Doctors Lounge - Oncology Answers
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Forum Name: Breast Cancer
Question: Diagnosed in Spain
|CDS - Thu Jan 26, 2006 8:53 am||
I was dx March 2004 with a 9 x 7cm tumor in my right breast. Lobular infiltrante carcinoma. My first report also said T4 Nx Mx, the oncologist told me I was stage 111b. I had 3 cycles of epirrubicina & ciclofosfamida followed by 6 cycles of taxol & gencitabina. I was on a clinical trial and had treatment every 2 weeks. Four weeks after chemo I had a mastectomy, the report said that the tumor was 7.5cm diameter, grade one with 3 out of 12 nodes cancerous. RE(+) RP(+) and HER2 (-) Next I had 25 rounds of radiotherapy about 6 weeks after the surgey. I was put on tamoxifen which I have been taking since September 2004. I return every 6 months for blood tests, chest xrays, mamogram and ´manual´checkup with the oncologist.
I am 50 next month, March, female with no breast cancer history in my family.
Even though I am almost 2 years from diagnosis I am still not understanding the jargon, like what regime the chemo was, I often see abbreviated stuff but don´t know what mine is. My main problem or question is: How bad/good is this prognosis. When I first started out on this journey I had an excellent english speaking onc who was brilliant but only explained bare facts and told me that the above ´package´was what I was having, I wasn´t given a choice, I also read that people are given a choice. Now when I go back for check ups I get any available onc, they say I am cured? From what I read a reoccurance is more than likely. I really need to know what I have been through and maybe what I am likely to go through, can you give me an idea please.
|Dr. Tamer Fouad - Fri Jan 27, 2006 7:35 am||
It would be difficult to assess the absolute risk of recurrence in your case. Please note however, that one of the most favorable factors in your case is the fact that two years have passed without recurrence. Most recurrences are known to develop in the first two years after initial treatment.
Let me try my best to discuss a few independent aspects of your prognosis.
According to your stage, stage IIIB disease is associated with a 44% 5- year survival rate when given multimodality therapy such as the one you received. Meaning, in clinical studies a little less than half the patients that took treatment were still alive 5 years after the start of their treatment plan.
As regards your pathology invasive lobular carcinoma is associated with both synchronous and metachronous contralateral primary tumors in 30% of the cases.
Lymph node positivity is associated with a less favorable prognosis. However, the highest risk of disease progression was found in patients who initially had more than 4 lymph nodes harboring the disease. So in your case, you are not doing too bad there.
When it comes to the tumor size, large tumors such as yours are also a risk factor for recurrence.
On the other hand a negative Her-2/neu is associated with much better prognosis than those who are HER-2 positive.
The strong positivity of your ER and PR receptors confers excellent prognosis and allows you to benefit from adjuvant therapy in the form of tamoxifen.
As you can see it would be difficult to give you an absolute assessment, however please bear in mind that oncologists tend to breathe easier once two years have passed with no breast cancer related events.
If you have any further questions please do not hesitate to ask.
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