Breast cancer degree of longevity. Breast cancer Life expectancy after surgery

Breast cancer is the most common type of cancer among women. Moreover, it is the most studied type of cancer. Found Egyptian papyrus with a description of this disease dates back to 1600 BC. Of the eight cases described therein, one belongs to a man. Treatment in those ancient times consisted of cauterization by fire, but “There is no treatment for this disease; it always leads to death "- read the text on papyrus. For many centuries no shifts in treatment were observed, the result was still sad. And only in the XVIII century the first shifts in understanding the problem were outlined: it was then that the connection between the lymphatic system and the spread of the disease was discovered. Much time has passed since then, at the present time, the disease detected at an early stage is successfully treated. And although the disease still remains one of the most dangerous, today known factors affecting the prognosis of the disease.

To make an individual forecast, the following groups of factors are studied:

The size of the tumor, its localization, the anatomical form of growth, the rate of spread, etc.

• Related to hormone-dependent tumors and often developing amid hormonal imbalance, breast cancer, whose prognosis is more favorable, has a long period of pretumor state, with a predominance of differentiated forms. In contrast, a disease that occurs during normal hormonal status has an unfavorable prognosis.

Histological structure and degree of malignancy (differentiation)

• It is known that certain histological characteristics of a malignant tumor play a large role in the prognosis, even if there is no damage to the regional lymph nodes. For example, a tumor up to 5 cm in size of the so-called favorable histological type without spreading to the lymph nodes has better survival rates than an invasive ductal tumor of a much smaller size.

Presence of metastasis

• It has been proven that breast cancer, whose prognosis depends on the extent of metastasis, is much worse to treat if metastasis is affected by more than 4 lymph nodes.
• Regional metastasis in most cases more favorable hematogenous. The absence of metastases in the lymph nodes, especially when a tumor is larger than 2 cm in size, is usually a bad sign due to the likelihood of hematogenous metastasis.
• Remote metastasis from the primary tumor means the worst prognosis.
• Statistically it is known that a tumor up to 2 cm metastasizes in 2-15%; up to 5 cm - in 20-60%; more than 5 cm - in 70-80%.

Estrogen and progesterone receptor levels

• Essential for a neoplasm is the presence of estrogen / progesterone receptors in the tumor tissue. This is reflected in the sensitivity to hormone therapy, and also indicates a higher differentiation of the tumor, which, in turn, leads to more rare metastasis. The absence of receptors indicates resistance to the ongoing and unfavorable prognosis.
• Based on clinical studies, it was determined that in premenopausal patients with a low content of receptors in the primary malignancy, visceral metastases are more often detected. In postmenopausal patients with a high content of receptors in the tumor, bone lesions are more common.

Indicators of tumor markers

• The risk of recurrence or metastasis increases by 1.5-2 times, if the level of tumor markers exceeds the norm.

Scope of surgery and methods of complex treatment

• An indicator of the effectiveness of therapy is the five-year survival rate, that is, the number of surviving patients within 5 years from the moment the tumor was detected. For breast tumors, the survival rate is 55%. This means that more than half of the sick patients will live at least 5 years from the time the disease was detected, with no treatment, this figure does not exceed 10%.

Currently there are data on 76 prognostic factors. More than half of them are divided into groups, among which the main ones are:

• epidemiological factors (age, race, comorbidities, etc.);
• Morphological and anatomical (TNM criteria, histology, receptors, the degree of malignancy, etc.)
• Molecular genetic

However, at present, prognostic factors are not fully understood and need further study.

Women with an identified breast tumor are primarily interested in at what stage the disease, its treatment methods and the chances of recovery. The result of treatment depends on how much the malignant process has spread in the breast, lymph nodes, and whether there are metastases to other organs and tissues. As a rule, the disease at the initial stage is completely cured in 95% of cases.

How many live with breast cancer?

This diagnosis occupies a leading position among all malignant diseases in women. Annually in the world about one and a half million cases are celebrated, of which approximately 400 thousand are fatal. During the first year, mortality from breast cancer with an unrestrained progression of the disease is more than 10%.

