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Breast Cancer

breast cancer  stage I -- need statistics

I searched  for survival statistics for breast cancer vs treatment options and did not find many really useful tables. I notice many of your answers to specific questions included the phrase " These and other statistics are helpful when used generally to make recommendations and decisions regarding treatment".

Well I'm trying to decide among the various treatment options for Stage I breast cancer after a lumpectomy with good boundaries, no lymph node involvement and estrogen receptor positive.  So where do I find these 5 and 10 year survival rate vs treatment option statistics?
5 Responses
1119363 tn?1330359040
Statastics are helpful in  comparing treatment options, but each case is very different and it is hard to find a lot of specific information that fits one's own characteristics closely.  It is also hard to find many studies dealing with stage one cancers.  Have you been tested for the Her2 oncogene?  Has anyone suggested an Oncotype DX test?  (It checks 21 genes and determines a risk of recurrance score and provides some insight into your specific case as compared to their database.)  I have found good information on breastcancer.org.

What you say above is good:  stage 1, good boundaries (margins), no positive lymph nodes, and estrogen positive.  Other factors, such as Her2 positive status or having the BRCA genes can dramatically change what treatment you choose.  

Often, with a lumpectomy, radiation is recommended.  If you are at higher risk for recurrance, chemotherapy may be indicated.  If you are Her2 positive, Herceptin will be considered.  Some of the treatments are unpleasant, but they are temporary and when you have stage 1 cancer, you are looking long-term and hoping for a cure.  If cancer comes back, it is most often a metastasis and stage 4.  That's why you want to beat it now.

I am 48, had a stage one, .5cm tumor, ER/PR+, Her2 positive, clean lymph nodes and margins after a mastectomy a little over a year ago.  I took chemo (taxotere, carboplatin and Herceptin) 4 of 6 rounds due to severe and lasting side effects, Herceptin for a year (1 more dose to go!) and tamoxifen that /I will take for 5 years.  I am going to my surgeon in Dec. to have a preventative mastectomy on my other breast and then will consider that I have done all that I can.  I spent a lot of time researching and discussing treatment options with my doctors and trying to discern the best way to go.  I was surprised to see how much leeway that I as the patient was given.  I could have said that I want no adjunctive treatment and the docs would have been uneasy, but even that was one of the options on the table.  When my Oncotype score came back as a 31 (30-40% chance of recurrance) I knew that I needed to take chemo.

Please stay in touch and we will support you all we can as you explore treatments and then implement your plans.  I am thinking of you.
962875 tn?1314213636
You did not state what type of BC you have, but here is a link to a detailed discussion of the treatment of invasive BC,  by stage, provided by the American Cancer Society.

http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Treatment_by_Stage_Breast_Cancer_5.asp?rnav=cri

This will give you a good view of treatment options, which of course have been developed from the whole body of clincal research regarding which txs are most effective, but does not specifically include the survival rates you are looking for.

To put the phrase you quoted, "These and other statistics are helpful when used generally to make recommendations and decisions regarding treatment." in context, this is usually accompanied by the explanation that survival statistics are overall averages, based on statistics gathered over a past period of 5 or 10 years (plus the amount of time required to analyze the data and the wait for it to be published) and are therefore already out of date in view of all the new treatments that have meanwhile been put into  use. Plus they have little predictive value in regard to a specific individual, since they are only numerical averages of a wide range of different lengths of survival, including all different types of BC, different txs, different pt. ages and overall heath status, etc.

If you still want to see the statistics, do a search under "breast cancer survival rates," and I'm sure you'll find many different tables. However, I would venture to say most of us don't put a lot of faith in "survival rates," having seen so many cases that don't match the "predictions."

Best wishes...

Avatar universal
Sorry it took me so long to get back... I had computer problems...  Now I'm not sure how to mark the best answer (yours, thank you!).

I understand about statistics and also I understand that cases differ.  What statistics tell you is not what to do but what the odds are for different courses.  For instance the odds are that 1 in 4 women will get breast cancer. Great! I have beaten the odds (4 to 1 against getting BC) and done it. There are also odds on whether I'll get it again (almost the same, interestingly). Since whatever I do is a gamble, I like to take the course with the best odds.

The site you pointed me to did not have any statistics, only guidelines, but at least it had something. And you are right that searching can help, but I had done that.Thanks for your help..
Avatar universal
Thanks for answering! My apologies for taking so long to get back--I had computer problems. Just as a hint, though, answering the question is always best. You were very considerate to point out that people are often misled by statistics (e.g. they may think that the most probably outcome is what will happen to them but that is NOT what statistics mean). However, since I am asking about them, if you know of any, please point me at them. I know that statistics do not tell what happens in individual cases, I know that my exact circumstances may not be found exactly represented, I just wanted the closest I could find. And, of course, they are out of date as they represent cases that started 5 or 10 years ago!

On the other hand what better guide to strategy does one have? What statistics say is not a guarantee, if anything it tells you the odds on unfavorable outcomes as well as good ones. Indeed, I was very glad to see that chemotherapy had very little effect on survival rates for cases similar to mine if I have radiation. Focused radiation is much less generally destructive than chemo and chemo certainly has worse side-effects, so I was glad to see that statistic. I have no compunction waiving chemo with such a small statistical effect.

Given that it is impossible to tell what is really best in any individual case, if you go with the statistics, you are at least gambling with the odds. After all, how does one know if one is at higher risk except from the statistics? As soon as someone says "risk" they are talking about statistics -- that's what risk means: possibility of difficulty, and the statistics quantify it. Much easier to compare two methods if you have the statistics.

Thanks again for your good wishes!
962875 tn?1314213636
Hi again,

Actually, the figures I have seen for developing BC are in the range of 1/7 to 1/9, but that's still not too good...

Another stat is that 1 out of 4 Americans die of some type of cancer; such a terrible disease!

Since you still are interested in stats and understandstand their limitations, I'm going to copy some info relevant to your stage:

In the U.S., about 40,410 women will die from breast cancer this year, making it the second most lethal cancer in women. (Lung cancer is the leading cancer killer in women.) The good news is that early detection and new treatments have improved survival rates. The 5-year survival rate for women diagnosed with cancer is 80%. About 88% of women diagnosed with breast cancer will survive at least 10 years. Unfortunately, women in lower social and economic groups still have significantly lower survival rates than women in higher groups.

If the cancer is ductal carcinoma in situ (DCIS) or has not spread to the lymph nodes (is node-negative), the 5-year survival rates with treatment are up to 98%. However, cancer recurs in 9 - 30% of such node-negative cancers. Recurrence is a potentially life-threatening problem, even if the disease relapses locally in the same breast. In one study of DCIS patients with locally invasive recurrence, 8-year mortality rates were only 12%."

(I will send you the link for the whole article, and for a discussion of prognosis by the National Cancer Institute, in a private message.)

Regarding selecting "Best Answers," I believe there is a little box in the upper right hand corner of each answer, but that you can select just one. However, the boxes are visible only on the screen of the person who started the thread, so I'm unable to see them and provide clearer instructions. If you can't find how to do it, click on "contact us" way at the bottom of the page, and the MH staff will help you.

I hope by now you are well along in tx and doing well! Please let us know, if you don't mind sharing.

Wishing you all the best,
bb
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