Will 30% of Early Stage (1-IIIA) go on to metastasize??
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Hello! I've read every single post on this thread over the last few weeks (yep...I'm a lurker!) Sooo...I've been following along and sbelizabeth...as I sit here in my comfy recliner, I too laughed to the point of almost peeing in my pants when I read ChiSandy's post earlier! And now hours later am I'm laughing again! Thank goodness the kids are in bed!
ChiSandy - I don't think we have ever interacted on the boards before, but I have literally read hundreds of your posts! Your father in law was hoot (and so is your PCP!)
Maryann
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I really have to get off BCO for the evening (but probably won't!) 10 minutes later and I still can't stop laughing about his "cocktail" combination! LOL! Sounds like something we would all need to drink during one of our many treatments. You know diarrhea and constipation all at the same time! LOL!
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ChiSandi,
The cocktail brings back memories from 30 years ago. I had recently been introduced to Indian food and was intrigued by the lassi yogurt based drink. I was suffering from morning sickness and constipation. Skipped the Miralax, but mixed up a yogurt and prune juice drink that got me past the worst months.
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Momine....Never said that weight gain and mobility issues were universal but they are the 2 most common SE of aromatase inhibitors. The main reason I mentioned it is because I think we deserve better treatment options that do not impact our QOL. Good luck to all.
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Dtad, absolutely and we agree.
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I know this has nothing to do with this topic but you all are so knowledgeable I thought maybe one of you might be able to help me out . my daughter just had a 3-D mammography and it came back with nodular density and they are asking for her to come back for more pictures and ultrasound.. how common is this? As you can imagine I'm going to worry until she gets the results and everything's OK . She goes on Tuesday.
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ThinkingPositive - Without exception, every single mammogram that I had for more than 20 years required me to come back for a screening mammo and an ultrasound because my breasts were dense. For a VERY long time, it was nothing more than dense breasts. Tell her not to panic.
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MinusTwo..thanks for responding. I think I am more nervous than her. I keep thinking this can't happen.
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Thinking, prayers for your daughter that all comes out well!
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thank you lovinggrouches!
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A lot of states now require additional imaging for women with dense breasts.
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I'm another one who never just had a mammogram and walked away. That's why when it was finally cancer I wasn't surprised and said take them off!
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Here is another interesting article regarding tumor suppressor genes. What is interesting in this article, is the fact that they mention the changes in the mammory glands due to lactation. We were always told nullparity was a risk factor, so I guess this is a different angle on the issue?
scienmag.com/a-new-tumor-suppressor-gene-for-breast-cancer-in-mice
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Anyone else out here getting nervous reading about the 30% possibilities. I've had hip pain for about 3 weeks and worried it was a metastases even though the likely cause was puppy training and lifting. Luckily today pain in mostly gone so will rest easier tonight with a much bigger dose off gratefulness than usual. I had a BLM because I wanted to avoid the anxiety of possibilities and further mammograms and biopsies.
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Fleur, that makes perfect sense to me. I had weird changes to my right breast after I stopped nursing my daughter. I was checked and deemed fine. I had another pregnancy in my early 40s, which didn't last, and I always wondered if those hormones kicked off the cancer
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For the umpteenth time, that 30% referred to ALL “early stage" tumors--which includes up to IIIA! It includes HER2+ and TN. It includes Luminal B as well as A. It does not, not, NOT mean that 30% of stage IA Luminal A patients will get mets. (But don't kid yourself that a BMX is an absolute guarantee against further testing).
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Chi, thanks for reposting that. It is important to keep in mind
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I'm stage IIB triple positive, luminal B. While my oncologist considers me high risk for recurrence due to tumor size (note no nodes) I realize that as I age I will continue to get new aches an pains. If there is an ongoing issue I get it checked out…and don't worry about it till I'm told that I actually have an issue.
I pay my oncologist to worry about this stuff. I have living to do.
I wonder how many of those 30% happen in the first 2-3 years. Also bet few are happening after 5.
