Learning that you or your loved one has breast cancer can be devastating news to process. However, once you have had time for this to sink in, you need to muster up all the courage in you and face this beast. This beast can be slayed, and the weapons are information and positivity.
In this space, we decode what your prognosis means and what the Doctors really mean when they talk about the stage of breast cancer that you are in. Let us understand how Doctors arrive at a prognosis before looking at the stages.
What is Breast Cancer Stages Prognosis And How is it Decided?
Prognosis is the Doctor’s estimation on the outcome of any disease, the person’s expected survival span, and the chances of recurrence.
Doctors base this on various indexes like the ones below – do keep in mind that the human body very often defies the best of tools and data to extend far beyond the prognosis.
- Doctors sometimes use online programs, such as Predict NHS, to estimate prognosis based on personal information, breast cancer stage and historical research.
- MRF ANN, and AutoIHC scoring and Nottingham Prognostic Index (NPI) are other scoring systems used around the globe that use data such as the grade and size of the breast cancer and whether there are any breast cancer cells in the lymph nodes.
- Oncotype DX analyses groups of genes found in breast cancer to provide information about the risk of recurrence.
Important to Know!
- The 5-year survival rate that Doctors often refer to is the percentage of people who live at least 5 years after being diagnosed with cancer. For example, a 90% five-year survival rate means that out of 100 people diagnosed with breast cancer, 90 are likely to be alive after five years. It does NOT mean that these people will only live for five years; it is the number of people who are likely to be alive at that point in time.
Factors That Affect Prognosis
- The type of breast cancer – if the cancer is invasive or is non-invasive.
- The grade of the breast cancer - based on how much the cells have mutated and how fast they are growing.
- The size of the breast cancer - how large the affected area is.
- Lymph node status - whether the cancer has spread to the lymph nodes.
- ER status - whether your breast cancer has receptors within the cell that bind to the hormone oestrogen and stimulate the cancer to grow, thus qualifying it for hormone therapy.
- HER2 status – whether the breast cancer cells have a protein called HER2 (human epidermal growth factor receptor 2) which stimulates their growth.
What is Staging in Breast Cancer?
Staging is the assessment of the size of the primary cancer and determination of whether it is contained (local) or spread out further (distant metastases).
TNM Staging System
TNM is tool that helps the Doctors stage the disease with the help of some diagnostic tests and scans to determine the following:
- Tumor (T): How large is the primary tumor? Where is it located?
- Node (N): Has the tumor spread to the lymph nodes? If so, where and how many?
- Metastasis (M): Has the cancer metastasised to other parts of the body? If so, where and how much?
Based on this information, Doctors will rate the chances for survival by stage of breast cancer. Non-invasive (stage 0) and early stage invasive breast cancers (stages I and II) will reflect a better prognosis than later stage cancers (stages III and IV). This is again influenced by if and how much the cancer has spread to the lymph nodes.
According to the National Cancer Institute’s SEER database of people diagnosed with breast cancer between 2007 and 2013:
- The 5-year relative survival rate for women with stage 0 or stage I breast cancer is close to 100%.
- For women with stage II breast cancer, the 5-year relative survival rate is about 93%.
- The 5-year relative survival rate for stage III breast cancers is about 72%. But often, women with these breast cancers can be successfully treated.
- Breast cancers that have spread to other parts of the body may be more difficult to treat. Metastatic, or stage IV breast cancers, have a 5-year relative survival rate of about 22%. Yet, there are many treatment options available and many statistics of survival.
Prognosis is an Estimate Not a Certainty
Prognosis is an estimate that Doctors provide using the data over a large number of patients over time. They take into account the personal health of the patient, the stage of cancer and the treatment efficiency. However, like all estimates, this cannot be 100 percent accurate. In many cases, the patient exceeds the prognosis delivered. Through all the chemo and costs and worry about the family, a few moments to fix your vision on your goal of getting healthy might be the tipping factor that ensures complete recovery.