Chances of recurrence/spread after 4 years?

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KP1970
KP1970 Member Posts: 192
edited June 2014 in Stage I Breast Cancer

I am a 4-year survivor of stage II. I have been doing pretty well trying not to worry about the cancer coming back...until just recently. My mom has been diagnosed with stage IV lung cancer and not only are we devastated, but it has also caused me to start worrying again about my own cancer returning. :(

My last chemo was in April of 2007, and I am counting my survival from that date. My oncologist said that I'm not "out of the woods" until I hit the 10-year mark, but I have heard 5 years seems to be the "magic number" (although I am aware that the cancer could return at any point, even after 20 years). Would you say though, that after 4 years of no treatment, chances are probably pretty good that it won't come back? I am feeling really anxious about this again... 

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  • pejkug3
    pejkug3 Member Posts: 902
    edited May 2011

    <hug>

    My MIL was diagnosed with Stage IV lung cancer last week.  We're all just shocked.  She's 57.

    I was talking to a friend who had Stage IV BC.  She's going on 10 years NED this year.  She said that you never get past that worry in the back of your mind.  :(

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  • debbie6122
    debbie6122 Member Posts: 5,161
    edited May 2011

    Kim- Im so sorry for your moms diagnosis, I know how hard that must be for you, not only worrying about her but also worring about a recurrance for yourself. I dont know what stage your moms cancer is but i hope she will get through this, i was dx with lung cancer a few years back, i had part of my left lung removed and and doing great in that area now.

    I guess my advice to you is try not to worry about a recurrance, some woman never get a recurrance with bc but i know it is always in the back of your mind. but I try to just live my life and enjoy it the best i can, knowing it wont make a difference by worrying so i try not too. 

    You and your mom are in my thoughts and prayers

    Hugs.

    Debbie

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  • debbie6122
    debbie6122 Member Posts: 5,161
    edited May 2011

    Kim, I just reread your post and realized your mom is stage IV I hope that she gets through this and has some successful treatments, one of my friends was dx 3 years ago withs stage IV lung cancer and is in remiission and i hope the same for your mom

    Gentle hugs,

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  • dsengplute
    dsengplute Member Posts: 19
    edited May 2011

    Hi KP.  So sorry you have to deal with cancer again.  My Mom had Cyberknife for her lung cancer about three years ago and has not had a problem since.  The tumor lays dead where they killed it.  It is my hope that your Mom's treatment is as easy and effective. 

    I know it's probably hard to do right now but honestly I believe worry activated cancer in my body so I think you just have to have full faith that after 4 years you are in fact cancer free and will stay that way.  I'm doing chemo now to help prevent any future cancer diagnosis but truly believe that after my double mastectomy I am cancer free.  When they're not pumping poison or pills into me I feel amazing, better than I have in years.  It's gone, that's it - yes the cancer may surprise me again as it did this time - I'll deal with it then.  

    Do something good for you everyday, take care of your Mom and enjoy every minute together.  Sending you hugs and prayers. 

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  • Beeb75
    Beeb75 Member Posts: 325
    edited May 2011

    Hi Kim,

    Your chances are pretty good that your cancer will not come back. They were pretty good from the outset (I see you are Stage 2b, like me. Assuming you did chemo and anti-hormonals, you probably only had a max 20 percent chance of it coming back.)

    From what I understand, with slower-growing ER+PR+Her2- cancers like ours, the recurrence risk is spread out longer. Of those who have a recurrence, about half do between years 1-5 and the other half between years 5 and 15. So since you have made it nearly 5 years, you are down to a remaining 10 percent chance of it coming back. 90 percent of women with your stage who have made it as far as you will have no future problems with breast cancer!

    Overall, your chances are a lot lower now then they were at your dx, so logically, you should worry less now. (Though I know our worries do not always follow logic!) 

    I'm sorry to hear about your mom and hope she does well with her treatments. 

