Survival Rate

[ceira]

I have had the surgery, rec'd a copy of my path report and see the oncologist on Wendesday. Have done some of my own research and would like to know my survival rate for 10 years and what you believe the recommended therapy will be. I know people hate to use stats, but I need them. Here is the scoop:

-right breast tumor 5 x 2 x 1.5 cm, nuclear grade 3, intraductal componetsolid and comedo patterns, ng3/3, within tumr(5-10%) and outside of tumor, with focal cancerization of lobules. Focal lymphovascular space invasion. no involvement of inked margins, invasive tumor close at deep aspect - <5mm, dcis clost to margin -  about 1 mm. estrogen receptor protein -  positive, prognesterone receptor protein positive, her-2 - positive(3+) (immuhumohistochemistry)
-excision lymph node axilla. metastatic ductal carcinoma involving 11/17 lymph node. focal involvement of soft tissue by ductal carcinoma.
-this high grade ductal carcinoma shows vascular space invasion and is extensively metastatic to axillary lymph noted. the surgical margins for both the invasive and in situ carcinoma are close.  

[seven7]

Dear Ceira,   Your case sounds a lot like mine.  I had cancer about the size of yours,  and I had 14 of 15 nodes positive.  I had the mastectomy April 2002,  and have has my year tests...CT scans, bone scans and lab work,  and they all show no cancer.

I did real well with the chemo, radiation, and am now on Tamoxifen .

The first chemo started making me vomit on the 2nd day after breakfast, and this kept up for a week.  I let my Oncologist know, and he gave me another pill to take and it sure worked.  I hardly felt sick at all with later chemos.

My Onclolgist gave me the stats of about a 50% chance of staying cancer free for 10 years.  I am feeling good, and have a lot of faith that I will stay well.    I am 70 but have a lot of living left to do.

[chicka]

my biopsy said lobular but surgical path report says ductal.
My oncology appt is in 2 weeks. Which is correct? Call the radioogist and surgeon?

[surgeon]

As you seem already to know, the problem with statistics is that they apply to large numbers of people, but there is no way to make a meaningful prediction for any one person at this stage of your treatment. In any group there are people at each end of the spectrum well outside the norm; some who do way better than expected, others who do way worse. Overall, the data you provide would mean less than half of the people with such information would be alive at 10 years. But, again, there would be some who would live a normal life, and some who would not respond to any treatment. Your treatment will be aggressive chemotherapy; there are various choices of drug combinations, and only your oncologist can give you the exact plan, and tell you why one choice would be made over another.

[CCF-RN,MSN-rf]

Dear ceira:  First, NO ONE knows how long a person will live.  Having said that, I will attach information from the AJCC staging manual that gives general guidelines for prognosis (measured in 5 years - 10 year statistics are not available).

5 year survival based on stage (AJCC Staging Manual, 1998)

Stage I - 87-98%
Stage IIA - 78-88%
Stage IIB - 68-76%
Stage IIIA - 51-56%
Stage IIIB - 42-49%
Stage IV - 13-16%

Please keep in mind that in order to have 5 year survival data, the numbers must be at least 6 years old assuming the data were all collected the same year. Also, take into account the year of publication and the data are even older. In the last 10 years, many new treatments have been developed that have likely improved survival - but we won't know that statistically for a few more years. New information is constantly being published that will have other statistical figures. Physicians must read these articles critically in order to interpret the data correctly and incorporate the information correctly into their practice. In other words, statistics provide a guideline only. They help to guide treatment decisions. They are NOT meant to be applied to individuals.

Based on the information you have supplied, it appears as though your cancer may be stage 3A, although I cannot be absolutely certain.  Likely treatment recommendations will include chemotherapy and tamoxifen.  Since your cancer is her2/neu positive, it is likely to respond to a drug called herceptin.  This drug is currently being used in clinical trials along with chemotherapy.  You might be well served by investigating this sort of protocol.  Large teaching hospitals may be best equipped to offer this type of therapy.