A five-year survival rate is taken as an indicator of the effectiveness of treatment, i.e. the number of patients who survived during this time period after the diagnosis of a malignant neoplasm. Approximately 50% of women receiving appropriate and adequate treatment live five years or more after a tumor has been detected. Five-year survival for breast cancer without treatment is no more than 12-15%.

There are a number of factors that have a huge impact on the prognosis of survival for a given disease. Of the favorable, hormonal sensitivity to the tumor can be distinguished (when there are receptors for progesterone and estrogen on the surface of the malignant cells). An unfavorable factor is the presence of the Her2neu neoplasm marker (indicating a high aggressiveness of the tumor formation).

What is the survival rate for breast cancer in stages?

Depending on the size of the tumor and the prevalence of the malignant process, there are 4 stages of the disease. The survival prognosis worsens in direct proportion to the stage at which the tumor process was detected:

• Stage 1 - a neoplasm of no more than 2 cm in size, the malignant cells did not spread to the axillary and occipital lymph nodes. Five-year survival for breast cancer at this stage ranges from 70 to 95%;
• Stage 2 - a neoplasm from 2 to 5 cm, but there is no spread to the lymph nodes or a neoplasm in sizes no more than 2 cm, but malignant cells were found in 4-5 lymph nodes. The prognosis at this stage is also favorable, the five-year survival rate ranges from 50 to 80%;
• Stage 3 - a tumor in the size of more than 5 cm, malignant cells infect the lymph nodes, sometimes germinate in the code of the mammary gland. Five-year survival ranges from 10 to 50%;
• Stage 4 - neoplasm of arbitrary size. Distant metastasis of various organs and tissues occurs (lungs, skin, bones, liver, etc.). Five-year survival ranges from 0 to 10%.

If we talk about the ten-year survival rate, the picture is somewhat different:

• at stage 1 - from 60 to 80%;
• at stage 2 - from 40 to 60 %%
• at stage 3 - from 0 to 30%;
• at stage 4 - from 0 to 5%.

For the general prognosis, along with the stage, the number of lymph nodes affected by the metastatic process is of no small importance. In the absence of regional metastases, the ten-year survival rate is about 75%, while they are also present - 25%. If 3 or less lymph nodes are affected, then the ten-year survival rate is about 35%; with the defeat of 4 or more lymph nodes, it decreases to 15%.

Is it possible to somehow affect these numbers? Of course! Timely combined treatment will undoubtedly lead to a favorable result. The best combination of chemotherapy, radiation therapy and surgical treatment. Only strict adherence to medical appointments, the correct daily regimen and nutrition can prolong life for many years.

The prognosis of breast cancer is the likely outcome of the disease. He points out how likely the patient is to be completely cured, and how long they live with breast cancer.

Breast cancer - according to WHO - the most common cancer in women around the world. About 16% of all cases of malignant neoplasms in women fall on this disease. In addition, breast cancer is one of the leading causes of oncology mortality in the world for women.

After diagnosis, people often begin to think about the prognosis of their illness. But they all want to get different degrees of information. Some prefer not to ask about their prospects, while others want to know all the possible data.

It should be understood - the prognosis of the disease is based on statistics from previous years, but each case is unique, and no one can predict what will happen with this particular patient.

The good news is that early detection of symptoms and new treatments can significantly improve breast cancer survival rates. Currently, in developed countries, the five-year survival rate of all women with breast cancer, regardless of stage and degree, is 80%. Unfortunately, in countries with less prosperous medicine, life expectancy is much lower.

Due to improved treatment, the death rate from this disease has decreased by about 25% since 1990. However, the surviving women live with an uncertain possibility of recurrence of the disease and with the risk of complications from the treatment of the tumor.

The recurrence of cancer and its symptoms usually develops within 5 years after treatment. Approximately 25% of relapses and about half of new tumors in the opposite mammary gland develop after 5 years.

What influences the prognosis for breast cancer?

Several factors influence the determination of the prognosis, risk of recurrence, likely life expectancy and success of treatment.

