Download Breast Cancer Prognosis

FA C T S F O R L I F E
Breast Cancer Prognosis
• Tumor size,
What is prognosis?
Prognosis is the expected or probable outcome of
a disease. It is a best guess of a person’s chances
of survival (recovery). Your breast cancer prognosis is based on how well other people with a
similar type and stage of breast cancer have done
when getting the same treatment. Each person is
different. Your doctor cannot say for certain
what will happen to you.
What does my pathology
report show?
Breast tissue that is removed during a biopsy or surgery
is sent to a pathologist. A pathologist is a doctor who
looks at the tissue under a microscope. They determine
if the tissue contains cancer. If you have cancer, your
pathology report describes your diagnosis. This report
will also describe many features of the tumor. Try not
to focus on any one item in the report. It is the sum of
all the information that is most important to your
prognosis and treatment. Your doctor (either your
surgeon or your oncologist) will go over the main
findings of the report with you. They can answer any
questions you may have. Make sure you ask your
doctor for copies of your reports and keep them for
your records.
Some of the most important items you may find on
your pathology report(s) that help determine your
prognosis are:
• Whether or not the cancer has spread beyond the
breast to the lymph nodes,
• Tumor grade (how closely
the cancer cells look like
normal cells), and
• Characteristics of the
tumor (such as hormone
receptor status and
HER2/neu status).
Breast cancer stage
Breast cancer stage is used to help plan your treatment.
It is the most important factor for prognosis. Stage is
not always listed in pathology reports. It comes from
the results of the biopsy of the tumor tissue, any
biopsies of the lymph nodes and other tests. These
biopsies and some tests may not be done at the same
time. You may have more than one pathology report.
Your medical team combines all the information and
determines the breast cancer stage.
There are a few ways to classify stage. The most widely
used is the TNM system (which stands for tumor,
nodes and metastases). TNM takes into account:
• The size of the tumor (T),
• The number and location of lymph nodes (N) with
cancer, and
• Whether or not there is metastasis (M).
Doctors use a scale to describe breast cancer stages:
0, I, II, III and IV. In general, the earlier the stage,
the better the prognosis. So, stage 0, I and II breast
cancers have a better prognosis than stage III and IV
breast cancers.
For more information, visit www.komen.org or call Susan G. Komen’s breast care helpline at
1-877 GO KOMEN (1-877-465-6636) Monday through Friday, 9 AM to 10 PM ET.
Non-invasive and invasive breast
cancers
Non-invasive cancer
Ductal carcinoma in situ (DCIS) is a non-invasive breast
cancer. It is also called stage 0. In situ [in SY-too] means
“in place.” With DCIS, the abnormal cells are still
within the milk ducts (the canals that carry breast milk
to the nipple during breastfeeding). They have not
invaded the surrounding breast tissue. Although DCIS
is non-invasive, without treatment, the abnormal cells
could turn into invasive breast cancer. With treatment,
prognosis for DCIS is excellent.
Invasive cancer
Invasive breast cancer has spread from the milk ducts or
lobules (the round sacs in the breast that produce milk)
into the surrounding breast tissue. It is possible that
they could have spread to the lymph nodes or other
parts of the body. Prognosis of invasive breast cancer
depends on the stage and other factors.
Tumor grade
Tumor grade is a measure of how similar tumor cells
are to normal cells under a microscope. The more
abnormal the cells appear, the higher the tumor grade.
In general, the lower the tumor grade, the better the
prognosis. Grade 1 has the best prognosis.
Proliferation rate (cell division)
The proliferation rate describes how quickly the tumor
cells are growing. This helps show how aggressive a
tumor is. Also, how likely it is to spread to other parts
of the body. When this rate is low, the cancer is growing
more slowly and the prognosis is better. The Ki-67 test
is a common way to measure this rate. These tests are
not done at all hospitals.
Your pathology report may include other information
not described on this fact sheet. Make sure you ask
your doctor to discuss your report with you.
Type of invasive breast cancer
Most invasive breast cancers begin in the milk ducts
(invasive ductal carcinomas). The next most common
type of breast cancer occurs in the lobules (invasive
lobular carcinomas).
Other factors related to prognosis
Hormone receptor status
Some breast cancers need estrogen and/or progesterone
(female hormones that are produced in the body) to
grow. These breast cancers are “hormone receptorpositive.” They can be treated with hormone therapy.
Hormone therapy improves survival for these breast
cancers.
HER2/neu status
Some breast cancers have a lot of HER2/neu protein on
the surface of their cells. These “HER2/neu-positive”
tumors tend to be aggressive. They also have been
related to a poorer prognosis in the past. But, there
are now effective targeted therapy drugs such as
trastuzumab (Herceptin®). These targeted therapies have
greatly improved survival for those with these cancers.
Resources
Susan G. Komen®
1-877 GO KOMEN (1-877-465-6636)
www.komen.org
Susan G. Komen®’s pathology report information
— www.komen.org/diagnosis
National Comprehensive Network (NCCN) —
1-888-909-6226, www.nccn.org
Related fact sheets in this series:
• Biopsy
• Coping With a Cancer Diagnosis
• Inflammatory Breast Cancer
• Metastatic Breast Cancer
• Types of Breast Cancer Tumors
• What is Breast Cancer?
The above list of resources is only a suggested resource and is not a complete listing of breast cancer materials or information. The information contained herein is not meant to be
used for self-diagnosis or to replace the services of a medical professional. Komen does not endorse, recommend or make any warranties or representations regarding the accuracy,
completeness, timeliness, quality or non-infringement of any of the materials, products or information provided by the organizations referenced herein.
The Running Ribbon is a registered trademark of Susan G. Komen®. ©2014 Susan G. Komen® Item No. KOMEED009900 11/14