Will 30% of Early Stage (1-IIIA) go on to metastasize??
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The lump I have is solid when I push on it. Not squishy. It feels just like the cancerous lump I had in my right breast.
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mine too paper.. it felt hard.. but it was a dark spot on the US.. so I knew it was fine.
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Thank you all very your responses. I greatly appreciate all of your input.
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paper...yes. radiologist number one wanted to biopsy one of my cysts. A second radiologist disagreed with the first radiologist. Radiologist number two wanted to biopsy a DIFFERENT cyst. That cyst was mucinous breast cancer. My moral of the story is that if a patient is going to have diagnostic imaging....it needs to be done by an excellent team. After my diagnosis...I dreaded imaging. However...that second radiologist is my friend for life! I send EVERYONE to him. I have 100% confidence in him. If anyone is concerned about their imaging...then speak up and find an imaging group that you trust. Then....let them do what they do best so you don't need to worry.
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barbe1958 it is a proven fact that you can reduce your risk of recurrence with exercise and weight control. But it's not a guarantee. Just like you can reduce your risk if you remove your breasts, but there's still a 3% chance of a new breast cancer diagnosis.
"Short of resorting to such drastic measures, all women can reduce the risk of getting breast cancer by drinking less alcohol and losing weight. "Patients want to know what they can do," says Cobleigh. "It used to be you could say, 'There really isn't anything.' Now you can say, 'If you control your weight after a diagnosis of breast cancer, you'll be less likely to die.'" source: linky
and"Regular exercise is an important part of being as healthy as you can be. More and more research is showing that exercise can reduce the risk of breast cancer coming back (recurrence) if you've been diagnosed, as well as reducing the risk of developing breast cancer if you've never been diagnosed." source: linky
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Somewhere in all my readings I found a study that said drinking alcohol implies an unhealthy lifestyle. So lack of exercise and bad dietary choices would be the same thing. Yet there are hundreds of health conscious women that recur or develop mets. Again it's a way of blaming the patient. Some women feel the need to be in control so saying eat well, diet and exercise and you'll be fine works for some. But hey doc! I was doing that before and got breast cancer anyway!!
We all know if we're ER+ we don't want extra estrogen in our bodies and fat produces estrogen. So why aren't all the fat, lazy women the ones recurring??
We have to consider lurkers and newbies who cannot exercise for other reasons reading all this and panicking. Of course it's healthier to try if you can but it's no guarantee you won't move on to stage IV.
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Barbe, I understand what you are getting at, but the argument does not really hold. Taking femara or doing chemo or exercising or maintaining a healthy weight will each and all reduce the risk of recurrence. None of the above will eliminate the risk. So you can do everything "right" and still recur. You can also do everything "wrong" and never recur. So whatever you do, it remains a crap shoot. But you can still improve your odds, however slightly
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Paper dolls, the fact that your lump hasn't increased in size in a year is a good thing. If it was cancerous it certainly would have grown by now.
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I'm with Momine on this one. I play the odds in my favor if I can. My risk of getting breast cancer at age 49 with my risk factors (no kids, dense breast tissue, female) was below average, less than 2% for my age. Someone has to fall in that 2%. But I will still try to reduce my risk for recurrence. My oncologist considers me high risk for recurrence.
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I think, as has been said, that many things have been shown to reduce risk, but reducing risk does not mean eliminating risk. I think it is helpful to do things to reduce our risk, but we still have to live. None of us knows why we got cancer.
I exercise daily, eat a vegetable based diet (but if my kids bake cookies I eat some), am thin and fit, and breastfed my 3 kids for a year each. That stuff all looks great on paper; to look at me, I am the picture of health and look super low risk. BUT.....I have a rotten family history that gets worse with every generation, I wonder about environmental factors where I grew up (5 of the 7 girls on my street were diagnosed with breast cancer in our 40s and the other 2 have irregularities that are being followed), I work a job that involves shift work (a risk), and work a job that could potentially expose me to hazards. But, I love, love, love my job, and have never once felt like I was going to work. I look forward to going to work every day and know not many people can say that. The stress if I did not do my job would probably negate any gains in quitting my job. I think this site is so helpful in helping us to understand various things that we can do to reduce our risk and positive changes we can make to reduce our risk, but as has been said previously, reducing your risk does not involve eliminating risk. If I recur again, and I do know I likely will, I will not feel guilty for working my job, I will not feel guilty for eating the cookies my kids bake, and I am comfortable with my treatment and general health decisions. I think we all need to find that place where we're doing what we're comfortable with to reduce our risk (because cancer takes a lot of control away and making positive changes gives us a little control back), but at hte same time, live life and love life.
