For the prognosis of breast cancer, the decisive factor is the stage of the disease the patient is in. Early detection measures significantly improve the chances of recovery and can be over 90%. This applies to women whose tumor is in an early stage at the time of diagnosis. In general, the prognosis and thus the chance of a cure in breast cancer also depend on many other factors.
The age of the patient, accompanying illnesses, aggressiveness and type of breast cancer, as well as lymph node involvement and the presence of metastases all play a role. Whether or not the tumor reacts sensitively to therapy with hormone preparations can also be decisive (hormone-dependent breast cancer).
As a rule, the prognosis for cancer is given in the form of the so-called 5-year survival rate (5JÜR), i.e. one looks at the proportion of women who are still alive five years after diagnosis.
In the early stages of the disease, the 5-year survival rate is up to 97%.
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Also read our page Therapy for breast cancer.
Statistically, one in eight women will develop breast cancer at some point in their lives. The fear of getting sick one day is therefore great for many women. Those affected often ask themselves what the chances of survival are with the disease and which factors have a significant influence on survival. The involvement of the lymph nodes plays a decisive role in breast cancer. Breast cancer metastasizes via the lymph nodes, which is why, during breast cancer operations, the surrounding lymph nodes are examined for infestation and removed if necessary. In fact, this so-called lymph node status is the most important prognostic factor for breast cancer. Tumors that have already infected lymph nodes are classified in the so-called high-risk group. Breast cancer of this kind has a worse chance of recovery than a locally limited tumor that has not yet metastasized. The prognosis worsens with the number of affected lymph nodes. The lymph node involvement is also very important for the therapy decision. Tumors that have infiltrated lymph nodes have a higher risk of recurrence, that is, a relapse of the disease. Therefore, more aggressive therapy options are usually used to prevent this. However, the chances of survival and recovery cannot be expressed in numbers, as they depend on many different factors. They must therefore be assessed individually for each woman.
$config[ads_text2] not foundRead more about this: Lymph node involvement in breast cancer
If cancer cells are already found in the armpit lymph nodes, it is a sign that the breast cancer is at a more advanced stage. Accordingly, the chance of a cure is also lower than with a locally limited tumor.
The 5-year survival rate at this stage is about 81%. Nowadays, the lymph nodes are cleared out directly when they are infected, which is why this stage can often still be treated well.
Read more about: Breast cancer stages
The most important prognostic factor for a good healing of breast cancer is the lymph node status. This is determined on the basis of the metastases in the lymph nodes. Depending on the malignancy, breast cancer tends to metastasize rapidly to the lymph nodes in the chest wall and armpits and from there to other lymph nodes in the body. At a later point in time, organ metastases also develop, for example in the lungs, liver, skeleton or brain. Breast cancer that has already formed in lymph node metastases at diagnosis tends to have a worse prognosis than non-metastatic cancer. The number of lymph node metastases is also important for the healing prognosis. But not only lymph node metastases play an important role, but also organ metastases.
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$config[ads_text3] not foundYou might also be interested in the following topic: Metastasis in breast cancer
If the breast cancer is more advanced, it can metastasize. Degenerate cells spread to more distant tissues and organs, where a malignant ulcer then also develops.
Metastases are not always easy to treat, especially when they are very numerous and in many different places. Accordingly, the chance of recovery at this stage is significantly lower than in earlier stages.
The 5-year survival rate is about 23%.Therefore, therapy at such a stage no longer focuses primarily on healing the patient, but rather aims to slow the progression of the disease and improve the woman's quality of life.
Please also read our page: Metastases in breast cancer
One speaks of an early or initial stage when the breast cancer does not already show metastases in organs and lymph nodes. It is a localized tumor in the breast. During this phase, the chances of a cure for breast cancer are particularly high. The therapy decision, however, is always made individually within the framework of a tumor board, in which surgeons, gynecologists, radiologists and oncologists advise one another. In some cases, surgical measures with postoperative radiation are sufficient for a cure. Chemotherapies are also used at such an early stage if they make sense for the respective tumor. Apart from the stage of the tumor, other factors such as the grade and the receptor status are also very important for the chances of recovery. Some types of breast cancer are very aggressive and difficult to treat even in the early stages, while others respond very well to therapy. In general, however, the chances of recovery are higher if breast cancer is detected and treated early.
