Breast Cancer, Pt. 1

Angela Lanfranchi, M.D.

Breast cancer not only affects a woman, it affects her spouse, family, friends and most especially her children.  What better way to conquer fear than the grace of hope.  Hope in a cure.  Hope in prevention.  Hope that whatever it is they will be challenged with, that they will be able to surmount it and live their lives to fullest each day into their survivorship. 

This is part 1 of a two part post on breast cancer.  Today, I focus on the hope in a cure.   

We all hear that 1 in 8 women, or 12.5% of women, will develop breast cancer in their lifetime. That is the cumulative lifetime risk for breast cancer. It is a statistically derived number that assumes all women will live to be the age of 82 and not die of something else first. Many times, women hear that number 1 in 8 and they look about the room and start counting off: “1, 2, 3” and they believe that someone in that room will get breast cancer if there are more than 8 of them. 

But we also need to know that if a women has no risks for breast cancer (other than that she is a woman, living in this country and getting older) her risk of getting breast cancer is only 3.3%.

Unfortunately few women have no risk factors.  But even if she has a risk factor that increases her risk 100%, or doubles her breast cancer risk, her risk is now only 6.6%.  That’s a lot different from one in eight. 

We also need to hear that a woman’s chance of dying from breast cancer in this country is 1 in 35, or less than 3%. 

So can we really hope for a cure?

 Most women are unaware that it’s already happening.  Lots of women are being cured without great fanfare. You see, one is only officially cured of breast cancer when one dies of something else first, like a heart attack in old age. That’s just how statistics are done and reported.  We hear about 5 and 10 year survival rates.  Maybe some 10 year survivors will have a relapse of cancer.  So we have to wait until they die of something else first before we say they were cured.

But what about women who have stage 0 breast cancer, also known as ductal carcinoma in situ or DCIS? With a partial mastectomy and radiation, they have a 97% cure rate.  With mastectomy they have a 99.9% cure rate.  No chemotherapy is needed to cure them. According to the American Cancer Society, there were 62,280 women diagnosed with in-situ breast cancer in 2009. We can expect that a minimum of 60,411 to be cured!  We just can’t know who they are until they die of something else first.

What about women with Stage 1 invasive breast cancers? Those are the women with small tumors, less than ¾ of an inch, which have not spread to the lymph nodes under the arm. Those women have a 95% cure rate. Since there are many patients with Stage 1 breast cancer treated at my clinic, I would expect the vast majority to be cured with present treatment regimens.

At the Steeplechase Cancer Center where I work, 53% of all patients who are found to have cancer were detected just because they went for a screening mammogram – nobody thought they had cancer when they were screened.  Slightly over half, 53%, were Stage 0 and Stage 1.  That’s why mammograms are so important.  They give women excellent odds for a cure and no bookie would take a bet against them. 

Based upon data when treatment wasn’t as sophisticated and effective as it is now, the 5 year survival rate for tumors up to 2 inches and which had already spread to local lymph nodes, or Stage 2 breast cancers, is 86%.  So I do believe there will be even higher cure rates in the future. 

Tomorrow, we will take a look at the hope in prevention of breast cancer.

2 thoughts on “Breast Cancer, Pt. 1

  1. Although median survival is about 4.5 years, I’ve have many patients that are alive at over 10 years and one over 20 years. Your friend should never feel there is an expiration date stamped on her after reading statistics which only hold true for populations, never for an individual. I suggest that she gets a team of oncologists she trusts and get involved in a Wellness Support Community which are nationwide. I also suggest getting the book Prayer Is Good Medicine by internist Larry Dossey MD which documents the scientific studies that show prayer can impact even cancers.