What Is Breast Cancer Prognosis?
Breast cancer is the most common cancer in women in the developed and developing world. Breast cancer cases have a good prognosis if detected and treated early.
Prognosis refers to the outlook or chance of recovery from a disease. It is an estimate of the likely course and outcome of a disease - breast cancer, in this case. This includes the likelihood of recurrence and life expectancy.
Breast cancer prognosis is based on observing large groups of people affected by the condition over the years. It can be qualitative and described as excellent, good, or poor. It can also be quantitative in the form of survival rates or hazard ratios.
What Is Cancer Survival Rate?
The survival rate is determined by observing several people affected with breast cancer for many years, usually five or ten years. Survival rates are a key part of cancer prognosis. It indicates the percentage of people alive after a certain period of time, usually five years, after they were diagnosed.
Survival rates can help give you a better understanding of how successful your treatment may be. Two main survival rates used in breast cancer cases include
- Breast cancer survival rate: The percentage of women who are alive for five years or longer after their diagnosis.
- Relative survival rate: The percentage of people with breast cancer who have lived for a certain time, usually five years after diagnosis, compared with people who do not have breast cancer.
According to the National Cancer Institute, 90 percent of women with breast cancer survive five years after diagnosis, regardless of the stage. This indicates a 90% five-year survival rate - 90 out of 100 people diagnosed with breast cancer are likely to be alive after five years.
What Is Hazard Ratio?
Another parameter used to determine prognosis in cancer patients is the hazard ratio. Hazard ratios are used to measure survival in a group of patients who have been given a specific treatment in a clinical trial setting.
The patient group is compared with the control group, who are given a placebo, a treatment with no therapeutic value.
Hazard ratio can either be equal to, lesser than, or greater than one.
No difference in survival between the two groups receiving different treatment is denoted by a hazard ratio of 1.
A value greater than or lesser than one indicates better survival in one of the treatment groups.
Understanding Prognosis
Prognosis in terms of survival rates or hazard ratio is just an estimate based on previous outcomes of large groups of people with specific cancer. Every case is unique, and the survival rate is not a very accurate prediction of a specific person’s prognosis.
The statistics can be confusing and alarming in some cases. Talk to your doctor about these statistics, how they apply in your case, and what you can do about it for better clarity.
The prognosis for breast cancer survivors and their survival depends on many factors. This can be assessed only by a qualified physician familiar with the medical history, response to treatment, type and stage of cancer, and cancer-specific characteristics.
How Genes Influence Breast Cancer Prognosis
A family history of breast cancer increases the individual’s risk of developing breast cancer. Genetics also influences breast cancer prognosis. Changes in certain genes may be responsible for the considerable differences in survival among breast cancer patients.
The RAD51B Gene
The RAD51B gene contains instructions for the production of a protein involved in DNA repair. Along with other proteins of this family, the RAD51B protein is involved in repairing damaged DNA. Changes in this gene can disrupt the DNA repair process and influence breast cancer prognosis.
rs3784099
rs3784099 is a single nucleotide polymorphism or SNP in the RAD51B gene. Carriers of the A allele are found to have lesser survival time and unfavorable prognosis.
Non-Genetic Factors
Apart from genetic factors, your doctor will consider several other factors to determine prognosis, including:
- Medical history
- Response to treatment
- Type, stage, and grade of cancer
- Other specific characteristics of the cancer
- Menopausal status
- Smoking habit
- Alcohol consumption
- BMI
Recommendations to Improve Breast Cancer Prognosis
The statistics, survival rates, and hazard ratio values can be confusing. A doctor familiar with your medical history can help interpret breast cancer prognosis based on genetic and non-genetic factors. Certain ways to improve the prognosis of breast cancer include
Getting sufficient sleep: Breast cancer survivors need about 7 to 9 hours of sleep every night. In a study conducted by researchers from Fred Hutchinson Cancer Research Center, Seattle, women who slept for a period of 5 hours or less every night before being diagnosed with breast cancer had a 1.5 times higher likelihood of poor prognosis when compared with women who slept for 7 to 9 hours every night.
Regular exercise: Regular exercise improves prognosis; however, it might not be possible for everyone to exercise daily during the treatment. According to a study conducted by researchers at The University of California-San Diego Moores Cancer Center, a 12-week exercise program increased information processing speed by 2 times. This indicates cognitive benefits of exercise; however, the benefit is obtained only when the exercise program starts within 2 years of being diagnosed with breast cancer.
Alternate or Complementary Therapy: In North America, nearly 80% of breast cancer survivors depend on complementary therapy to cope with breast cancer. The most sought-after therapy is yoga.
Yoga has been shown to reduce fatigue, improve sleep quality, physical functioning, and overall quality of life.
Lifestyle: Try to moderate or avoid smoking and alcohol consumption as these are risk factors for many types of cancer and may result in an unfavorable prognosis. Eat a healthy and balanced diet to maintain a healthy weight.
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Summary
- Breast cancer, the most common cancer in women in the developed and developing world, has a good prognosis if detected and treated early.
- Prognosis is an estimate of the likely course and outcome of a disease. It can be understood as the outlook or chance of recovery from breast cancer.
- Prognosis can be indicated using survival rates or hazard ratios. The 5-year survival rate of women with breast cancer is found to be 90%.
- Hazard ratios are used to measure survival in a group of patients who have been given a specific treatment in a clinical trial setting. The hazard ratio is denoted by a value equal to, less than, or greater than 1.
- Certain changes in genes like the RAD51B are found to influence breast cancer prognosis.
- Medical history, response to treatment, the type, stage, and grade of cancer, other specific characteristics of cancer, and menopausal status are the non-genetic factors that influence breast cancer prognosis.
- Getting sufficient sleep, doing yoga, exercising regularly, and maintaining a healthy weight are some of the ways that can help improve breast cancer prognosis.
References
- https://www.cancer.net/cancer-types/breast-cancer/statistics
- https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/breast-cancer-survival-rates.html
- https://www.healthline.com/health/breast-cancer/survival-facts-statistics
- https://www.breastcancer.org/symptoms/diagnosis/prognosis
- https://www.sciencedirect.com/science/article/pii/B9780128170847000358