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Iago, I just looked it up, perfunctorily albeit, and from what I read, it seems like the vast majority of recurrences do indeed happen in the first 5 years. TN, HER+, stage 3 and luminal B more so even.
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I think MORE are happening after 5 years and that's why there is this false sense of security at 5 years!!!! I think some studies stopped looking after that 5 year mark.
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I agree with Barbe. ER+ are > chance after 5 yrs than within.
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TN are suppose to be less after 3 years. No matter the initial stage. It's a roll of the dice and only our bodies know the real percentage. When I had BC 24 years ago, due to my age (32) and hormones was told initially without the clinical trial of tamoxifen, I had a 90% chance of recurrence of 40% with tamoxifen within 5 years. What it was based on I did not drill it down, compare, worry where it came from, I was at a major university hospital (University of Chicago) had the team approach, and just agreed with whatever they said because I trusted them as the experts.
Turns out, I have not recurred. Had a new cancer based on the usual risk factors of being a woman and having breasts.
Just my 2 cents and my experience.
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I'm anal when it comes to numbers, so just to clarify: despite the significant residue risk of recurrence for ER+ breast cancer beyond the first 5 years, the risk is not MORE than years 0-5.
At a median follow up of 24 years, the study reported outcomes of 4,105 patients who were diagnosed from 1978 to 1985 and participated in the International Breast Cancer Study Group Trials I to V. During the first 5 years of follow-up, risk of recurrence was lower for ER-positive compared with ER-negative disease: 9.9% vs. 11.5%. Beyond 5 years, risk was higher: 5-10 years, 5.4% vs. 3.3%; 10-15 years, 2.9% vs. 1.3%, 15-20 years, 2.8% vs. 1.2%. At 20-25 years, risk was 1.3% vs. 1.4% (P less than .001)
http://www.oncologypractice.com/specialty-focus/br...
And this is older data, with AIsand 10+ year hormone therapy that is becoming more common, residue risk could fall.
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Many studies have calculated the degree of recurrence of both ER-positive and ER-negative tumors. None of them suggest that for ER-positive tumors, the recurrence rate is higher after the first five years than during the first five years. There is a steady decline in recurrence for both ER-positive and ER-negative tumors, with ER-positive showing less of a decline in the years following the five-year threshold. The recommendation is for longer follow-up for patients with ER-positive tumors.
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Hi:
This has been studied, with long-term follow-up (24-years). Results from five prospective and randomized IBCSG studies, including 4,105 patients randomly assigned from 1978 through 1985, were reported, with a median follow-up of 24 years from diagnosis of operable breast cancer. With such long-term follow-up, there have been changes in systemic treatments and radiation therapy, so that patients diagnosed more recently may fare better.
Colleoni (2016): http://jco.ascopubs.org/content/34/9/927.abstract
A complete pdf copy can be obtained for a small fee (currently $2.00) via the PatientACCESS option, with free registration at the Copyright Clearance Center.
Annual Hazard Rates of Recurrence for Breast Cancer During 24 Years of Follow-Up: Results From the International Breast Cancer Study Group Trials I to V
Marco Colleoni, Zhuoxin Sun, Karen N. Price, Per Karlsson, John F. Forbes, Beat Thürlimann, Lorenzo Gianni, Monica Castiglione, Richard D. Gelber, Alan S. Coates and Aron Goldhirsch
"Abstract
Purpose Predicting the pattern of recurrence can aid in the development of targeted surveillance and treatment strategies. We identified patient populations that remain at risk for an event at a median follow-up of 24 years from the diagnosis of operable breast cancer.
Patients and Methods International Breast Cancer Study Group clinical trials I to V randomly assigned 4,105 patients between 1978 and 1985. Annualized hazards were estimated for breast cancer–free interval (primary end point), disease-free survival, and overall survival.
