Agressiveness

newter

Agressiveness

newter

I have been wondering what is the most agressive form of BC. I know grade 3 is the highest grade but what type is most aggressive or does anyone know the hierarchy of the following assuming all grade 3:

IBC

IDC

ILC

Tubular

Medullary (sp)

Pagets

And how about the hormone receptor status?:

Triple negative

Triple positive 

ER/PR + only

Her2 + only

These are all I can think of at the moment.

iodine

Just a guess on my part : what I'd fear most was inflammatory.  I have no stats or links to provide you, tho.

Paulette531

IBC...and I think because it's been the hardest to detect. MD Anderson recently opened an IBC center.

mkl48

Sometimes a more aggressive cancer is more able to be "cured". ER+PR+ Her - may be not as aggresive, but triple neg are the ones who respond best to chemo and esp if her + though her+ was thought of as being a poor prognostic sign. Now if you get it neo adj with chemo it makes the DFS much better.  ER+ Her- women are at risk for rec for their lives, esp 10 years while 3 negs are in better shape by three years if no rec.The ER+ Her+ may have the most options and the her + part makes the chemo more likely to work. Tubular has a very good prognosis.IBC is quite aggressive and just now being a unique area of study at MDA.Beth

otherme

Beth, can you please fill in the blank - what is DFS?

Where does the info you're referring to come from?

Thanks. 

newter

Bumping up in case someone else has some good info

sam52

Yes, in general IBC is thought of as a particularly aggressive form of bc. Statistically, the survival rates for this type of bc are below other types of the disease.

Yes, HER2+ is also more aggressive; it does respond better to some chemo regimes (notably the taxanes),and there is the 'miracle' drug herceptin.But of course not all HER2+ tumors respond to herceptin.....quite a lot of them don't.

Yes, triple neg has the reputation of having a poorer prognosis, but it does respond better to chemo and after 4 years with no recurrence, the prognosis is very good.

HOWEVER - there are many other factors that are not usually factored in, when assessing the aggressiveness of a tumor;for example :P53, VEGF and numerous oncogenes indivicual to a particular tumor.These can make a seemingly 'well-behaved' grade 1 tumor as aggressive as a supposedly more aggressive grade 3.

This is a very complex issue and the answers just highlight the fact that the prognosis for most types of bc is rather a crap-shoot........

Sam

LAphoenix

My understanding is that the most telling component of your tumor grade is the mitotic rate, or the proliferation rate.  If that's a 3, your cancer is especially aggressive, even if the other two parts of the grade (the Nottingham scale or whatever it's called) are 1s.  So one woman's grade 2 may not necessarily be the same as another's, even if they have the same total number on the scale.  I too have heard that aggressive non-hormonal cancers respond better to chemo and can be wiped out for good, but that ER+ cancers tend to hide out in your body after treatment, rearing their ugly heads years after treatment. 

Anonymous

I think its all a crapy shoot and all breast cancer is aggressive.  Some do well and others get a reoccurance. 

My guess would be IBC since even early diagnosis of it puts you automatically at stage 3. 

Despite some saying triple negatives respond better to chemo - well most of the ladies we have lost recently were triple negative.

Someone made a statement that er/pr + and her2 negative is the most aggressive cause you are at risk for reoccurance the rest of your life?  Sorry, but I disagree with that.  We all are at risk for reoccurance the rest of our lives.

Im not feeling real good myself, sitting here being er/pr negative and her2 positive.  I failed herceptin and Im not on any treatment at all now.  Nothing out there for me.

Guess what Im trying to say is that bc just stinks no matter what our diagnosis is.

Nicki

ravdeb

If we are talking in general then IBC is the most aggressive cancer and one of the most difficult to diagnose in the first place.

And other than that...all the other subtypes of bc are unknown as to their aggressiveness until they figure out how to test for all these new proteins and whatevers they are finding. It seems that no matter what type of tumor you have, it depends on the tissues surrounding it and the p53 or whatever it's called. That, they are saying, is what will tell you your chances of recurrence.

Lymph node involvement will not tell you for sure about mets or recurrence risk because the cells can move about through the blood.

So..because we just don't know..it's not really a crap shoot but rather a lack of knowlege on what we really have. Those elements we thought would tell us a real prognosis...it just aint so.