 1,435
    edited October 2013
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    Vi, that's not what the data is saying. Claire said that the 100% 5-year survival rate for Stage I is based on the latest data just recently released. So it's not talking about all Stage I women ever. The 100% survival rate applies only to the most recent group of women diagnosed as being Stage I who've been tracked for 5 years. I believe this would be women diagnosed as Stage I either in 2004 or maybe 2005 (I've seen the 2004 stats; not sure if the 2005 stats have been released yet).


    In the past, certainly some Stage I women did die within the first 5 years post-diagnosis. But now, with the treatments that we have available, all Stage I women are surviving at least 5 years.

  • violet_1
    violet_1 Member Posts: 335
    edited October 2013
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    Beesie,

    Thanks for clarifying. .BUT are you saying still that ZERO % OF Stage 1's with the new advances we have NOW MEANS that ZERO women presently will absolutely not die of BC&/ or that NO ONE HAS DIED YET ANYWHERE OF BC /stage 1-ers in the recent past 5 years?

    Sorry...just trying to get this shet straight...

    Vi

  • nancyhb
    nancyhb Member Posts: 235
    edited October 2013
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    I suppose what the stats are saying is that someone diagnosed as Stage 1 on 1/1/2008 was still alive on 1/1/2013. Let's say they did chemo and rads, and on their first anniversary (1/1/2009) they were still NED. Six months later they discover mets. With aggressive treatment, 3.5 years later, they are still alive.


    Early stage BC won't kill you. It's what comes after that - particularly mets - that will cause our death.


    What the stats don't say is how many of those Stage 1 women are not just "alive" but "alive and well" at the five-year mark. That may, in some ways, be just as important as how many are alive at five.

  • beesie.is.out-of-office
    beesie.is.out-of-office Member Posts: 1,435
    edited October 2013
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    I'm not saying anything. :-) I'm just explaining the data. The data is saying that of the Stage I women most recently tracked by the SEER database, either no women died within the first 5 years after diagnosis or so few died that the result still comes out to be reportable as 100% survival.


    I don't have the raw data so there's no way for me to know if zero women died. If 120,000 women were diagnosed with Stage I breast cancer that year (probably 2004 or 2005; 120k is probably in the ballpark), possibly a few women died within 5 years of diagnosis. But if 10 women died, the survival percentage would be 99.99167%, which would be reported as 100%.


    As for the past 5 years, that data isn't available yet.


    And as for the next 5 years, whatever the past data says, there is no way that anyone can guarantee or say with absolute certainty that of all Stage I women diagnosed today, zero women will die within the first 5 years after diagnosis. However what the data is saying is that the likelihood of surviving at least 5 years with Stage I breast cancer is virtually 100% (and may be absolutely 100% but that can't be guaranteed).


    This is U.S. data. So it's not reflective of those diagnosed ANYWHERE, but only is reflective of the U.S..

  • bluepearl
    bluepearl Member Posts: 133
    edited October 2013
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    Thanks for correcting me Beezie. Between a stomach flu and other stresses, I just seem to like making things worse for myself. I contacted John Hopkin's Breast Cancer Center and they said to take such stats with a grain of salt for precisely the reasons I outlines....tumors vary considerably in many ways. We are scared and it is reflected in this discussion. I didn't do well in stats in university (how can you tell) so appreciate so very much Bessie's explanation and breakdown.....I like your quote as well. Sp TRUE!!!!

  • violet_1
    violet_1 Member Posts: 335
    edited October 2013
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    It's just a crying shame all the different stats are so complicated to decipher.  Hard enough for those of us used to researching...nearly impossible to understand when one is a new BC patient. 

    I'm not asking out of fear personally,  I'm just trying to discern what the hell each organization /study is trying to say...and questioning that which SOUNDS loo-loo...;) Crazyland.

    AND,  I think it's true...take 'em ALL w a grain of salt...OY! 

    VIOLET

  • littlemelons
    littlemelons Member Posts: 23
    edited October 2013
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    The 100% 5-year survival rate for stage 1 is comforting, but becomes less so as you approach the 5-year mark.  What are the most recent stats for 10 years or 15 years?   At 5 years we may have to give up our anti-hormonal treatment and the stats are less clear, so it starts to get scary then. Thanks for your explanations, Beesie, they are very helpful.