Cancer grade

It is known that the prognosis for breast cancer depends on the stage of the disease. But it also depends on its degree, that is, on how the cancer cells look under the microscope. After the doctor removes the tumor during the operation or takes a biopsy from it, he sends the samples to the laboratory, where the pathologist determines the degree of the tumor.

In breast cancer there are three degrees - 1, 2 and 3. The higher the degree - the faster the tumor grows, becomes invasive and metastasizes, it is more likely to develop relapses. Therefore, the doctor takes this information into account when choosing a patient’s treatment and determining the likely life expectancy.

Stage of cancer

The prognosis of breast cancer depends on the stage at which the disease was diagnosed - early or advanced. The earlier the tumor is detected, the greater the chance that it will be small and has not yet metastasized. Non-invasive or invasive cancer in the early stages (I and II) have a more favorable prognosis than neoplasms in the late stages (III and IV).

Stage of breast cancer	5-year relative survival in women	5-year relative male survival
0	100%	100%
I	100%	100%
II	92%	91%
III	72%	72%
IV	22%	21%

As can be seen from the statistics presented in the table, the prognosis of breast cancer in men is slightly worse than in women. True, this disease is much less common in them.

Cancer type

In situ ductal carcinoma is divided into comedo and non-comedo subtypes. This division provides additional prognostic information on the likelihood of disease progression and relapse after treatment. In general, the prognosis for the duodenal carcinoma subtype is worse. In about 10–20% of women with lobular carcinoma, invasive cancer develops within 10–15 years after diagnosis. Infiltrative ductal carcinoma tends to metastasize through lymphatic vessels.

Tumor location

Placement of a tumor is a significant factor in determining the prognosis for breast cancer. If this is duct carcinoma in situ, or if the tumor has not spread to the lymph nodes, the five-year survival rate with proper treatment reaches 98%. If the cancer has spread to the lymph nodes or beyond the primary location of the tumor (invasive cancer), the five-year survival rate is approximately 84%. If the disease has metastasized to other organs (most often to the lungs, liver and bones), the average is 27%.

New drugs (for example, aromatase inhibitors) can prolong the life of women with stage IV cancer. The location of the tumor inside the breast is also an important predictor. Neoplasms that develop closer to the outside of the breast tend to flow more easily than those tumors that are located closer to the middle of the breast.

Hormone receptor - positive or negative state of the tumor

Breast cancer cells may contain receptors (binding sites) for the hormones estrogen and progesterone. Cells that have these binding receptors are called hormone receptor-positive. If they do not have these binding sites, then the hormone receptor-negative cells. Approximately 75% of breast cancers are estrogen-receptor-positive (ER-positive or ER +). Approximately 65% ​​of ER-positive tumors are also progesterone-positive (PR-positive or PR +).

Cells that have receptors for at least one of these hormones or for both of them are considered receptor-positive. This cancer is also called hormone-sensitive (hormone-dependent), because it responds to hormone therapy (tamoxifen or aromatase inhibitors). Hormone receptor-negative tumors are called hormone-insensitive or hormone-resistant.

Women have a more favorable prognosis if their tumor is hormone-dependent, since its cells grow more slowly than receptor-negative ones. In addition, women with hormone receptor positive cancer have more treatment options, while hormone receptor-negative tumors can only be treated with chemotherapy. The recent decrease in mortality rates for this disease was the most significant among patients with ER-positive tumors, in part because of the widespread use of hormonal therapy after surgery.

Oncomarkers

Tumor markers are proteins found in the blood or urine in the presence of cancer. Although they are not used to diagnose tumors, the presence of some of them can help in predicting how aggressive a patient’s disease can be and how cancer will respond to a certain type of drug.

The main tumor marker of breast cancer is HER2. HER2-positive tumors usually occur in young women; they grow faster and more aggressively than other types of neoplasms. HER2 tumor marker is present in approximately 20% of cases of invasive breast cancer. Women with HER2-positive tumors can be treated with trastuzumab. Other tumor markers for breast cancer include: CA 15-3, CA 27.29, CEA, ER, PgR, uPA and PAI-1.

