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February 9, 2012

Breast Cancer (cont.)

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What is the prognosis of breast cancer?

Survival rates are a way for health-care professionals to discuss the prognosis and outlook of a cancer diagnosis with their patients. You have to determine if you want to know this number or not and should let your health-care provider know.

The number most frequently discussed is five-year survival. It is the percentage of patients who live at least five years after they are diagnosed with cancer. Many of these patients live much longer, and some patients die earlier from causes other then breast cancer. With a constant change in therapies, these numbers also change. The current five-year survival statistic is based on patients who were diagnosed at least five years ago and may have received different therapies than are available today.

All of this needs to be taken into consideration when interpreting these numbers for yourself.

Below are the statistics from the national cancer database and reflect patients who were diagnosed with breast cancer in 2001 and 2002:

Stage Five-year survival rate
0 93%
I 88%
IIA 81%
IIB 74%
IIIA 67%
IIIB 41%
IIIC 49%
IV 15%

Can breast cancer be prevented?

There is no guaranteed way to prevent breast cancer. Reviewing the risk factors and modifying the ones that can be altered (increase exercise, keep a good body weight, etc.) can help in decreasing the risk.

Following the American Cancer Society's guidelines for early detection can help early detection and treatment.

There are some subgroups of women that should consider additional preventive measures:

Women with a strong family history of breast cancer should be evaluated by genetic testing. This should be discussed with your health-care provider and be preceded by a meeting with a genetic counselor who can explain what the testing can and cannot tell and then help interpret the results after testing.

Chemoprevention is the use of medications to reduce the risk of cancer. The two currently approved drugs for chemoprevention of breast cancer are tamoxifen (a medication that blocks estrogen effects on the breast tissue) and raloxifene (Evista), which also blocks the effect of estrogen on breast tissues. Their side effects and whether these medications are right for you need to be discussed with your health-care provider.

Aromatase inhibitors are medications that block the production of small amounts of estrogen usually produced in postmenopausal women. They are being used to prevent reoccurrence of breast cancer but are not approved at this time for breast cancer chemoprevention.

Preventive surgery: For a small group of patients who have a very high risk of breast cancer, surgery to remove the breasts may be an option. Although this reduces the risk significantly, a small chance of developing cancer remains.

Some of the reasons for this approach may include

  • mutated BRCA genes found by genetic testing,
  • a strong family history,
  • a personal history of cancer in one breast.

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