Recurrence risk and ER/PR positive

LM070917

Hey all,

Not sure if this is the right place to post or not, I've heard that the risk of recurrence for ER and PR positive Bc goes up after 5 years,is this correct and if so what's the explanation for it? I thought the biggest risk was the first 2-3 years after initial diagnosis. Does that mean risk always remains high for our type?

Traveltext

No, five years is a major milestone for all of us being treated as stage III, and the risk of recurrence actually goes down after this.

cp418

https://www.researchgate.net/post/How_long_after_b...

Anonymous

Interesting. We should also consider that taking AIs for extended lengths of time seem to render them ineffective in some, rather like taking antibiotics, when patients become resistant to the drug's effectiveness when prescribed for lengthy time periods. "These drugs have been incredibly successful, but for reasons that are still unclear, patients often develop resistance to them, especially when their tumors migrate—metastasize—to other organs." Link to article provided here. http://www.the-scientist.com/?articles.view/articleNo/38155/title/Decoding-Breast-Cancer-Drug-Resistance/

cp418

Yes - as patients we are certainly caught in the middle deciding what to do.

tangandchris

Breast Cancer = uncertainity

Lily55

For those of us with lobular cáncer our risk increases as time goes by.......................challenging but sadly true

Anonymous

Lily55, well, that's damned grim. I prefer to refer to this statement, from Healthline.com: "Although survival rates are similar between ILC and IDC, research has shown people with lobular breast cancer have a slightly better outlook for both short- and long-term survival. A study published in the British Journal of Cancer in 1997 showed that people with ILC had less spread of cancer and higher five- and 30-year survival rates than people with IDC. In ILC, the five-year survival rate was 78 percent, and the 30-year survival rate was 50 percent. In IDC, the five-year rate was 63 percent, and the 30-year rate was 37 percent." Probably super old research, but it sounds much better to me.

From an old thread (2009): From another study in www.pubmed.gov:
"The 5- and 30-year corrected survival rates of women with ILC were 78% and 50%, respectively, compared with 63% and 37% for women with IDC.... We conclude that ILC is associated with better survival than IDC."

At any rate, I will continue to take my AI until I'm told to stop by my MO. Rather safe than sorry, and I want no regrets that I didn't take advantage of the best tx offered to me if something happens in the future....:)

grandma3X

I think this is a misunderstanding - the data shows that the rate of recurrence in the first 5 years for ER-/PR- is higher than for ER+/PR+, but then declines very quickly for ER-/PR- cancers, while the rate of recurrence declines at a slower rate for ER+/PR+ cancers (but it is still lower than it was in the first 5 years).

The same for ILC and IDC - ILC has lower rate of recurrence in the first 5 years, but after 5 years, ILC has a greater tendency to recur than IDC (but the rate of recurrence for both continue to decline). So the rate of recurrence doesn't actually go up after 5 years, it's just higher than the rate of recurrence for IDC.

So if you are ER+/PR+ and/or ILC, your risk of recurrence is lower in the first 5 years, and continues to decline after 5 years, but it will never really disappear.

BarredOwl

Hi:

I agree that in general, it is more that risk persists over time for hormone receptor-positive disease. Here is a 2016 article discussing same:

"Annual Hazard Rates of Recurrence for Breast Cancer During 24 Years of Follow-Up: Results From the International Breast Cancer Study Group Trials I to V"

http://jco.ascopubs.org/content/34/9/927

The full-text of the article is available via the patientACCESS option for a minimal charge, with registration at the Copyright Clearance Center. Click on the full-text option at right, then scroll to the bottom of the page, choose the patientACCESS option, and follow the links to register.

BarredOwl

Anonymous

Grandma3X, exactly--and that's why I've resigned myself to taking an AI for the rest of my life, most likely (and hinted at by the onc at my last check up).

Warrior_Woman

Thank you, BarredOwl. Once again you've helped me through my confusion.

BarredOwl

Hi Warrior_Woman:

. . . and thanks to cp418 for first alerting me to the study in her routine research update postings!

BarredOwl