Breast Cancer Stage?

I have double breast cancer due to the BRCA 2 gene.  It is considered a stage 2 with 3 node involvement that has not spread.  Why is my survival rate 5-7 years?  I plan on having the ovaries removed and the breasts removed?  Where will it return?

[Fernando Roque, MD]

Hi.  I would just like to ask where you got your information that your survival rate is only 5-7 years?  I think this may be erroneous. This is what I know of the published literature regarding BRCA-2 gene carriers:

1. They do have an increased risk (greater than triple) of developing breast cancer compared to the general population
2. BRCA-2 carriers have an increased tendency for developing cancer in both breasts
3. The prognosis and survival of BRCA-2 carriers are NOT SIGNIFICANTLY WORSE than non-carriers, when the stage of the disease is factored in.  This means that BRCA-2 carriers and non-carriers would tend to have similar survival rates if they have the same stage of the disease. So you are not any worse off than other women with Stage 2 cancer who do not carry the BRCA-2 gene.  If you want detailed information you can try reading these articles:   a) Rennert G, et al "Clinical Outcomes of Breast Cancer in Carriers of BRCA1 and BRCA2 Mutations" N Engl J Med 2007; 357:115-123.  b) Eur J Cancer. 2000 Jul ;36 (11):1365-73 "Prognosis and Clinical Presentation of BRCA-2 Associated Brast Cancer"

Since you have stage 2 disease, you still have a real chance for a cure, as long as the appropriate treatment is given (this will probably involve a combination of surgery, chemotherapy and radiation treatment).

As for the question of where the cancer will return: since you carry the BRCA-2 gene, you have an increased risk of developing cancers in the ovary, pancreas, fallopian tube, larynx as well as a risk of developing some forms of lymphoma.  But having an increased risk does not mean that you will  inevitably develop these cancers.  It just means that you need to be more vigilant about your condition and follow up with your doctor often.