Will 30% of Early Stage (1-IIIA) go on to metastasize??

Hi exercise_guru:

No, I haven't researched that, although I feel virtuous when consuming crucifers or cooked exotic mushrooms, as I ponder all the potentially healthful effects of cruciferous beta-carotene, lutein, zeaxanthin, indoles (e.g., indole-3-carbinol), and isothiocyanates (e.g., sulforaphane) or strange mushroom triterpenes and polysaccharides.

BarredOwl

Regarding the asparagine study, they do say it doesn't cause cancer. It might make some cancers more likely to spread. That is an important distinction. They are already targeting asparagine to treat a type of leukemia, so it very well could prove to be a factor in other cancers.

However, these studies are usually conducted in a vacuum. The mice they studied were triple negative, and not receiving conventional treatment for cancer. In order for asparagine to make cancer spread you would have to have the right kind of cancer cells in your body. If whatever treatment you have done or continue to do has dealt with the cancer, there won't be any there to spread.

We all know there is a risk of metastisis, and this may prove to be one of the mechanisms scientists can target to prevent it, but I doubt it will turn out that changing your diet would make much difference. You can't avoid asparagine completely because it is in so many other foods besides asparagus.

I had just finished off our second pot of asparagus soup in a week when I ran across this news. I was like, DAMN! I'm already on a very restricted diet and I feel like I'm running out of choices. I always like to err on the side of caution so I'll probably eat less asparagus soup, but I'm not going to stop eating asparagus all together.

BarredOwl, why are you removing so many of your posts?

May I ask why you were getting annual MRIs?

unless they is something that may be suspicious there are no annual mri's. If you have symptoms that makes sense to scan then that's when it's done. Mri is pricey so unless there is a good reason, it won't be covered. But if your doc is good with coding, maybe with the right code it may work. My checks on my bilat mx with implants is my docs feeling around for lumps. So unless I have a symptom, no scans.

I also have one dense breast and one implant. I get an annual mammogram but also get an MRI every 3 years. And since I have a breast exam by my BS, MO and GYN, I spread them out over the year so I get a physical breast exam every 4 months. My BS orders the mammograms and MRI. He says the MRI is to catch anything the mammogram doesn't as well as to check the implant to make sure it's holding up and hasn't sprung a leak. My insurance only pays if I've hit my deductible but my BS makes the hospital give me a steep discount.

I still get the mri every year and it is covered by my BCBS.

So my BS’s PA called me today to let me know she was able to get it approved. Thank you all for your responses. Nice to know there is somewhere to go and talk to those who understand!!

mstein1970- I'm still relatively new to this breast cancer learning curve. I was diagnosed the second week of December in 2017. I'm hormone negative and her2 positive. I've already had a BMX with one positive lymph node and clean margins. I just finished Round 4 of tchp. So far minimal side-effects. I am very interested in learning about the different types of testing and how it impacts are treatment and recurrence rates Could you please explain ANA?

minus2-thanks for the explanation. Hope you are feeling well.

Hey - just thought I would join in on the subject of inflammation. I have been reading a lot of journal articles as well linking inflammation to not only auto-immune disorders but also diseases like cancer, Alzheimer's, depression, schizophrenia, diabetes, heart disease etc. Researches are really just starting to get the bigger picture of the detrimental, degrading quality of inflammation on the immune system. I have been trying to talk with not only my MO but my GP and my psychiatrist about this. However, they wont test me for inflammation so I will probably end up going private for on going testing as also think it is a good indicator of what is going on. Tumours also increase inflammation in the body. The reason why my docs wont test me is because the science is just at the discovery stage. They are starting to do trials with anti-inflammatories with cancer treatment with some success. For my own health I also eat a low inflammatory diet and I also include Bromelain (pineapple enzymes) to decrease inflammation in my body. Low dose naltrezone also helps your body with auto-immune disorders as well.

