Breast Cancer Survival: How to Get Through It

PJ Hamel Health Guide
  • What does it mean to have breast cancer?

    Is it a serious condition that you operate on and cure, like appendicitis? Do you treat it with the understanding that it may return – at any time? Or is it chronic, with treatment continuing indefinitely?

    And the answer is – all of the above. As is so often the case with cancer, “cure” is a relative term. Are you cured if you’re cancer-free for 5 years? 10 years? 20?

    Or are you only truly “cured” when you finally pass away, at age 97, from natural causes?

    Let’s begin by defining what’s meant by “cure.” If your definition of cure is “cancer is gone and there’s no chance of it coming back” – then there’s no cure for breast cancer.

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    There’s remission, which is any period of time where the cancer has ceased to grow. And NED (no evidence of disease), when scans and tests fail to identify cancer anywhere in your body.

    But cure? With cancer, there’s always the chance, no matter how slight, that a single cancer cell has survived your treatment; and at some point, your cancer may return.

    Still, if you look at overall statistics, your chances of surviving breast cancer are good to excellent.

    First, let’s look at the overall death rate for breast cancer. According to statistics from the American Cancer Society, since 1990 this rate has been decreasing by around 3.2% annually in women under 50; and 2.0% in women 50 and older. Earlier detection and better treatment are at the heart of these gains.

    That’s the good news; the less positive news is, women of color have seen less benefit from these gains. Though the mortality rate has been dropping for all women, it hasn’t dropped as much for women of color. Research from the ACS points to later detection, and the incidence of more aggressive cancers in younger women, as the reasons for this disparity. 

    Now, let’s get a bit more specific. What’s your chance of being alive 5, 10, or 15 years after diagnosis?

    Overall, 89% of women have NOT died of their breast cancer within 5 years of diagnosis. The rate decreases to 82% at 10 years, and 75% after 15 years. Beyond that, the rate changes in tiny increments, and very slowly, so it’s not worth breaking down any further.

    Does that mean YOU have a 25% chance of dying of breast cancer within 15 years? No, not at all. There are many factors that influence breast cancer survival rates. Which are most important?

    The most critical factor influencing survival rate is whether the disease is local (cancer that hasn’t left the breast); regional (cancer that’s spread to the lymph nodes, but not beyond); or distant (cancer that’s metastasized to another part of the body, beyond the lymph nodes). 

    The 5-year survival rate for localized cancer is 98%; this includes both in situ cancers (e.g., DCIS); and invasive but small cancers that haven’t spread to the lymph nodes. For regional cancers, the survival rate is 84%. And for distant cancers, it’s 23%.

    Hold on; why are we only looking at 5-year survival rates, rather than longer term?

  • Because detection methods and treatment are constantly improving. A woman diagnosed with cancer 10 years ago may face a different outcome than one diagnosed today. It’s a case of comparing apples to apples; beyond 5 years, the comparison starts to become skewed by significantly different treatments.

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    But back to those numbers. There are factors beyond how far the initial cancer has spread that affect survival. For instance, the smaller your primary tumor, the better your survival rate. Women whose tumors are 2cm or smaller have a 44% greater overall survival rate than women whose tumors are larger than 5cm (95% vs. 66%). And women diagnosed at age 40 or older are 7% more likely to survive breast cancer than are younger survivors (90% vs. 83%).

    Socioeconomic factors and race also contribute to survival rates. Women living in lower-income areas have a poorer prognosis across the board.

    Why is this? Lack of health insurance, limited access to health care facilities, and other underlying health conditions can all influence survival rates.

    African-American women experience lower survival rates, as well. Statistically speaking, African-Americans are more likely to be uninsured and lower-income, thus facing the issues outlined above. And their diagnosis often comes at an earlier age, with a more aggressive cancer.

    There are many other factors affecting survival; chiefly, treatment. It’s not useful to try to give survival statistics for various treatments here; the permutations are way too numerous. Your oncologist will be able to tell you how surgery, chemo, radiation, and/or hormone therapy can improve your outcome.

    It’s possible to ferret out just about every conceivable statistic regarding breast cancer. But at the end of the day, it boils down to this: all breast cancer is personal. Data is used to build averages; for every set of data, there’s the middle ground, where most of us fall; and the ends, which represent improbable, though possible, outcomes.

    Where do you stand? Uncomfortable though we Americans are with lack of control, this is a question that’s simply unanswerable. You won’t know if you’ve survived cancer until you die of some other cause.

    In the meantime – why not put the numbers aside, and simply live?

Published On: April 11, 2011