In the U.S., over 90 percent of breast cancer diagnoses happen during the early breast cancer stages. Early detection is good news for the patient as it often translates to effective treatment.
Nonetheless, early diagnosis is only a fraction of the whole medical picture. Other disease characteristics, like hormone receptors and lymph nodes, can aid in prognosing results and help doctors and patients choose the right treatment.
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?
The Early Stages of Breast Cancer
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 Node Indicators
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.
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.
The Grade of Tumor
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.
Estrogen and Progesterone Receptors
Estrogen and progesterone receptors within the tumor is also used to prognosticate breast cancer during the earlier stages. Generally, those patients with a receptor-positive form of breast cancer tend to have a better prognosis and survival rate than those who don’t.
HER2/neu as an Indicator
HER2/neu is what’s called a marker – it’s a biological element typically present in the body or within the tumor in about 25% of all breast cancer cases. When HER2/neu levels are high, that usually translates to a more aggressive variety of breast cancer and a worse prognosis.
Age of the Patient
Generally, patients who are older (50 and up) have a better prognosis than patients under the age of 35.