Mstein1970 - i would also be concerned as well if your ANA levels keep increasing. You may want to consider full body scanning if you can afford it or get insurance to cover it. Or you may want to include other cancer markers in your blood work to see if you have other elevated levels.

minustwo- you are correct. I had surgery first before Chemo. So since I had one positive lymph node radiation was recommended after chemo. That's Okay. We do what we have to do to get through this thing. Have a great weekend.

jo6359, the ANA is a non-specific indicator of inflammation in the body. As Roaming Star says, the medical profession knows still understands very little about its role in cancer, and most doctors still think of it mostly in relation in autoimmune diseases like lupus. Despite my long history of abnormal ANA levels, my medical oncologist refused to order my most recent ANA test for me, saying it was irrelevant. (One of my other doctors ordered it.) But studies clearly show that it is an indicator of inflammation that may be caused by cancer (often before the cancer is diagnosed). And that the inflammation may then create conditions that enable the cancer to spread. Here are links to some studies (I may have copied some links twice)::

http://news.cornell.edu/stories/2013/01/study-find...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC44534...!po=47.8022

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3867234/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC44534...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC38672...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC28030...

I am supposed to get yearly MRIs done as well as part of my overall treatment plan as set up by my surgeon and MO. I was 36 at diagnosis and have extremely dense breasts so they wanted me doing MRIs every year so they can spot any changes right away. What's funny though is that the first MRI I had showed the tumor and that nothing had spread beyond it, so they were going to go ahead with the lumpectomy but the MAMMOGRAM I had at the surgeons office showed calcifications and other things within the breast which is why they opted for the mastectomy instead. I don't think mammograms show lymph nodes and the chest wall obviously, but the calcifications weren't picked up by the MRI.

I'm a new early stager and was linked to this thread. I found it really interesting and want to thank everyone who provided on-topic, substantive, and thoughtful information.

Others have probably seen this study but I don't think it was linked here yet and it seemed on topic for at least a subset of us (node negative, ER+, Her-). Although it only goes out to ten years, I still found it encouraging.

Luminal-like HER2-negative stage IA breast cancer: a multicenter retrospective study on long-term outcome with propensity score analysis

It's a 2017 Italian retrospective study (with the limitations that entails). They looked at outcomes for women with early stage who got tamoxifen alone versus tamoxifen plus chemo. Overall, the women who got chemo had higher risk factors (makes sense why their doctors would have prescribed chemo).

10 year disease-free survival rate/Overall Survival Rate

• tamoxifen alone (tended to be lower risk): 94.1%/99.4%
• tamoxifen+chemo (tended to be higher risk women): 87.8%/96.9%
• Everybody together: 91.5%/98.3%

They found that the 'best' predictor of higher recurrence was the grade of the tumor.

They said that the chemo used was mostly older technologies, due to the timing, and this shouldn't on its own be taken as an indicator against using the newer more customized chemo regimes for HR+ women. Still, it might make other women like me feel better about avoiding chemo - just because adding chemo feels like doing more, it's not necessarily actually 'throwing the whole book at it' or anything.

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I also want to mention the new staging guidelines. They were revised to make prognostication more consistent, and they might be helpful to women looking to better understand our own risk profiles. I found that my doctors were not at all good about communicating with me the nitty gritty of this.

One thing that was a nice surprise, though it doesn't apply to me personally, is that under the new guidelines, HER+ actually reduces staging. I presume that's because of the efficacy of herceptin.

These are some helpful resources I found, but none of them is a really good 'snapshot' approach so if anyone has that, that would be helpful:

• Small 2018 study: A retrospective prognostic evaluation analysis using the 8th edition of the American Joint Committee on Cancer staging system for breast cancer: Research paper with many charts with survival rates, compares the clinical/anatomic staging to the new pathological staging
  • It notes that the anatomic and pathologic staging only matched about 50% of the time. To me that means that if you haven't figured out your pathologic stage according to the new guidelines, it would be helpful to do that and verify if it's the same or different.
• Powerpoint about the need, application and impact of the guidelines
• Powerpoint overview of clinical/anatomic, genomic, and pathological prognostic staging, with charts near the end
  • Notes that node negative ER+/HER- tumors 5cm or less with oncotype score under 11 or 'low risk' in other indexes, stage is 1a regardless of other factors.
• AJCC Cancer Staging Manual chapter about new breast cancer staging. Control-f '629' for the beginning of the prognostic staging charts.