my wife was diagnosed with stage 1, grade 3 breast cancer at the age of 31. She's had chemotherapy and a lumpectomy and is currently on regular (four times a year) check ups with so far no signs of recurrence. Because of the disparity between stage and grade we have had some conflicting and uncertain answers about survival rate over 5, 7 and/or 10 years. Could someone please clarify the rate of survival and likelihood of recurrence in Stage 1, Grade 3? (the cells by the way had not spread to the lymph nodes)
Dear Bright: Stage is determined by the size of the tumor and whether there was any spread to the nodes or elsewhere in the body. Stage l means that the tumor is less than 2 cm (and this can be subdivided further). Much of the survival data is related to stage. More recently, other factors, such as grade, angiolymphatic invasion, hormone receptor status, HER2 neu status, etc. are being considered in terms of risk for recurrence. At a minimum, tumor size and hormone receptor status are needed to estimate prognosis. Any statistical numbers you see or hear must be considered as numbers reflecting large groups of women - and cannot be applied to any individual person. Also, numbers will vary depending on the type of study done, the age of the study, and what treatments those people may have had. Keep in mind, given the long survival of women with breast cancer, survival data you get today may reflect treatments done as long as 15 -20 years ago. A lot has changed since then. In terms of looking at your wife's situation, the best advice is to review it with the oncologist - this is the individual with the most information regarding statistics. Try not to get too hung up on numbers and focus more on making sure she follows up regularly.
Many people are confused by Grade vs Stage. Of the two, stage is by far the more important. Stage means, basically, how far the cancer had gotten at the time of discovery. Stage one (which, by definition, means it hadn't gotten to the nodes, and that it was small) carries an excellent prognosis. Grade really doesn't enter significantly into prognosis: it refers to how tumors look under the microscope. The correlation between grade and behavior is not really exact; you should really ignore that data and concentrate on stage.
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