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  • peggy_j
    peggy_j Member Posts: 1,700
    edited May 2011

    Sorry to hear you're going through this. If I were in your situation I'd be stressed out too. FWIW, I've heard a magic number of 5 yrs. I've also recently read that the first 3 years are critical, which is why they do extra screening. Personally, I find all this what-if odds-making to be super stressful. Arg! Do you have any support groups you can turn to? i.e. caregiver groups or even BC support groups? I go to a "healing imagery" group and there are patients there that are 8 and 15 yr survivors, so it's clear these concerns continue for many patients. Best of luck for you and your mom.

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  • mmm5
    mmm5 Member Posts: 1,470
    edited May 2011

    Kim

    I have done some research on this and have spoken to a couple of Oncs regarding this at teaching hospitals. Usually 3-4 years are the most important years for a fast growing tumor or Grade 3 which it looks like you are grade 3. The more aggressive the tumor the more likely it would come back early. There are no guarantees as you know but that sounds like the group you would fall into 

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  • 37antiques
    37antiques Member Posts: 643
    edited May 2011

    mmm5, is that true across the board, or does it differ depending on hormone receptor status? Or does hormone status not enter into it at all because the signature can change with a recurrence?  And does stage enter into it at all?

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  • mmm5
    mmm5 Member Posts: 1,470
    edited May 2011

    those are all excellent questions and of course I am NO Doctor, I was just told based on my tumor type which was highly aggressive with Her2 that these tend to recur early and grade 3 as well.

    I specifically started asking and looking into the ER piece as well because I am a triple positive. In my case they state that the Her2 piece most likely trumps the ER piece as Her2 is the driving force. The assumption is again based on an "aggressive tumor". Take a look at your pathology, specifically the ki67 score and see if it was a fast moving aggressive tumor (most are at a grade 3) but this will tell you a bit of the picture by illustrating the pace of the tumor.

    Also I did ask about stage and I was told stage would not play a significant role in the length of time to metastasize as a cancer cell either got out and was not killed or it was and if it is going to metastasize it will whether or not you are stage 1-3. I have seen stage 0 progress to mets in 2 years as well, it was the aggressiveness of the tumor. (and grade plays a significant role in this) 

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  • 37antiques
    37antiques Member Posts: 643
    edited May 2011

    mmm5 Thank you very much, that helps to clarify things.  I understand youa re no doctor, but I can tell you that I have a lot of faith in the girls here knowing more than any single doctor ever could.  A meeting of the minds, so to speak.  I'm glad stage doesn't enter in, being unstaged I have felt kind of "homeless" about my future prognosis.  I didn't have the Ki67, they figured mine on the Scarff-Bloom-Richardson scale, with an overall score of 8 out of 9.  The overall mitotic count was greater than 20, where it is usually 15 at most, so it was aggressive.  And of course I let it grow for a long time before I called the doctor (yes, I can be a big moron) so we're pretty sure it had lots of time to get into my bloodstream and begin a party somewhere else.

    Kim, I'm sorry for being sidetracked, I always like to hear good information from oncs, not all of them share comprehensive information because it might scare us. I think it's totally natural for you to be feeling this way when you have had another cancer dx touch you so closely.  mmm5 is right, only your onc can give you the greatest detail regarding your own prognosis based on your individual signature and treatments you have had, there is no single good answer for any of us.  I would think at 4 years, given that you have done all of your routine follow ups and have not noticed anything new, you are most likely doing well and should not cause you any over anxious moments right now, although this is completely normal and any of us would probably react the same.  It is unfortunately a touch of ptsd that we all get in some degree when something like this happens.  We are forced to face the fact that we can't control everything in our lives no matter what we do, and it is especially hard when someone as close as your mom has a new dx.  I'm sorry this has happened, but like the other girls said, there is hope, even for stage IV lung cancer.  I have a friend that had the same dx, he had a portion of his lung removed and a few months later started working at a full time job, so even stage IV does not always mean the worst.  ((Hugs)) to you and your mom, you will get through this and we are here. 

