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

Thanks Salamandra! The staging flow charts in one of the power points cleared some things up for me. My stage from my biopsy said 1a, but pathology said 1b. I was node negative, ER/PR+, so definitely 1a.

is that what the BCI test tests for?

HERB - is this a test that drs only do AFTER the 5 years or do they do at the beginning?

You would think after reading the article that these tests would be run in the BEGINNING so that patients know.

I see my MO this week and will be asking about this test and sharing the article with her.

Thanks.

I had stage 1a. No node involvement. 9 months after I finished treatment diagnosed with stage iv. tnbc.

Since it to determine if you need to take hormone blockers or tamoxifen drugs for 10 years they will do the test as early as year 4 of taking AI or tamoxifen. but it a 2 part test tell your risk of Metatic breaset cancer and your benefit of being on AI or tamoxifen for 10 years.

So sorry to hear ..I know it hard Keep living live large. I am resolved to not shut down knowing im at high risk myself. and I have lost friends already and saw their struggles, so I know whats in store if it comes back.... What did they put you on?

How is BCI tested? They told me I have poor prognosis due to high grade, high Ki67 and lots of nodes involved.

Lala - I spoke with my MO this week about the BCI test. It's definitely only done after 5 years of therapy. Her thoughts were best summed up as it's a very good test but there are certain exceptions where it doesn't give very definitive answers. Sort of like grey areas and giving you info that you're not able to act on for x y z reasons (these went over my head). She will definitely run this after my 5 year mark.

Unfortunately I had so many other more important, pressing questions that I didn't get around to asking why they do not run it in the beginning. Maybe someone else will be able to get that answer. Although obviously we know it's one of the main determining factors about assessing whether 5 more years is effective for patients. There could be other reasons they wait. IDK.

The site does state that the test has been validated for up to three nodes positive, based on two studies involving 1700 cases.

I don't know that I'd feel comfortable relying on that but it is something I'll discuss with my MO later this year.

https://www.breastcancerindex.com/prognostic-studies

I had the opportunity a couple of years ago to informally consult with 2 of the top oncologists specializing in BC and one of the questions I asked was how reliable the BCI test was. Both said they felt it was one the more accurate tests out there in the toolbox....to the point of being accurate within .0001%! I don't know why or how they came up with that but I trust the experience of both. Doesn't work too well in my favor since I was High Risk for Recurrence/Low Benefit from continuing therapy but all their advice for future health was very helpful and eased my mind.

Hi Peregrinelady,

My oncologist at Johns Hopkins says no more than 4 glasses of wine a week. 2 glasses max, twice a week were actually his exact words.

Peregrinelady---Both my MO and my BS offered the same advice. They said lose 10 pounds (which still wouldn't put me in normal BMI but pretty close), exercise 5 days a weeks for at least half and hour to 45 minutes ( I do 6 days a week for 45-60 minutes sometimes broken up throughout the day), eat "some" fruits and/or veggies every day, try for 8 hours of sleep in a dark-as-you-can-get-it room which helps with melatonin production and get Vitamin D levels up to good range.

As to Vit D, my levels were in the 20s as diagnosis despite an outdoor job which my BS attributes to heavy sunscreen use. He'd like it to be closer to the 70s. So he put me on 5000IU daily and I am now at 73. He's completely convinced that low Vit D levels contribute to BC and our increased use of sunscreen is the problem. He doesn't advocate sitting around in the sun of course but taking Vit D supplements.

As to getting "good" sleep, he advocates keeping a regular bedtime, sleeping in a very dark room (I use a sleep mask) and keeping the temperature low which promotes healthy sleep. I have a fitness watch which tracks and scores my sleep and I can attest to all these tips working very well!

As to the fruits and veggies, I am a terrible eater of the good stuff! I hate to cook and prefer that all my food come at me through a window! But I've gotten better and try to eat at least one big serving of a fruit and veggies every day even if it's nothing more that adding a bunch of lettuce to a sandwich.

Both of these doctors gave me percentage improvements for these tips. They said if my recurrence put me at about 7-8% then losing 10 pounds would cut that by 20% and exercising daily (ish) would cut that by another 30%. And the fruits and veggies, for me, would give another 20% and the Vit D another 20%. They put it all to paper for me and calculated that I would go from the 7-8% chance to about a 2-3% chance. And that would reduce my odds by more than if I continued on Tamoxifen for another 5 years!! I'll take those odds any day! Now none of this means they would EVER say not to do my 5 years on Tamoxifen. It's just an example of how much lifestyle changes can help with recurrence rates.

And as a last note, I no longer drink. Even before my diagnosis, I would only drink about half a dozen times a year. I had a total hysterectomy 2 years after BC and drinking makes my hot flashes so bad it's totally not worth it. But my best friend was diagnosed after going through a rough patch and drinking waaaay too much at night. I asked my docs about how that could have affected her diagnosis and they both said they think drinking more than a drink or 2 a couple of nights a week increases your risk by about 30-40%! They don't say quit totally but definitely would rather I didn't drink. So yeah, just another reason for me to not drink. Doesn't mean I'm giving up my chocolate though!! I just make sure it's 72% or greater cocoa just to make me feel a wee bit better for eating it!!

Sorry this is so long. Hope some of it helps!

lala1...wow! I refused anti hormone therapy from the start and have always thought that weight loss and exercise reduces recurrence rates by about 40 percent. Now you are telling me that an expert in BC is saying 50 percent! I also have always thought that taking a drug that makes both weight loss and exercise difficult, if not impossible for some, is very contradictory. We all have to make our own informed decisions and I expect that, but this is very enlightening information! Thank you and good luck.

yeah. There is no magic bullet. I know some big time exercisers who eat healthy mets. Blows my mind. It's a crapshoot bottom line.

jo..... I am in the same boat. I eat healthy, am thin, exercise daily (did a half marathon during chemo...albeit a slow one), and still got BC...twice. We do all we can to reduce our risk, but many things come into play, and sometimes things just are the way they are. I also recovered from surgery quickly, and had an "easy" time with chemo. I don't know if it was lifestyle or luck, but I know the lifestyle surely didn't hurt!