What is Your Prognosis After Being Diagnosed with Breast Cancer?

The average 5-year survival rate for women in the United States for non-metastatic invasive breast cancer is 90%. The average 10-year survival rate for women with non-metastatic invasive breast cancer is 84%. If the cancer has spread to the regional lymph nodes, the 5-year survival rate is 86%. If the cancer has spread to a distant part of the body, the 5-year survival rate is 29%.

Breast cancer may spread to other parts of the body. Often the most common first detectable site of spread is to the lymph nodes under the arm. Axillary lymph nodes are divided into levels 1 (low axillary), II (mid axillary) and II (high axillary) in relation to the pectoralis minor muscle.

Lymph node metastasis is the most important predictor of overall recurrence and survival. Accurate assessment of lymph node involvement is an essential component in staging breast cancer and deciding the appropriate treatment. While the 5-year survival rate for disease localized to the breast is 98.8%, the figure drops to 85.8% for persons with regional lymph node metastasis.

The presence of axillary lymph node metastasis and the number and location of positive lymph nodes determines the pathologic stage of breast cancer. The definition of clinically suspicious lymph node is defined as having one of the following criteria: palpability at physical examination; suspicious imaging features; or proven malignancy at fine-needle aspiration biopsy or core-needle biopsy.

Round or irregular axillary lymph nodes with absent fatty hila or asymmetric cortical thickening are suspicious imaging findings. The number and location of suspicious nodes and any suspected extra-nodal involvement should be documented by the radiologist.

Ultrasound is the primary method to evaluate the axilla in women with newly diagnosed breast cancer. Ultrasound plays an important role in guiding biopsies of suspicious nodes.

Although ultrasound is the primary method for evaluation of axillary lymph nodes, breast MRI has advantages over ultrasound, such as improved visualization of the axilla. Breast MRI or chest CT scan can better demonstrate internal mammary and supraclavicular lymph node involvement and provide additional information for extensive nodal disease.

The common place for breast cancer to spread are the bones, lungs, liver, and brain. Metastatic breast cancer can occur at any number of years after initial diagnosis of early breast cancer, even after treatment. There’s more than one type of metastatic breast cancer, HR+ and HER2, is the most common sub-type of metastatic breast cancer, representing roughly 60% of all cases.

6% of women have cancer that has spread outside of the breast and regional lymph nodes at the time they are first diagnosed with breast cancer. This is called de novo breast cancer.

Most metastatic breast cancer is treated with systemic therapy. System therapy travels throughout the bloodstream, reaching cancerous cells throughout the body. These treatments affect both cancerous and non-cancerous cells. Sometimes different systemic therapies are combined with each other. Systemic treatments include hormone therapy, targeted therapy and chemotherapy.