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You might also be interested in this topic: Breast cancer stages
The staging of breast cancer is based on the criteria of tumor size, lymph node involvement and distant metastasis. In stage I breast cancer did not develop any distant metastases and at most one lymph node metastasis. Its size must also be less than 2 cm. It is a very early stage of breast cancer and the chances of recovery are usually good. At this stage, the disease can often be cured by surgical removal of the tumor and subsequent radiation and chemotherapy. In contrast to the advanced stages, chemotherapy at this stage has a curative - i.e. healing - intention. In the case of lymph node involvement, lymph nodes are also removed from the armpit.
In stage II the tumor is up to 5 cm in size, but organ metastases, as in stage I, must not be present either. At most one lymph node may be affected. Although Stage II may sound more negative than Stage I at first, it doesn't have to be. The chances of recovery can basically be similar or even equally good. The tumor is localized at this stage too and has not metastasized remotely. As a result, the chances of recovery are not necessarily worse than with a stage I tumor. A good response to therapy is important. If this is the case, the chances of recovery are very good even in stage II.
Stage III is characterized by involvement of several lymph nodes and an advanced tumor size. Aggressive tumors that attack the chest wall or break through the skin are also assigned to this stage. The particularly aggressive "inflammatory breast cancer" is also a stage III tumor. At this stage the cancer is quite advanced. However, this does not mean that a curative therapeutic approach is not possible in principle. However, the chances of recovery are generally to be assessed as poor compared to less advanced tumor stages.
In stage IV breast cancer, distant metastases are already present in various organs of the body. According to the current state of knowledge, a long-term cure in this advanced tumor stage is unlikely. In exceptional cases, however, long-term healing can also be achieved. In such an advanced stage of the tumor, the therapy goals consist primarily of freedom from symptoms and the maintenance of a good quality of life for those affected. However, there are also factors that have a positive effect on the patient's long-term survival. Above all, the absence of a relapse within the first 2 years after treatment is prognostically favorable. In this case, long-term healing is more likely than if there are early relapses after therapy.
$config[ads_text1] not foundApart from important prognostic factors such as the lymph node involvement and the receptor status of the tumor, the histological grading also plays an important role. The cells of the tumor from a tissue sample from the breast are assessed under the microscope and the grade is determined on the basis of this. Tumors whose cells closely resemble the tissue of origin are called G1 tumors. A strong similarity to healthy breast tissue is prognostically favorable. Such tumors can be classified in the low-risk group if they meet other favorable criteria. They do not require particularly aggressive tumor therapy and are associated with better chances of survival and recovery. The likelihood of recurrence is also lower than with tumors in the high-risk group.
G2 grading means that the tumor is already poorly differentiated and its structure differs more from the original breast tissue. Such tumors are usually more aggressive and malignant. They are therefore associated with a higher risk of metastasis. Such tumors are classified in a higher risk group than G1 tumors. However, a tumor with a G2 grading does not necessarily have to be associated with a worse chance of survival and recovery than a tumor with a G1 differentiation. Other factors such as lymph node metastases and the receptor status of the tumor are decisive.
Breast cancer grading plays an important role in a woman's prognosis, among other factors. A G3-graded breast tumor shows poorly differentiated tissue under the microscope. This means that the tissue of the tumor is very different from the tissue of the breast. A G3 grading is therefore considered to be prognostically unfavorable. The chances of recovery therefore appear worse at first than with a tumor with a better grade. However, this is not always the case. Much more important than the grading of the tumor are factors such as treatment response or metastasis. Tumors that are not metastatic, even with a higher grade, have a better prognosis than those that have a lower grade and are metastatic. The chances of recovery cannot therefore be determined on the basis of grading alone.
Also the Hormone dependence breast cancer can be crucial for the prognosis of the disease. Hormone dependence means that the cancer through female sex hormones (Estrogens) to the growth is stimulated. Using specially developed drugs, it is possible to reduce the estrogen effect on cancer cells to suppress and thereby prevent the disease from progressing.
A hormone dependency of breast cancer can therefore result from this further therapy option positive affect the survival rate and chance of recovery. In addition, hormone-dependent tumors form less common Metastases. Especially in women who develop such breast cancer before the age of 35, however, is Relapse rate (Recurrence rate) clearly elevatedi.e. they are more likely to develop breast cancer again in their later life.
The hormone-independent one Breast cancer grows more aggressively, but if it is completely removed, recurrences are less common. The prognosis therefore depends on the individual case. However, as people get older, the prognosis for hormone-dependent breast cancer is lower better than with hormone-independent breast cancer.
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The HER2 receptor is a protein found on the surface of cells. This receptor influences the division of cells. The more HER2 receptors the cell has, the more pronounced its division behavior.
