What are the chances of recovery if metastases are present? | Diagnosis breast cancer – How good are my chances of recovery?

What are the chances of recovery if metastases are present?

Probably the most important prognostic factor for a good cure for breast cancer is the lymph node status. This is determined on the basis of metastases in lymph nodes. Depending on its malignancy, breast cancer tends to metastasize rapidly to the lymph nodes of the chest wall and armpits and from there to other lymph nodes in the body.

At a later stage, organ metastases also form, for example in the lungs, liver, skeleton or brain. Breast cancer that has already formed in lymph node metastases at diagnosis tends to have a worse prognosis than non-metastatic cancer. The number of lymph node metastases is also important for the prognosis of recovery.

However, not only lymph node metastases play an important role, but also organ metastases. If the breast cancer is more advanced, metastasis can occur, i.e. degenerated cells can spread to distant tissues and organs, where a malignant ulcer also develops. Metastases are not always easy to treat, especially if they occur in large numbers and in many different places.

Accordingly, the chance of healing in this stage is much lower than in earlier stages. The 5-year survival rate is about 23%. Therefore, therapy in such a stage no longer focuses primarily on healing the patient, but rather aims to slow down the progression of the disease and improve the woman’s quality of life.

Chances of cure for breast cancer in the various stages

One speaks of an early or initial stage if the breast cancer does not already show metastases in organs and lymph nodes. This is a localised tumour in the breast. In this phase, the chances of a cure for breast cancer are particularly high.

However, the decision on therapy is always made individually within the framework of a tumour board, where surgeons, gynaecologists, radiologists and oncologists consult with each other. In some cases, surgical measures with postoperative radiation are sufficient for a cure. Chemotherapy is also used at such an early stage if it is appropriate for the tumour in question.

Apart from the stage of the tumour, other factors such as grading and receptor status are also very important for the chances of cure. Some breast cancers are very aggressive and difficult to treat in their early stages, while others respond very well to therapy. In general, however, the chances of recovery are higher if breast cancer is detected and treated early.

The stages of breast cancer are classified according to tumour size, lymph node involvement and distant metastasis. In stage I, breast cancer has not formed any distant metastases and at most one lymph node metastasis. Its size must also be less than 2 cm.

This is a very early stage of breast cancer with usually good chances of recovery. In this stage the disease can often be cured by surgical removal of the tumour and subsequent radiation and chemotherapy. Unlike in advanced stages, chemotherapy in this stage is curative – i.e. healing – in nature.

If lymph nodes are affected, additional lymph nodes are removed from the armpit. In stage II, the tumour is up to 5 cm in size, but organ metastases, as in stage I, must not be present. At most one lymph node may be affected.

Although stage II may initially sound more negative than stage I, this need not be the case. The chances of recovery can be basically similar or even the same. The tumour is also localised in this stage and has not metastasised by remote control.

This means that the chances of cure are not necessarily worse than for a stage I tumour. If this is given, the chances of recovery are also very good in stage II. A stage III tumour is characterised by an involvement of several lymph nodes and an advanced tumour size.

Aggressive tumours that attack the chest wall or break through the skin are also assigned to this stage. The particularly aggressive “inflammatory breast carcinoma” is also a stage III tumour. In this stage the cancer is quite advanced.

This does not mean, however, that a curative therapy approach is not possible in principle. However, the chances of a cure are generally considered to be worse than those of less advanced tumour stages. In stage IV of breast cancer, distant metastases are already present in various organs of the body.

According to the current state of knowledge, a long-term cure is unlikely in this advanced tumour stage. In exceptional cases, however, a long-term cure can be achieved. In such an advanced tumor stage, the therapy goals are primarily to eliminate symptoms and to maintain a good quality of life for the affected patients.

Nevertheless, there are also factors that have a positive effect on the long-term survival of the patients. A prognostically favourable prognosis is above all the absence of a recurrence within the first 2 years after therapy. In this case, long-term recovery is more likely than if there are early relapses after therapy.