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My IDC 2.0 cm lump on my left side was noted on the complete mammogram report (that I didn't receive) the year before my diagnosis. It was dismissed and reported as not a problem but they had me come in because of a concern about my right breast (2012). After an ultrasound, I was told to come back in a year for a regular mammogram. Then in 2013 after the mammogram, there was a concern about my left breast. I argued with my breast surgeon because I wanted them to recheck the right side. He told me he was not concerned about my right side but only my left side. I insisted and his statement was "if you want to get poked with a needle during an ultrasound, go ahead and do it." I have never argued with a doctor before, but I stood up for myself. It was only a cyst but I felt a lot better about having it checked. It also contributed to my having a double mastectomy because I didn't want to worry about it year after year. We are our own best advocates and have to stand up for ourselves. Or take someone with us who will do it for us. Take care!
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I had a large “estrogen window," but despite having a menarche before my 11th birthday, I was seriously underweight until my late teens and never overweight until my late 20s (and believe me, I would kill to be at the weight that sent me to Weight Watchers). I gained a lot of weight during my pregnancy but became anorexic from PPD and was once again seriously underweight for a year. When the depression lifted, my appetite (and capacity to keep food down & in) returned and I first became obese at age 37. (I am trying desperately to get down to that weight). I did not reach menopause until I was 55, and it was a breeze. I had only one child because of impaired fertility (short luteal cycles, too-frequent periods), had difficulty starting to breastfeed and had to stop because the antidepressants got into my milk. My mom also had an early menarche (10), a late and easy menopause (55), two kids (I was difficult to conceive, my kid sister was a “surprise") and never breastfed. She smoked for 50 years and was mildly obese until she was diagnosed with diverticulosis at 72--and as her doctor instructed her, “stopped eating junk." Yet she did not get breast cancer. I guess you can say she won that particular genetic lottery. As I tested BRCA-negative and have absolutely no family history of breast, gynecologic, colon or pancreatic cancer on either side, I was advised that neither my sister nor my son need be tested. (And because my sister's late MIL died not of breast but of smoking-induced lung cancer, there was no need to test my niece either).
My dietary habits leave much to be desired. I fall off the low-carb wagon on to the “comfort carousel" all too often these days; a mostly-plant-based sugar-and-starchless diet with moderate amounts of fat and animal protein is the only way I can lose weight any more. (I've tried 'em all--WW, Jenny Craig, Seattle Sutton, even Ornish--and anything that includes starches and palatable fruits might as well be a cake-and-ice-cream diet for all the good it does my physique and blood chemistry. A hybrid of Atkins/paleo/S. Beach seems to be the only thing that works). If I were to be ordered to give up dairy, most fats and meat, you might as well wheel me into the OR for a liposuction and gastric bypass, since a diet of berries and leaves is as distasteful to me as the mere nibbles of turkey breast & such to which I'd be limited after bariatric surgery. Heaven forfend I get a recurrence and it's also ER+ (or I have a cardiovascular “adventure") I will revisit my dietary habits & aversions. Meanwhile, there's a Greek salad with my name on it waiting for me in the fridge. (No retsina, though--I am rationing my alcohol to less than a pint of wine a week). And my exercise aversion is excused for the next few days while I heal from cataract surgery.
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sandy....I am exhausted from just reading about all of your dieting! I can only imagine how exhausted and frustrated you might feel. That said, you should applaud yourself for your effort!