In some breast cancers, an extremely large number of the receptors are located on the surface of the degenerate cells, i.e. breast cancer grows very quickly and aggressively due to its high division rate. This is accompanied by a poorer prognosis for the patient.
However, there are now drugs that block the HER2 receptors so that they can no longer transmit the growth signals to the malignant cells (so-called antibody therapy). This can increase the survival rate of affected patients. However, compared to breast cancers without HER2 receptor overexpression, the prognosis is still worse.
Triple negative tumors are characterized by the fact that they have no hormone receptors (estrogen and progesterone) and do not develop the so-called HER2 / neu receptor. These receptors are important targets for drugs that are used in the modern treatment of breast cancer. According to new studies, however, this does not necessarily have to go hand in hand with a generally poor therapeutic response. Such triple negative tumors sometimes respond very well to other chemotherapeutic agents and can thus also be treated with healing intent. However, triple negative tumors are also known that grow very aggressively and respond poorly to therapeutic agents. The chances of a cure for a triple negative tumor cannot therefore be given across the board.
Read more on this topic at: What is triple-negative breast cancer?
uPA and PAI1 are special Egg whitesthat can be produced by breast cancer cells. Low mirrors these proteins correlate with one more favorable course the disease while high mirrors for one more aggressive breast cancer and therefore also represent a poorer prognosis.
Women with high uPA and PAI1 values are therefore more likely to benefit from one chemotherapywhich takes place directly after the breast cancer surgery.
There are several genes that increase the risk of developing breast cancer. The genes BRCA1 and BRCA2, which are associated with an increased incidence of breast cancer in younger women, are particularly well known.
In principle, the prognosis is poorer with genetic predisposition. If breast cancer occurs early, the probability that it will develop again after a few years is significantly increased.
Treatment is also more difficult in many cases, as breast cancer is usually a particularly aggressive form of genetic predisposition.
A mastectomy, also known as a mastectomy, is always performed when a breast-conserving operation is not possible for various reasons or the patient wishes the amputation. Very large tumors called inflammatory breast carcinomas or multiple tumors in the breast (Multicentricity) make breast-conserving surgery impossible. A mastectomy increases the chances of recovery in such cases. The likelihood of a relapse, for example due to residual tumor remaining in the tissue, is thus minimized. A mastectomy, however, is not always necessary and absolutely beneficial. For tumors that do not require a mastectomy, the chances of recovery are not increased compared to breast-conserving surgery.
The greatest fear of most people with cancer is the occurrence of a relapse. Relapses are disease relapses that can occur even after breast cancer has healed. A distinction is made between early and late relapses. Early relapses occur within the first two years after the breast cancer is cured, and late relapses in the period after that. Early recurrences are particularly feared, as they suggest a very aggressive tumor. The chances of a cure are much lower with such early relapses than with late relapses. The chances of recurrence and distant metastases are also increased. The likelihood of surviving the disease for several years therefore decreases. It also plays a role where the relapse occurs and after which therapeutic measures. Relapses that occur at one point after radiation and breast-conserving operations show a 5-year survival rate of around 64%. This means that 5 years after the relapse, 64% of the patients are still alive. On the other hand, recurrences that occur in several places only have a 5-year survival rate of around 24%. Furthermore, the chances of survival and the chances of recovery are strongly dependent on the general condition of the person concerned and many individual factors.
The age of the patient is also important in terms of prognosis and the chance of recovery. The prognosis is rather poor in women who become ill before the age of 35. Such an early stage of the disease suggests a genetic predisposition and often leads to aggressive tumors with a high relapse rate.
In contrast, breast cancer in old age (from the 67th year of life) often does not reduce life expectancy with adequate therapy. Recurrences are less common, and in many cases the breast cancer is less aggressive.
Men can also develop breast cancer. Although this happens much less often, it is no less dangerous. The main danger lies in the fact that breast cancer is usually diagnosed late in men. There are no early detection examinations for men, such as mammography, which has become established in breast cancer screening for women.
Lumps or other changes in the chest area are often not perceived as potentially dangerous by men. Therefore, on average, going to the doctor takes place much later and the cancer has already spread further in the meantime.
However, the treatment is carried out as for the woman. The prognosis for the disease is then similar, i.e. if the cancer is discovered at an early stage, the prospect of a cure is very good. As the stage progresses, the prognosis and the chances of recovery worsen.
Read more on the subject at: Breast cancer in men
Early detection in particular plays a major role in the prognosis and the chance of recovery from breast cancer. If the cancer is detected early and adequately treated, it can usually be treated well and the chance of a cure is high.
You can find more information on our website: Prognosis in breast cancer
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