Over 90 percent of breast cancer cases are diagnosed during the earlier stages of the disease. Early spotting is beneficial for the patient as it typically means better treatment and a stronger prognosis.
However, this is only a portion of the whole clinical picture. Various characteristics, like lymph node engagement and receptor status, can help prognosticate outcome and aid in choosing a treatment selection, making them critical factors for survival.
Although breast cancer is on the rise in North America and the UK, the mortality rate is decreasing. This decline in mortality is credited to an increased number of women obtaining mammograms, improved evaluation techniques, and effective ancillary treatments.
Thus if the majority of diagnosed breast cancer cases are discovered during the preliminary stages, what effect does that have on patients and what are the best treatment courses?
An Overview of the Earlier Symptoms of this Disease
Earlier breast cancer stages are called TNM stages 1, 2 and 3a. This scoring system approximates how far the carcinoma has advanced. It's also based on whether any present tumors are operable.
Most instances of early-stage breast cancer are curable through surgery, radiation therapy or systemic therapy. The survival rate for patients diagnosed this early have a 5-year success rate of over 75%.
Normal Treatment Reactions
Treatment reaction generally hinges on lymph node engagement, the size and grade of any tumors, the age of the patient, hormone (estrogen and progesterone) receptors, and the status or condition of biologic markers like HER2/neu.
Lymph Nodes
Lymph nodes are an effective way to predict the effects of breast cancer. Essentially, the more positive lymph nodes that are present, the lower the patient's survival rate and the higher the chances of relapse.
Commonly, patients with earlier stage breast cancer are classified into either those presenting negative nodes, 1 to 3 positive lymph nodes, 4 to 9 positive nodes, or 10 and more nodes.
The Size of Tumor
If a patient exhibits negative lymph nodes and a tumor that is smaller than 1cm, the prognosis is often very good. Most doctors use tumor size as an effective and critical indicator during the early stages of this disease.
Tumor Grade
As the grade of the tumor increases, so does the potential relapse rate. However, due to the unreliability of tumor data, most pathologists do not rely on this information for their prognosis.
Hormone Receptors
The status of hormone receptors in the tumor is another indicator used by doctors when prognosing early stage breast cancer. Typically, patients who experience a receptor-positive cancer have a stronger survival rate than those who do not.
HER2/neu as an Indicator
HER2/neu is a tumor marker that is expressed in approximately a quarter of all breast cancer cases. If its numbers are high, this is usually associated with a more aggressive form of breast cancer.
Age of the Patient
Generally, patients who are older (50 and up) have a better prognosis than patients under the age of 35.
By: Trevor Price
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