Recently, my sister and I had a delicate discussion about her weight. I helped her choose an eating book, Mindful Eating. Notice I didn't use the word ....diet. Mindful Eating is about our relationship with food. Having a DH with a metabolic disorder allows us to work with world class endocrinologists and dieticians. IMHO...Mindful Eating is the only way to make peace with our food relationship. Learning now to eat properly when the a!ternative can be potentially be deadly is a frustrating way to live. But....with professional help...they have instilled in us how we can ENJOY eating. Most people do not enjoy eating. They might enjoy too much certain food....but have little appreciation for the food itself and the experience ...whether alone or with others. There are psychological, sociological and environmental AND genetic issues in play each time we bring food to our mouths. Mindful Eating helps us sort out these issues.
Anyone who is frustrated by food should look at the Mindful Eating theory and see if it makes sense to you. My sister now has a Mindful Eating workbook. Not sure if she is using it...Will see her in person soon. I will know if it is working once we see one another.....fingers' crossed....
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I took a mindful meditation course and that sounds intriguing!! I must look that up.
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http://onlinelibrary.wiley.com/doi/10.1111/obr.121...
Among researchers... it looks like the Mindful Eating theory is gaining traction ....
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Interesting discussion. ChiSandy, I laughed at and loved your post!
After we're diagnosed, I think we all feel some pressure to make lifestyle and diet changes. The question is, do these changes make a difference? The answer is: For all of us together who have ever been diagnosed with breast cancer, Yes, absolutely. But for each of us individually, it's more of a Maybe Yes, Maybe No.
The thing to remember, as has been pointed out in previous posts, is that there likely are dozens (if not hundreds) of different factors that individually or in combination either cause the development of breast cancer, or, after treatment, may trigger any remaining dormant cancer cells to develop into a recurrence. To complicate things further, we aren't all affected by the same factors, and the specific factors that affect each of us as individuals are impossible to know. What is a risk factor for me might not be a risk factor for you, and vice versa. That's why some women do everything 'wrong' and yet never develop breast cancer or a recurrence, while other women do everything 'right' and yet still develop breast cancer or a recurrence. And that's why while there are things we can do to try to reduce our risk, we can never eliminate all of our risk nor can we ever know if what we are doing will in fact benefit us.
Here is a simple example. Let's say that after a full course of treatment, Patient A is left with a 20% risk of distant recurrence (i.e. the development of mets). Now let's match Patient A up with 299 women just like her, so that we have 300 women, all of whom have a 20% risk of mets following treatment.
- 100 of these 300 women make no lifestyle or diet changes.
- 100 of these 300 women increase the amount they exercise, and improve their diets, eating healthier. While it's difficult to get figures on how much exercise and diet affects breast cancer specific mortality (most studies report on 'mortality from all causes'), a quick review suggests that adding exercise and improving diet might reduce breast cancer mortality by as much as 30%.
- 100 of these 300 women also increase the amount they exercise, and they too make the same diet changes. In addition to that, these women reduce and/or eliminate the amount of alcohol they consume. The impact of reducing or eliminating alcohol consumption is even more difficult to quantify, because the studies are all over the map. The latest assessment I could find actually suggests no impact at all on mortality (Alcohol use and breast cancer survival among participants in the Women's Health Initiative) but there are other studies that have shown a small improvement in survival. So let's say the impact is a 10% reduction in mortality.
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So how do these lifestyle changes affect the risk level and mortality rate for each group of 100 women?
In each group, there are many survivors. And in each group, there are some women who will develop mets. In the second and third groups, where lifestyle/diet changes were made, there are also a number of women who will not develop mets, and who will therefore survive, because of the changes they made. So yes, these types of changes absolutely do affect survival rates.
That's what happens when you look at a group of 100 similar women. But what happens to each of us as individuals? If you make lifestyle and diet changes and don't recur, was it because of these changes? Or were you one of the ones who was not going to recur anyway, no matter what you did? If you don't make lifestyle and diet changes and you do recur, was it because you didn't do these things to reduce your risk? Or were you one of the ones who was going to recur no matter what you did? No one can ever know. That's why, when someone does have a recurrence, no one should ever suggest that it was because of what that individual did or didn't do. There is no inconsistency in acknowledging that certain lifestyle and diet changes are beneficial and do reduce breast cancer mortality overall, while at the same time also saying that no one should ever blame the patient who didn't make these changes and does have a recurrence.
