Prognosis and chances of cure of breast cancer
A number of factors determine the course and prognosis of breast cancer. Knowledge of these prognosis factors makes it possible to estimate the risk of tumour metastasis and relapse after treatment. Age and menopausal status (before or after menopause), the tumour stage, the degree of cell degeneration and characteristic properties of the tumour all play a role in the chances of recovery.
The smaller the tumour is, if no lymph nodes are affected and no metastases have developed, the better the prognosis and thus the chances of cure. Later stages are often less favourable. The degree of degeneration of the malignant tumour cells can also be helpful in assessing the prognosis.
The tumour stage provides information about the aggressiveness and growth rate of the tumour. In addition, there are certain characteristics of breast cancer cells which determine the growth of the cell and which differ from one breast cancer disease to another. For example, cell growth can be promoted by female hormones (oestrogens) because they possess so-called oestrogen receptors.
Other types of receptors also play a role. Knowledge of these characteristic properties of tumour cells makes it easier to choose the right treatment and provides information about the prognosis. Another prognostic factor is the age of the patient at the time of diagnosis, since women under the age of 35 are more likely to suffer relapses and the prognosis is considered less favourable than in other age groups.
It is also relevant for the prognosis whether the patient is still menstruating or is beyond the menopause. In principle, the earlier breast cancer is detected, the better the prognosis and the chances of recovery. The survival rate for cancer is given as a 5-year survival rate.
This statistic does not look at how long the individual patients survive, but how many patients are still alive after 5 years. The general 5-year survival rate is 88% for women and 73% for men. The 10-year survival rate is 82% for women and 69% for men. However, the individual rate depends on many factors, such as tumor size, degree of degeneration or lymph node involvement, so that the survival rate must always be calculated individually.
Is breast cancer curable?
Breast cancer is the most common form of cancer in women and the number of breast cancers continues to increase in western industrialized countries. However, the mortality rate of the disease has been declining significantly in recent decades. The chances of recovery from breast cancer are good, with more than three-quarters of those affected still alive five years after treatment.
The significant improvement in the chances of recovery and the quality of life of those affected is due to progress in the diagnosis and therapy of breast cancer. The development of mammography screening (X-ray examination of the breast) and of organ-preserving and reconstructive surgical procedures, as well as the discovery of the hereditary forms of breast cancer and the availability of hormone, chemo and antibody therapies have contributed to the fact that breast cancer has become curable in an increasing number of cases. Early detection of the tumour usually means a greater chance of cure.
In more than 90 percent of cases, breast cancer can be cured if the tumour is smaller than one centimetre. If the tumour is two centimetres in size, the chance of cure drops to around 60 percent. In rare cases, however, breast cancer may still be incurable, even if it was discovered at an early stage.
Through the screening process (such as the annual check-up by the gynaecologist), about 70 to 80 percent of breast cancer tumours are discovered in a stage where they are curable. The relapse rate (recurrence) after an initially successful treatment of breast cancer has also decreased in recent years due to the optimized therapy procedures. There are certain mutations in the genetic material which lead to a higher risk of breast cancer and are also hereditary.
The best researched mutation is the BRCA gene, also known as the breast cancer gene. This mutation is inherited autosomal-dominantly. Humans have two copies of each gene.
In dominant inheritance, it is sufficient for the BRCA gene to be mutated on only one copy to increase the risk of cancer. This also means that a carrier of this mutation has a 50 percent probability of passing it on to his or her children. Since it is an autosomal inheritance and not a gonosomal one, the sex of the children is irrelevant.
In addition to the BRCA gene, there are a number of other genes that increase the risk of breast cancer or other types of cancer when mutated. A distinction is made between high-risk and moderate to low-risk genes. The BRCA gene and also the PALB2 gene belong to the high-risk genes for breast cancer. Moderate to low risk genes are also associated with Li-Fraumeni syndrome, Fanconi anaemia or Peutz-Jeghers syndrome, among others.