  • beesie.is.out-of-office
    beesie.is.out-of-office Member Posts: 1,435
    edited October 2013
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    LittleMelons, the SEER database doesn't provide 10 year or 15 year data by Stage. But here is the overall survival data, for all women diagnosed, all Stages:


    Year of Diagnosis ...5 yr survival...10 yr survival....15 yr survival....20 yr survival


    1975-1979....................74.6%..............62.4%................56.0%.................51.7%


    1980-1984....................76.3%..............64.4%................58.2%.................54.7%


    1985-1989.....................82.2%.............73.3%................68.1%.................64.4%


    1990..............................84.6%.............77.0%................71.8%.................67.5%


    1995..............................86.8%.............80.6%................75.9%...............Not Avail.


    2000..............................90.2%.............84.5%...............Not Avail............Not Avail.


    2005..............................90.5%..........Not Avail..............Not Avail............Not Avail.


    So you can see the significant improvements in all of the rates. What's interesting is that the improvements in survival rates at 5 years seem to always continue to be reflected at 10 years, and in fact the 10 year improvements are generally better than the 5 year improvements. Same for the 15 year and 20 year rates. So although 15 year and 20 year rates aren't yet available for more recent years, if this pattern continues, we can expect to see very significant improvements in the 15 and 20 year rates for those diagnosed in the later '90s and 2000s.

  • claireinaz
    claireinaz Member Posts: 682
    edited October 2013
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    I'm also going to mention that this study doesn't include hormone tx (tamoxifen, arimidex, etc.), does it? Anyway, I'm not going to stress about this, stage 2, grade 1 or not. As I've mentioned before, stats generalize to the whole. I don't feel that is helpful for me. Now off to bikram yoga for me!


    Claire in AZ

  • littlemelons
    littlemelons Member Posts: 23
    edited October 2013
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    Wow, thanks for posting these stats, Beesie. These percentages are higher than I thought.  Very encouraging.  As you pointed out the improvements are even greater at the 10-year point.  A 22% percent difference between 1975 and 2000 is a great number of lives.  I count myself lucky to be stage 1, but have had a few scares - spots on liver, suspicious spots on spine which required further scans - so the fear lurks.  Let's hope for more effective new treatments and of course a cure so that stage IV will not terminal.

  • farmerlucy
    farmerlucy Member Posts: 596
    edited October 2013
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    Beesie - AWESOME! So very interesting! Thanks!

  • voraciousreader
    voraciousreader Member Posts: 3,696
    edited October 2013
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    I think the takeaway message here is that patients should NOT have a knee jerk response when they see headlines involving statistics. Unless you have taken a college level course in statistics, try not to understand what you rip from the headlines. Instead, patients need to discuss with their physicians what is their personal risk of recurrence. Then, as new studies are reported, once again contact your physician and try to understand how the study relates to YOU.


    As I mentioned earlier on this thread, often the way studies are conducted today, it is often difficult to extrapolate how the data relates to individuals. Hopefully in the near future, studies will be conducted in a way that patients will have a better way of identifying, with more precision, how the study relates to YOU.


    Another takeaway message from the statistics, is that you can see from the time when endocrine therapy began and from when Herceptin made its way into usage, breast cancer is now becoming one of the MOST treatable cancers. No cure, but certainly for MOST patients it's become a treatable and controllable disease. Putting this into perspective, according to The American Cancer Society, there are over 2.8 million patients in the US who have at some point been diagnosed with breast cancer who are ALIVE.


    I think with the proposed changes that Dr. Topol suggests in his book, The Creative Destruction of Medicine (which, by the way, are already occurring), and with researchers like the one I am supporting from Sloan Kettering, we will one day soon see fewer deaths from this vicious disease AND a cure AND a vaccine to prevent all kinds of cancers!

  • LizA17
    LizA17 Member Posts: 102
    edited October 2013
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    Amen and thank you for that perspective voracious reader!

  • TheNancyGirl
    TheNancyGirl Member Posts: 1
    edited October 2013
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    Oh no Fran. I read the other thread. HUGE hugs. Drink and sleep if it makes you feel any better.