Gene expression profile

Determining the profile of gene expression in tumor tissues allows you to know the likelihood of recurrence of the disease after completion of treatment. These tests are also used to determine whether to conduct adjuvant drug therapy after surgery.

The size and shape of the tumor

Large tumors represent a higher risk than small ones. Undifferentiated neoplasms with fuzzy edges are more dangerous than tumors with clearly defined boundaries.

Cell division indicator

The higher the growth rate of the tumor - the more dangerous it is. There are several tests that measure cell division and can predict the course of the disease. For example, the mitotic index is a measurement of the rate of cell division. The higher the mitotic index, the more aggressive the cancer.

How can I estimate the forecast?

Nottingham Prognostic Index - this scale is used to determine the prognosis after surgery for breast cancer. It takes into account three criteria - the size of the tumor, the number of affected lymph nodes and the degree of the tumor. After calculating the score on this scale, a forecast is set, which can be excellent, good, moderate or bad.

• Computer programs. Doctors sometimes use an online program to forecast, such as Adjuvant! Online or Predict. The result is often presented as a percentage of survival at 5 or 10 years after diagnosis. Programs also evaluate the benefits of conservative treatment or surgery.
• Oncotype DX - This test analyzes a sample of breast cancer tissue to identify its genetic structure. This test determines the likelihood of tumor recurrence and its symptoms by analyzing a group of 21 genes that helps the doctor decide which type of treatment is best suited to the patient.

Breast Cancer Disability

The diagnosis of breast cancer itself is not a reason for assigning a disability group. However, the disability associated with this disease, its treatment (surgery, chemotherapy, hormone therapy), the occurrence of distant metastases in the later stages, may be grounds for referral to medical and social expertise. Any disability group can be established - from III to I.

How can the prognosis affect the patient?

Some people have a hard time understanding and accepting information about their prospects. A good prediction can provide confidence, joy, and hope. If the prospects are less bright, this may cause anxiety about the future. But the patient must understand that no test or analysis can say with complete certainty what will happen to him. Sometimes people with a worse prognosis live for a long time. At the same time, breast cancer can recur with very good prospects.
  Patients may need the support of friends and relatives to cope with the uncertainty that arises after they detect breast cancer.

The reputation of cancer is so bad that they are often called fatal, and patients with such a diagnosis require the help of a psychologist. If diagnosed, how much live after surgery? This issue concerns all patients and their relatives.

Malignant tumors of the breast lead in the number of patients and mortality. Although the disease has been known since ancient times (the first mention of the symptoms dates back to 1600 BC.), The causes of the disease are still unclear.

Modern methods of treatment do not guarantee a favorable outcome of this terrible disease. Breast cancer is characterized by a variety of forms, different rates of development and the complexity of early diagnosis. The main treatment is surgical removal of the tumor at any stage of the disease.

In this regard, the patient raises the question of what is the survival rate for breast cancer, is it worth it to agree on the operation. Will there be a satisfactory quality of life after (not counting the aesthetic defect rigidly connected in women with psychological discomfort), and often the underlying tissues of neighboring organs.

Official statistics answers the question about the life expectancy after surgical treatment of cancer is unambiguous: the “younger” the tumor, the more favorable the prognosis. That is why early is a priority goal of treatment and preventive measures.

The individual characteristics of a particular case also affect the patient's life span:

Long-term observations of doctors showed the positive role of the optimistic psychological attitude of the patient and readiness to fight.

Survival statistics for breast cancer

Official statistics consider the outcome favorable if the patient has lived for 5 or more years after treatment. Survival data suggests that the number of adverse outcomes after surgery is directly proportional to:

For the 10-year life expectancy, Stages 3 and 4 have the saddest statistics from 0 to 30% and from 0 to 5%, respectively. The survival rates of patients and the first 2 stages are reduced.

However, one should not get depressed and give up: there are always people who have managed to become an exception in their category, refute the statistics and disappointing forecasts of doctors. And what happened with one person can happen with another.

