When given a diagnosis of breast cancer, the question of prognosis is a natural one for a patient and her family to ask. Even with the established, known prognostic indicators, there is no set prognosis for each stage. Each patient is an individual and has her own risk factors and characteristics. This serves as a generalized overview of prognostic factors in breast cancer, but is by no means definitive, and does not replace a discussion with your oncologist.
Stage
Prognosis for breast cancer is largely dependent on the stage of the disease. Breast cancer is staged from Stage 0 (in situ disease) to Stage IV (metastatic disease). Staging is determined by the size of the tumor, whether any lymph nodes are cancerous and how many are involved, and is the cancer has spread to any other organs. The more lymph nodes that are involved, the worse the prognosis tends to be, although the other tumor characteristics also play a role in the prognosis.
Tumor Characteristics
The size of the tumor is important, as well as whether the cells are well-differentiated or poorly differentiated. If they are poorly differentiated, they do not have clear margins, and poorly differentiated cancers have a worse prognosis. The speed of cell division, otherwise known as mitotic index (MI) is also important in determining the aggressiveness of the cancer. The faster the cells divide, the more aggressive it is and is more likely to spread.
Hormone Receptor Status
Once breast cancer is diagnosed, the doctor will test the cancer to see if it is estrogen-receptor (ER) positive, progesterone-receptor (PR) positive, and if it overexpresses the HER2 protein. If the tumor is ER positive, it will respond to hormonal therapy, giving the patient more treatment options. ER positive cancers have a better overall prognosis than ER negative cancers. While cancers are HER2 positive are more aggressive, they can also be treated with Herceptin, which has been very successful.
Triple-Negative Breast Cancer
Triple-Negative breast cancer refers to breast cancer that is ER negative, PR negative, and HER2 negative. It does not respond to hormonal therapies like Arimidex or Tamoxifen, nor does it respond to drugs like Herceptin. Surgery, chemotherapy, and radiation are the only treatments for this type of breast cancer. It tends to be more aggressive and occur in younger women, especially women of color.
Metastatic Breast Cancer
Metastatic breast cancer is cancer that has metastasized, or spread, to another part of the body. The most common places for breast cancer to spread include the liver, lungs, brain, and bones. Once it has spread to another place, it is still breast cancer, just in another part of the body-for example, if it spreads to the brain, it is not brain cancer, but breast cancer. If it has spread to other organs, the breast cancer is not considered curable. Instead, it is treatable. The main goal of treatment is to control the cancer and minimize spread.
Tags: breast cancer, breast cancer, cancer spread, more aggressive, poorly differentiated, another part, breast cancer
