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Breast Cancer (Expert Forum)
Prognosis
Questions posted in the Breast Cancer Forum are answered by medical professionals from The Cleveland Clinic. Topics include Breast Biopsy, Chemotherapy, Hormone Therapy, Lumps, Lumpectomy, Lymph node dissection, Lymphedema, Mammograms, Mastectomy, Radiation Therapy, Reconstruction, Self Breast Exam, and Surgery.
Prognosis
by Scrunch, Jul 24, 2001 12:00AM
I had a lumpectomy for a cancerous tumor on May 11th of this year. I was told that the tumor was Stage I, Grade 2. There was a difference of opinion between my surgeon and my oncologist as to whether the lymph nodes were negative or positive. My surgeon said that they were "borderline", but the oncologist said that they were definitely negative. I am in the middle of having 33 radiation treatments at present. The oncologist suggests that I take Tamoxifen for 5 years, but I have strong misgivings about it in reading about it and in talking to others who have gone through cancer treatments. By the way, I am 69 years of age. I feel that the risks of taking Tamoxifen at my age outweigh what would be the benefits. What is the prognosis for me if I have had the lumpectormy and radiation, without any further treatment? Thank you.
Doctor's Answer
by CCF-RN,MSN-JS, Jul 25, 2001 12:00AM
Dear Scrunch, Stage 1 disease is a tumor that is 2cm or less in size, without any evidence of spread to nearby lymph nodes or distant sites. For many years it was not customary to treat Stage I breast cancer with chemotherapy or hormone therapy. Recent trials suggest that Stage I patients will benefit from adjuvant therapy. (Adjuvant treatment is treatment given after surgery to try to prevent or minimize the growth of microscopic deposits of tumor cells that might grow into a recurrent tumor).
Two large trials by the National Surgical Adjuvant Breast Project (NSABP) showed significant reduction in recurrences in the opposite breast at four-year follow-up for estrogen-receptor-negative patients given chemotherapy and for estrogen-receptor-positive patients treated with tamoxifen.
A study published in The Lancet (May 16, 1998) found that taking tamoxifen for five years significantly reduces both breast cancer recurrence (42%) and mortality (22%) for all women. Results found that premenopausal women, not just postmenopausal women, and those whose breast cancer has spread to the local lymph nodes benefit substantially from tamoxifen therapy.
Discuss your concerns with your oncologist and review the risks and benefits specific to your individual situation. The decision whether or not to take the treatment would ultimately be up to you.
Two large trials by the National Surgical Adjuvant Breast Project (NSABP) showed significant reduction in recurrences in the opposite breast at four-year follow-up for estrogen-receptor-negative patients given chemotherapy and for estrogen-receptor-positive patients treated with tamoxifen.
A study published in The Lancet (May 16, 1998) found that taking tamoxifen for five years significantly reduces both breast cancer recurrence (42%) and mortality (22%) for all women. Results found that premenopausal women, not just postmenopausal women, and those whose breast cancer has spread to the local lymph nodes benefit substantially from tamoxifen therapy.
Discuss your concerns with your oncologist and review the risks and benefits specific to your individual situation. The decision whether or not to take the treatment would ultimately be up to you.
Member Comments (2)
by Scrunch, Jul 25, 2001 12:00AM
When I first asked a question regarding my breast cancer diagnosis, I wanted to know what the prognosis would be at my age having had a lumpectomy and 33 radiation treatments and no further treatment, but your answer did not provide this for me. Also, the Tamoxifen trials done so far have only been done on premenopausal women, haven't they? I think a trial is currently going on with postmenopausal women (of which I am one), and I would prefer to know the results of this trial before I would consider taking Tamoxifen. Please give me your prognosis for me if I don't take Tamoxifen at present. Thank you.