The only thing you should not go against is to refuse the help of doctors or the recommended surgical intervention. Only 12–15% of patients who do not want to see a doctor fall short of a 5-year term, while cancer patients who receive high-quality medical care have a 50% favorable outcome.

The effect of molecular type tumors on the prognosis

The level of malignancy of a neoplasm affects how much people live with breast cancer. In modern medicine, there are four types of structures of mutated cells that form a tumor. The type of treatment, the rate of growth and spread of the tumor and, accordingly, the prognosis depends on what type is found in the patient (this is detected by histological examination);

Subtypes are listed by degree of aggressiveness. A triple negative type has the most adverse prognosis of survival.

How to live after surgery

For psychological comfort, you can make a plastic breast, especially this is true for patients under 40 years old (women more older are more tolerant of deterioration of appearance). Unfortunately, breast cancer has become “younger” in recent decades, and cases of sickness in the childbearing age are already frequent. This is due to the deterioration of the overall environmental situation in connection with the development of industrial enterprises.

Doctors say that the incidence of breast cancer is higher in developed countries, which are characterized not only by the abundance of highly toxic enterprises (nuclear power plants, chemical plants, etc.), but also by the popularity of food with carcinogens (fast food, products containing artificial colors, flavor enhancers, thickeners, flavorings, vegetables with herbicides).

To reduce the likelihood of recurrence, you should follow all the recommendations of the doctor, not only with regard to medication, but also lifestyle. Special exercises, diet and a positive attitude will help to preserve the quality of life. Patients with no recurrence and well-being are able to give birth to a healthy child. Of course, you can plan your baby only after consulting with your doctor.

Folk methods against cancer

It is dangerous to appeal to healers and psychics instead of going to an oncologist. A lost month in cancer treatment can result in a shortening of life for decades. Herbal medicine and diet are used only in combination with the main methods and after consultation with the doctor.

Many women are interested in the question: how many live with when faced with such a similar ailment. Doctors ascertain that the survival rate is quite high (up to 90%), but with timely diagnosis and effective treatment in the future.

The statistics is such that basically the disease has a hereditary factor and the risk of getting a breast cancer to a woman, if there were similar cases from close relatives, increases several times.

It should be understood that after the operation to remove the tumor, life does not end, compliance with all the doctor’s prescriptions during the prophylaxis period, as well as regular examinations will allow you to keep your well-being under control, thereby significantly prolonging life even with such a serious cancer.

The malignant processes of neoplasms occupy a leading position among onkonedugov, and the causes of occurrence today are fully studied, and doctors can not guarantee a favorable outcome. Breast cancer has many forms with different flow rates and is difficult for physicians when conducting examination of patients.

In the initial stages, the tumor is usually removed surgically. Survival and quality of life in the future are directly dependent on the degree of cancer development, the effectiveness of the treatment course to remove the tumor. Of course, tumorous cell particles remaining in the breast after the operation can progress again, thereby worsening the situation.

In addition, the survival rate is much lower if the woman has chronic diseases, and the doctor’s appointments are not respected. After all, it is the right lifestyle, sports, a positive attitude to a cure that play an important role for patients with the goal of extending their lifespan.

The effect of cell malignancy on prognosis

A malignant tumor in a diameter of not more than 2 cm suggests that 95% of cancer patients live up to 5 years. 80% of women for the duration of up to 5 years can hope when they reach a neoplasm of 5-6 cm, while there is no damage to the lymph nodes.

With the defeat of no more than 5 lymph nodes the probability of overstepping the 5-year mark is 30%. In the presence of distant metastases and the size of the tumor more than 5 cm in diameter, the survival rate is almost zero.

Still, timely and adequate gives a completely favorable outcome even at stage 3–4 of cancer, but of course, but a ten-year many survival thresholds are found in statistics in only 5% of cancer patients.

Doctors advise regardless of the stage of cancer in any case not to fall into depression and not to listen to the statistics about how much they live with, but on the contrary, to fight in every way to the end with an insidious illness. Although statistics confirms disappointing forecasts, today medicine is strong and everyone has chances to overcome the disease.