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  • kathleen1966
    kathleen1966 Member Posts: 793
    edited May 2011

    Personally, I believe that no-one is ever out of the woods from their breast cancer coming back.  Ever.....But as time goes on, we start to slip back into the security of living until we are old and dying from something else, like the rest of the normal, non cancer population. You won't know that it's not coming back until you die of something else.  If I am still here by year 10, I am quite certain I will be convinced it's not coming back. This won't be true, but that is where my mind will be. I will be very, very grateful if this is the case and will live each year, day, as if it might be my last to the best of my ability.  I don't think I'm going to be moving to a third world country to help out at an orphanage like Mother Theresa, nor will I go sky diving, and I won't be winning a Nobel Peace prize or write a best selling novel, and I know I  will never be on the cover of the Sports Illustrated swim suit issue.  But I will stop and notice the roses, so to speak. And I have plenty in my own backyard.  We have no control over the future. Just today. Just tell yourself, I am OK today, I am ok today. I am alive TODAY!  Ahhhh...... smell the air outside. Put your face in the sun or the rain. You can feel it.....because you are ALIVE and you are well!!! 

    Sorry to be soo corny.......Money mouth

    I hope I helped.......Sealed

    I really like these smiley faces....Tongue out

    Also, I am really sorry about your Mom. It is going to be very hard for you as a caretaker seeing her go through the challenges she will face in the near future.  You may want to consider getting a therapist or counselor to help your mind sort through this difficult time. Exercise will also help with those horrible thoughts going through your head.  I have a heavy heart for you.  I hope you have a lot of family and friends to support and love you and your mom during this time. 

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  • pejkug3
    pejkug3 Member Posts: 902
    edited May 2011

    So, since we're talking about grades...my Elston-Ellison grade was II/III.  So am I a grade II or a grade III?  Version 2.5?  ;)

     It's crazy, but I'd feel a lot better about being a II.  Yeah, I know, I know...

    I never saw anything about a ki-67 on my reports.  Is that a standard test?  Perhaps my surgeon would have some info on that.

    My pathology was a little weird in that my core biopsy removed all the IDC.  When I had my lumpectomy, only ADH and DCIS remained.  So two hospitals had to collaberate and stage me because my biopsy and my surgery were done at different facilities.

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  • kathleen1966
    kathleen1966 Member Posts: 793
    edited May 2011
    I was also told grade II/III.  My score was a 7.  My Mitonic rate was only 1.  But they came up with the system for a reason.  Technically, I am grade II. Though I'm not sure how you can be her2+ and grade II at the same time.  Technically, I am stage IIIa but was also told I am more a IIb/IIIa.  With one less node, I would have been IIa.  It's all a bit of nonsense?  All I hear is I'm not stage o Frown and I'm not stage IV..... Smile
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  • pejkug3
    pejkug3 Member Posts: 902
    edited May 2011

    Hmm...now I'm more interested in how they arrived at my score.

    I'm stage IIa...3.0mm of mets in one node.  And my tumor was offocially sized at .5cm.  That little creep was on the move and already in my nodes. 

    Thank GOD that I didn't listen to the GYN who said I was too young and overly worried - come back in 5 years when I'm 40 for a mammo.  Yeah, in 5 years I may not have been sitting here worrying about what the grade of my tumor really is.

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  • 37antiques
    37antiques Member Posts: 643
    edited May 2011

    They grade them on 3 categories,   You add each number for each category together, the highest possible score is 9, divide by 3, and that is your grade.

    Tubule Formation (% of Carcinoma Composed of Tubular Structures)Score
      > 75%1
      10-75%2
      less than 10%3
    Nuclear Pleomorphism (Change in Cells)Score
      Small, uniform cells1
      Moderate increase in size and variation 22
      Marked variation3
    Mitosis Count (Cell Division)Score
      Up to 71
      8 to 142
      15 or more3

    Staging is done based on T (tumor size) N (node involement) and M (mets).  So if you have a very small turmor they call it T0, which is DCIS because it has not spread.  If you have any M, you have mets and that is stage IV no matter what the other numbers are.  Even a low T number could be a higher stage because of node involement.  If you get a moron like my surgeon was, your dx is stuck at T1, NX, MX and you can never be staged, because the difference of stage 1 and stage 3 is determined by 2 little nodes (or absence thereof).

    I had both DCIS and IDC, my IDC is grade 3 while the DCIS was grade 2.  They mix all of that up in a blender and come up with a treatment plan, generally more toxic based on grade rather than stage.

    pejkug, do you think my surgeon and your gyn went to the same school?

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