The following are the most important diseases or complications that may be contributed to by breast carcinoma:
Endocrine, nutritional, and metabolic diseases (E00-E90).
- Diabetes mellitus – incidence (frequency of new cases) is moderately increased for postmenopausal women with breast carcinoma
- Hypercalcemia (calcium excess) due to tumor hypercalcemia (tumor-induced hypercalcemia, TIH).
Cardiovascular System (I00-I99).
- Lymphedema (after mastectomy/breast removal); risk factors: Body mass index > 30, cup size (Cup C and above), extent of surgery, number of resected lymph nodes, location of tumor in upper outer quadrant, hypertension (high blood pressure).
Infectious and parasitic diseases (A00-B99).
- Infections due to weakening of the immune system
Neoplasms – tumor diseases (C00-D48)
- Increased risk of breast carcinoma occurring in the contralateral (“in the opposite side”) breast; independent risk factor for this is breast density (risk ratio increased by 80%; vs. lower density)
- Recurrence (recurrence) of breast carcinoma in the ipsilateral (“on the same side”) breast
- Malignant melanoma (primary melanoma) (5.13 times standardized incidence rate as ratio of observed to expected tumor incidence)
- Metastases (daughter tumors), unspecified (typical localization: brain, bone (approximately 70% of all patients with metastatic carcinoma have bone metastases), lung, pleura/lung, liver)
- Thyroid carcinoma (55% increased risk).
- Occurrence of other tumor diseases such as ovarian cancer (ovarian cancer), endometrial cancer (uterine cancer) or acute leukemia (blood cancer). The increased risk of leukemia exists only in the case of chemotherapy of breast carcinoma performed.
Psyche – nervous system (F00-F99; G00-G99).
- Anxieties
- Chemobrain – cognitive impairment, impaired concentration, forgetfulness (described complaints of patients with breast cancer and chemotherapy); in the acute phase after the end of therapy, there is a clear association with self-reported symptoms; over months and years, these seem to diminish.
- Depression
- Fatigue syndrome (exhaustion syndrome) – bes. after Radiatio (radiotherapy) and/or chemotherapy.
Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).
- Ascites (abdominal dropsy)
- Phantom chest pain
- Pain, neuropathic (especially in the area of the surgical procedure).
Other
- Functional decline in women older than 65 years after adjuvant chemotherapy: have a relevant loss of function:
- 42% of patients immediately after chemo
- 30% of patients after one year of chemo
Prognostic factors
- Pregnancy: In a retrospective population-based cohort study, overall survival rates of pregnant as well as nonpregnant breast cancer patients showed no difference. However, tumor characteristics were less favorable overall:
- More frequently stage II to IV (77.8% vs. 71.5%, p < 0.001).
- More frequently nodal positive (52.1% vs. 47.7%, p = 0.02)
- More frequently ER-negative (36.5% vs. 23.2%, p < 0.001) and triple-negative (27.3% vs. 16.8%, p = 0.001)
Note: Women who decided to have a child only after diagnosis and waited at least six months had a particularly favorable 5-year survival rate of 96.7% (95% CI 94.1%-99.3%).
- BRCA1 or -2 mutations: Women who developed breast cancer before age 40 did not have a worse prognosis if they were found to have mutations in the breast cancer genes BRCA1 or -2.
- Expression of FGFR1 (fibroblast growth factor receptor 1) was found to be an independent prognostic factor for overall survival in individuals with TNBC (triple-negative breast cancer; triple-negative breast cancer, i.e., lacking estrogen receptor (ER), progesterone receptor (PR), and HER2/neu). Frequency: approximately 15% of breast carcinomas.
- Diet: red meat from the grill or barbecue smoker before or after breast cancer treatment may increase mortality (death rate) (+31%).Conclusion: Patients with breast cancer should avoid eating grilled and smoked red meat products.
- Former and current smokers with breast cancer had lower survival rates in one study, compared with patients who had never smoked.
- Obesity (obesity) – acetyl-CoA carboxylase 1-dependent protein acetylation controls breast cancer metastasis and recurrence.
- Diabetes mellitus is associated with an increased risk of recurrence (recurrence of disease). This risk may be even higher in individuals receiving insulin therapy.
- Metformin possibly reduces all-cause mortality (overall death rate) in breast cancer patients.
- Patients with HER2-positive breast carcinoma and diabetes mellitus benefited from treatment with metformin; when diabetic women with hormone receptor-positive tumors were not treated with metformin, the mortality risk (risk of death) actually climbed threefold.
- Acetylsalicylic acid (ASA): In some breast cancer patients, ASA use is associated with longer survival; one study demonstrated that women who had taken ASA before diagnosis and whose DNA in the BRCA1 and PR promoter regions was not methylated and who also had global hypermethylation of LINE-1 died less frequently from breast cancer or other cause than women who had taken ASA but whose BRCA1 promoter had methylation. Detection of a methylated BRCA1 promoter was associated with a 67% increase in all-cause mortality.
- Particulate matter – increase in mortality (death rate) from stage I tumors (independent of lifestyle and other factors) at high PM2.5 levels: significantly increased breast cancer mortality; this increased by 64% per 10 μg/m3.
Predictive factors for invasive recurrence after diagnosis of ductal in situ breast carcinoma (DCIS).
- Detection of DCIS by palpation (palpation) (+84% = relative risk of recurrence increased by 84%).
- Positive excision margins (+63%),
- Diagnosis before menopause (female menopause; time of last menstrual period) (+59%).
- High expression of the tumor suppressor p16 (+51%).
- African American ancestry (+43%).
- Histologically fine tissue) poorly differentiated carcinoma (+36%).
