Stage 4 Breast Cancer Prognosis Factors

There are four stages of breast cancer, from stage 1 to stage 4. In stage 1, the cancer is least severe and the chance of recovery is still high. However, at stage 4, the malignant tumor has spread to other parts of the body (such as the lungs, skin, bones, liver, brain, or distant lymph nodes) and is very difficult to cure. Thus, this stage is also known as advanced or metastatic stage. The cancer might be already at the advanced stage when it is first discovered, but it can also be a reappearance of previous breast cancer that has already affected other parts of the body. It is a very serious condition and requires focused treatments. Stage 4 breast cancer prognosis involves the prediction of outcome and the chance of survival that are based on other patients' experiences. Here are the prognosis factors of a stage 4 breast cancer:

1. The first factor is the survival tendency. As a matter of a fact, the five-year survival rate for patients suffering from metastatic breast cancer is only 20 percent. Thus, the aim of the treatment is a long term survival of the patient, since the cancer at this stage is incurable.

2. Hormonal factors also play an important role. Estrogen and progesterone that can be found in birth control medications or hormone replacement therapy can actually cause the cancerous cells to grow. A hormone receptor status test will show whether or not any of these hormones are causing the growth of the malignant tumor. If the patient is estrogen receptor positive (ER+) or progesterone receptor positive (PR+), the cancer should respond well to hormone suppression treatments. Moreover, the three-year survival rate for ER+/PR+ patients reaches 97 percent while the survival rate for ER-/PR- patients is only 83 percent.

3. Histology is another important factor since it determines the degree of aggressiveness of the disease by identifying the types of cancer cells found in the tumor. For instance, the type of breast cancer known as tubular adenocarcinoma is considered as the most survivable. On the other hand, inflammatory breast cancer is very aggressive and the five-year survival rate for stage 4 is only about 11 percent.

4. Other factors that affect the stage 4 breast cancer prognosis and survival rates are the areas in which the cancer has spread, the size of the tumor, age and race factor, genetic history, response to treatment such as chemotherapy, biological therapy, clinical trials, medications, radiation therapy and surgery.

Figuring out stage 4 breast cancer prognosis is crucial. It can help finding out the chance of survival of the patient and the treatment required.

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Oncotype DX: Do All Patients With Early Stage Breast Cancer Need Chemotherapy?

What is Oncotype Dx?

There are over 25000 genes in human beings. Several of these genes were analyzed in breast cancer patients undergoing clinical studies to identify a group of 21 genes that were most strongly correlated with cancer recurrence. Studies done on these genes in breast cancer tissue became the basis for developing the Oncotype Dx test to determine what is called a Recurrence Score.

How do you use the information from this test?

The Recurrence score determines the risk of patients developing a recurrence of their breast cancers over the following ten years.

This information also helps cancer physicians choose the most appropriate form of treatment including the ability to determine the likely benefit from chemotherapy.

Thus, this test not only allowed physicians to be able to predict the behavior of these cancers better but also allowed a more accurate estimation of the beneficial effects of adding chemotherapy.

Do we need to perform this test on ALL patients diagnosed with breast cancer?

Traditionally, physicians have used breast cancer characteristics such as size of the cancer, receptor status, and lymph node status to estimate how likely their cancer is to come back, and to help determine treatment decisions including the need for chemotherapy. These characteristics are still helpful in choosing a course of treatment, but the additional information provided by the Oncotype DX test has helped refine the treatment choices that can be offered to these patients.

We do not need to perform this test on ALL patients diagnosed with Breast cancer. Oncotype Dx for breast cancer was initially used to help patients with stage I and II cancers who do not have lymph node or distant spread of their tumors and who have tumors that were positive for estrogen receptors. Traditionally, these patients have been treated with such medications as Tamoxifen alone. It was felt that many of these patients failed this form of treatment and could have been served well with the addition of chemotherapy in addition to Tamoxifen. Oncotype Dx thus allows identification of this subset of patients who could benefit with the addition of chemotherapy while sparing others from it.

Newer studies are suggesting similar predictive and prognostic value in those patients who have early stage, estrogen receptor positive breast cancer who already show cancer spread to lymph nodes in the axilla.

There is no benefit of this test in patients with non-invasive breast cancers and those who have obvious evidence of breast cancer spread.

In summary: Oncotype Dx is a simple test that has had a profound impact on our ability to predict the prognosis as well as to tailor make more precise treatment decisions in patients with early stage breast cancers.

This test is but a harbinger of things to come in the world of cancer care where testing cancers at a molecular level for each individual patient will lead to further refinements in our ability to plan effective treatment strategies for them.

Dr. Kumar is a board certified Radiation Oncologist who is co-founder of a private practice group in Florida. He has over 17 years experience dealing with cancer patients including several members in his own family who have been afflicted by this disease.

His philosophy of managing patients is through a unique holistic approach that takes into account the wishes and needs of patients and their families. He believes that any battle is won at the level of the mind first before the body goes into action to win the war. His website http://curingcancerofthemind.com/ reflects this philosophy.

He is always available to help any patient with questions regarding cancer and radiation therapy and can be reached at 772 293 0377.

Original article