Results For the entire group, the annualized hazard of recurrence was highest during the first 5 years (10.4%), with a peak between years 1 and 2 (15.2%). During the first 5 years, patients with estrogen receptor (ER) – positive disease had a lower annualized hazard compared with those with ER-negative disease (9.9% v 11.5%; P = .01). However, beyond 5 years, patients with ER-positive disease had higher hazards (5 to 10 years: 5.4% v 3.3%; 10 to 15 years: 2.9% v 1.3%; 15 to 20 years: 2.8% v 1.2%; and 20 to 25 years: 1.3% v 1.4%; P < .001). Among patients with ER-positive disease, annualized hazards of recurrence remained elevated and fairly stable beyond 10 years, even for those with no axillary involvement (2.0%, 2.1%, and 1.1% for years 10 to 15, 15 to 20, and 20 to 25, respectively) and for those with one to three positive nodes (3.0%, 3.5%, and 1.5%, respectively).
Conclusion Patients with ER-positive breast cancer maintain a significant recurrence rate during extended follow up. Strategies for follow up and treatments to prevent recurrences may be most efficiently applied and studied in patients with ER-positive disease followed for a long period of time."
And from the full-text:
"For the entire group, the annualized hazard of breast cancer recurrence was greatest for the first 5 years (10.4%), with a peak interval between years 1 and 2 after surgery (15.2%; Fig 2A). The hazard decreased consistently during years 5 to 10 (4.5%) and then remained stable. During years 10 to 15, 15 to 20, and 20 to 25, the hazard of recurrence was 2.2%, 1.5%, and 0.7%, respectively (Table 2)."
Please note the following:
-- For the entire group, the annualized hazard of recurrence was highest during the first 5 years.
-- For the entire group, the annualized hazard of recurrence showed a peak between years 1 and 2 after surgery.
--The hazard fell off in years 5 to 10, and then persisted at a low level over time, particularly for ER+ disease.
-- Comparing ER+ versus ER-, they observed a statistically significantly lower hazard of breast cancer recurrence for patients with ER+ disease versus those with ER- disease during the first 5 years (9.9% v 11.5%; P = .01). However, the hazards of ER+ and ER- disease crossed between years 2 and 3, and beyond 5 years, the hazard of recurrence was higher for patients with ER+ disease compared with that of those with ER- disease.
NOTE: This is NOT saying that that the annualized hazard of ER+ patients increases after 5-years, but only that their annualized hazard remained higher than that faced by ER- in later time periods.
BarredOwl
[Edit: I was composing at length while Erento posted. Colleoni is the article featured in her post. As is often the case in this thread, Colleoni was discussed and quoted previously in the thread.]
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ErenTo, sbelizabeth and BarredOwl, good for you for trying to set the record straight!
So many women read the title of this thread and get concerned. The fact that this thread is in the Stage I forum reinforces that concern, and the assumption that the title is stating an accurate fact about the risk faced by those diagnosed with Stage I breast cancer. We see it all the time in posts from newly diagnosed women who come to this thread, and I've had this thread mentioned to me, with great concern, many times in PMs that I've received from newbies.
MODs, is there anything that can be done to change the title of this thread?
And if not, could this thread be closed off so that it eventually gets buried way down the list? This thread has gone dormant for long periods of time, but because it hasn't been closed to new comments, eventually someone has always found it and brought it back to life. I always cringe when that happens because I know that more than anything, the thread will simply frighten those who are newly diagnosed. Yes, there have been some interesting discussions over the 48 pages. But more so, the 48 pages have been spent repeating, over and over and over again, the same points so that those who newly join the thread can be brought up to speed on the fact that the answer to the question posed in the title is in fact "NO! It is not true that 30% of Stage I bc will go on to metastasize.".
If there is any concern about leaving Stage I newbies with an accurate impression of what their risk level may be, I think it's time that something be done to fix this on-going and constantly repeating problem.
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This thread has great info. A lot of folks have put some work into giving info. I vote a title change if anything.
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I agree with Artista, a title change but closing it would be a shame.
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I vote for no title change and no censoring of the thread.
It's important to note that the title:
30% of Stage 1 bc will go on to metastasize?
has a question mark.
What follows is 48 pages of debate and information on the topic that is really valuable to all those interested in understanding recurrence, including newbies.
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Interesting topic but I have slways hated the title. Must scare the hec out of newbies when it is on page 1
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