You can not refuse women from the operation, not to delay treatment. Those who receive high-quality honey on time. help from doctors may well count on a favorable outcome in the future and life after cancer is there!

How can the molecular appearance of a tumor affect predictions?

Doctors distinguish 4 types of mutating cells (in the figure above): luminal (a), nominal (b), positive (c) and negative (d). If a species is detected after a histological examination, the appropriate medical tactics will be chosen by the doctor, and a forecast for the future will also be made. The position in the molecular form of a breast tumor may be worsened in women at risk:

• age 45-50 years;
• who gave birth to their first child after 30 years;
• faced with the early onset of menstruation before the age of 12, or vice versa, with the onset of menopause at the age of 40;
• never breastfeeding;
• having problems with the thyroid gland;
• leading irregular sex life;
• having diseases in the genital area;
• uncontrolled taking some contraceptives, hormonal drugs;
• previous diseases of the mammary glands;
• passive women who prefer to lead a sedentary lifestyle.

In addition, it is possible the development of breast cancer with their early injury, diabetes, hypertension, overweight in women. I risk getting smoker cancer, using alcohol, fatty and fried foods, working in hazardous conditions, or living in an environmentally unfavorable zone.

How does the location of the tumor in the mammary glands affect the prognosis?

It is the localization of tumors in the breast tissue that affects the outcome of the disease.   If the tumor is located in the outer quadrants of the mammary glands, this will allow doctors to identify the disease at an early stage and conduct an invasive therapy to remove the tumor.

When the tumor is located in the medial central areas of the mammary glands, the prognosis is already unfavorable. The neoplasm is developing rapidly, metastasizes. But, everything will depend directly on the type of cancer, the method of therapy chosen by the doctor, the body’s response to the metastases in the lymph nodes.

Experience shows that if breast cancer is detected, how many live after the operation in the absence of other concomitant pathologies? Survival up to 5 years is likely in 70% of women. Breast cancer is not a pleasant disease, but it is quickly diagnosed, and therefore allows you to keep the treatment process under control, as well as the state of health of the patients at the proper level.

There are cases of carcinoma after surgery, when a large amount of fluid and lymph accumulates in the glands, which can lead to a thinning of the operated glands. But the negative consequences can be avoided if after the operation take into account all the advice and instructions of the oncologist.

In addition, accumulation of fluid in the glands can cause injuries or even minor strokes on the glands, thus provoking the development of cancer cells. Women should in every possible way avoid rough impact on a sick chest, do not wear cramped clothes, bra.

Perhaps after the operation, consultation of a psychologist is required, the passage of special support groups for cancer patients who have undergone surgery for breast cancer. The main thing is to keep women calm, to restore their health and not to give up. With the help of relatives and friends, survival can be significantly increased.

How long can you live with breast cancer

If the disease is detected at stage 1-2 after the operation is performed mainly by the laser method without the presence of other chronic pathologies in the body for 5 years, 70% of women will survive.

Today, many seek to resort to unconventional methods of therapy, neglecting radical and refusing adequate treatment. In such cases, doctors do not give predictions for a long life. A 5-year mark after breast cancer is diagnosed in only 15% of cases.

The living period will directly depend on the stage of tumor detection, the timely removal operation. You should not hope at random, different tinctures and poultices, recommended by grandma's recipes.

Today, breast cancer is established in developed countries, in particular in Russia, with an abundance of nuclear power plants, chemical plants, plenty of products with dyes, artificial flavor enhancers, substitutes, flavors and herbicides.

Best of all, when women are susceptible to the development of breast cancer, it is not only their lifestyle that is correct, to consult with their doctors for any reason, especially when unpleasant breast lumps appear.

Also, do not neglect the diet, special exercises to preserve the quality of life. If breast cancer is detected at stage 1-2, do not delay treatment. There are many cases when oncology patients treated in time at an early stage managed to get pregnant and give birth to completely healthy babies.

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