Ultimately, because there is so much uncertainty about what will happen to any of us as individuals, we each just have to do what we feel is right for ourselves. I suspect that each of us probably has some gut feeling as to what might happen to us, and that drives our decisions as to what we will or won't do to reduce our risk. How we manage fear and uncertainty drives our decisions. The extent to which we are willing to change and adjust our lives, and the ease or difficulty in making those changes, drives our decisions. The best we can do is to try to find our own balance and be happy with our own choices.
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beesie ....I will add....once we make our choices ...then....carpe diem!😘😘😘
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Well done, Beesie!!! The big number to look at is the 80% who survive no matter what!!!
I am saying this post exercised (5k run), good food w/veggies for dinner, and wine
As a point of reference, most cyclists I know also love beer. It's the libation of choice post cycling event. Because you need a "bit extra" whether cycling 100k or 100 miles.
I second (or third) "carpe diem" because there are no guarantees in life. I do know that you don't want to be the one wondering "what if"???
Hoping to get out to the San Juan Islands for a spot of cycling on Saturday. But only 50-60k. - Claire
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This is very interesting and informative Risk of recurrence in Early Breast Cancer
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barbe...never said exercise would eliminate risk of recurrence, just improve your odds. IMO its one of the things we can do to help ourselves. Just disputing your statement saying exercise has nothing to do with recurrence. As I said in my previous post, unfortunately there are no guarantees. Good luck to all...
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There are no guarantees in life, cancer or no cancer. Should we start stating the obvious in every post as a disclaimer?
I'm reading a book called 'You are the placebo', it's interesting and even though I can't buy into it 100%, I'm thinking it may not be a bad idea to consider myself cured until proven otherwise! And think that exercise, diet and AI are all good for me, it might as well be good if I think they're good.
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Me too,, Im NED and most of the time my mind thinks I'm cured
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"never said exercise would eliminate risk of recurrence, just improve your odds"
dtad, that's exactly what I was trying to show with the example and the 'survivor/develop mets' table in my post. If you look at the numbers, and they are pretty close to reality, your point becomes crystal clear.
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Here is some new research on preventing reoccurance of ER+.
http://scienmag.com/scientists-identify-genes-that-disrupt-response-to-breast-cancer-treatment/
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That's an interesting link, thanks zjosenthal.
People here who know their genetic predispositions know that they have extra recurrence burdens. Those feeling comfortable sitting inside the magic 70 per cent "safe" zone, who don't know their personal genetics, might consider some tests.
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So how many of us have gained significant weight since treatment (raises hand)
"Weight gain following breast cancer diagnosis: Implication and proposed mechanisms"
linky from World Journal of Oncology posted on National Center for Biotechnology Information, U.S. National Library of Medicine site0 -
Lago,
I gained over 10 lbs after dx but now that i started the hormone therapy, i am on strict diet so I lost some :-)
I am having light breakfast and healthy dinners (mostly salads with chicken or steamed veggies) lol
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Well, that was certainly a depressing read. Kind of insulting, too, in that they conclude that lifestyle counseling may be needed - and yet, the very women having the mist trouble with weight were those who presumably knwpew (and did) all the right things, since they were lean and healthy at dx. It was the overweight and obese who did not gain, or gained less.
Frankly, if I'd read that when I was first dx. I probably would have thrown in the towel then and there.
I also have a hard time believing that AIs have nothing to do with weight gain. I'm living on about 1200 cal per day and not losing, and that's in addition to copious, consistent amounts of exercise. I find the connection between tx and sarcopenia (loss of muscle mass) intriguing although, again, depressing.0 -
I gained 30 pounds on exemestane and anastrozole. Now that I'm not taking it I'm down almost 15 pounds. Back to high level of exercise to accelerate the process. I feel great, I really forgot how good I felt before my BC dx.
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