Indicators of 5- and 10-year survival do not give a true picture of the effectiveness of breast cancer treatment, since relapses are observed in a later period. In some cases, relapses are observed even 25 years after treatment. The prognosis depends on the size of the primary tumor, the stage of its development and the degree of malignancy, but it is probably not determined by the type of primary surgery.
A particularly important factor is the lesion of the axillary lymph nodes. So for patients in stage I of the disease (T1-2 N0), 10-year survival is 80%, and for patients in stage II (N2-3 M0) only 35%. Reliable information about the extent of damage to the axillary lymph nodes can be obtained using a biopsy of the node closest to the tumor, after a preliminary radioisotope scintigraphy.
Such a procedure in many cases makes it possible to dispense with an operation to remove the lymph nodes. So far, nothing can be said about the role of the patient’s age at the time of diagnosis. However, since the risk period for young women is very long, they can probably benefit more from adjuvant chemotherapy.
If breast cancer is diagnosed in a patient during pregnancy, this does not complicate the course of the disease. Research on the HABITS program (hormonal replacement therapy for breast cancer – is it safe?) Was devoted to hormone replacement therapy in patients with breast cancer.
Unfortunately, they remained unfinished due to the manifestation of the negative effects of HRT, although in such earlier studies no adverse effects were observed. These studies have aroused great interest around the world, but even the authors themselves are cautious in answering the question about the potential danger of HRT for breast cancer patients. Now this issue is extremely important, since for a large number of women who have cured for a long time there is a risk of irreversible menopause.
Useful prognostic information is provided by the complete sequencing of the p53 gene. So, it is shown that mutations in its individual loci indicate an unfavorable prognosis of the disease. Speaking of genetic predisposition, it should be pointed out that recent studies of the BRCA1 gene in patients with familial and sporadic breast cancer did not reveal any differences of prognostic value. In conclusion, we note that a system of measures for caring for patients with breast cancer has been developed in specialized clinical centers.