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Medical Forum / Diseases and Disorders / Breast Cancer / May 2005

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Rates of recurrence by year

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bryan@tonnet.org - 19 May 2005 06:01 GMT
I've been trawling through various web sites and news groups in search
of some statistics on recurrence rates by year.  Somewhere I have had
it put in my head that the first 2 years is the real danger period for
recurrence and that rates after that signifigantly decrease to 5 years,
then remain more or less flat until 10 years, then gradually tail off.

However, I cannot find any paper or other research that shows this, and
am beginning to doubt that what I remember is, in fact, true.  Does
anyone here have a pointer to a reliable source that shows recurrence
rates by year?

Thanks in advance

Bryan Tonnet
Tim Jackson - 19 May 2005 08:29 GMT
> I've been trawling through various web sites and news groups in search
> of some statistics on recurrence rates by year.  Somewhere I have had
[quoted text clipped - 10 lines]
>
> Bryan Tonnet

I haven't seen anything that puts that information in a simple graph,
but you could probably construct one from the US SEER statistical
database, which is I believe available on CD.

I am sure what you say is approximately true.  There are several
components to the risk you describe.

The first is the risk that the cancer had already metastasised and
produced distant tumours which were as yet below the detection
threshold.  Most of these cases should show up somewhere between six
months and two of years, so producing an initial bump.  They don't show
up in the first six months because if they were undetectable by
instrument at the time of surgery then they are unlikely to become
symptomatic in that time.

The second is the risk that some stray cells were in the bloodstream and
remained dormant for a long time before seeding a new tumour.  This risk
should decay over time looking pretty much like the tail of a normal
distribution, and is generally reckoned to have become an insignificant
part of the risk by five years.

The third is the risk of another primary starting up in tissue that has
already demonstrated a propensity for doing such things.  This is at
least a constant throughout life, or may even increase with age.  While
the lifetime risk of bc among the general population is about 1 in 8,
among bc survivors it is about 1 in 3.

Tim Jackson
A.P. Thorsen - 23 May 2005 20:28 GMT
> I've been trawling through various web sites and news groups in search
> of some statistics on recurrence rates by year.  Somewhere I have had
[quoted text clipped - 8 lines]
>
> Thanks in advance

If you have a specific diagnosis you're checking the stats for, you
might find some answers via the "Treatment Decision Tools for Breast
Cancer" at the American Cancer Society site (breast cancer page is
http://www.cancer.org/docroot/LRN/LRN_0.asp?dt=5 , and the link is in
the middle of the page.

One of the studies in my "outcomes tool" report gave the following
probabilities for *freedom from* recurrence by year with two different
treatment strategies.

Chemotherapy:

1yr   2yr   3yr   4yr   5yr   6yr   7yr   8yr   9yr   10yr
84    65    53    48    44    42    40    37    36    34

Radiation and Chemotherapy:
1yr   2yr   3yr   4yr   5yr   6yr   7yr   8yr   9yr   10yr
92    78    69    63    58    55    54    52    50    48

This is based on "Overgaard, M.D., Marie et al. 1997, Postoperative
Radiotherapy in High-Risk Premenopausal Women with Breast Cancer Who
Receive Adjuvant Chemotherapy, The New England Journal of Medicine. 337:
949-955".

Before anyone panics, please note that these are stats for certain
classes of high-risk cases, and they're stats about *recurrence*.
Survival stats are also in the report, and are several percentage points
higher, since many recurrences are local/new primary, which can be
pretty treatable.

FWIW,

Ann T.
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eveline - 24 May 2005 01:37 GMT
> > I've been trawling through various web sites and news groups in search
> > of some statistics on recurrence rates by year.  Somewhere I have had
[quoted text clipped - 42 lines]
>
> Ann T.

Thanks Ann for the statistics but I won't show them to my daughter.  I don't
want her to dwell on the probabilities.  She still gets the shots to get her
menapausal and frequent check-ups and blood draws. (She had the invasive
ductal positive her2neu.) She did go ahead with the chemo and radiation
after surgery.
We have seen first hand what happens as the years go by and the reacurrence
that has happened to family members. SO MANY in our family!  My niece
Marilyn's funeral
Wednesday.
My motto is to "live, live, live, until we die"
My daughter and I have been in Florida where she has chosen to live.  We
rented a condo with many amenities, just a few minutes from the beach.  She
will work there and I will
also spend much time there with her - especially in the winter.
We had a lot of fun looking for a place, met Pete Rose, ate out, enjoyed the
beach. Each good day a "present".  Hated to come back to rainy Ohio to take
care of things here.

Statistics are just that and we will never know where we fit while on our
journey.  I guess I don't want to know the specifics.  Might ruin my day at
the beach. (grin)

eveline
A.P. Thorsen - 24 May 2005 17:56 GMT
<snipped recurrence stats>

> Thanks Ann for the statistics but I won't show them to my daughter.  I don't
> want her to dwell on the probabilities.

One good side effect of my having recently started racing (rowing) is
that increasing I can look at the recurrence & survival stats is just
another goal time I need to beat <grin>.

In fact, so far (knock wood), I'm doing better vs. the BC stats than the
race stats.  (In almost all my races, I've been what the rowers refer to
as "DFL" - Dead <bleep> Last.  But I'm about four and a half years out
from a diagnosis of locally advanced BC, and still here to talk about
it, so far NED.)

> My motto is to "live, live, live, until we die"

And a good motto it is, too.  <Offensive language warning>  When I was
in college, (mumble) years ago, I knew a guy who had a t-shirt that said
"Boogie 'til you puke".

Given the kinds of acquaintences I had in college, I'm sure he meant it
*quite* literally.  In recent years, though, it's begun to seem to me
that it's not such a bad philosophical position, existentially and
metaphorically speaking.

> Statistics are just that and we will never know where we fit while on our
> journey.  I guess I don't want to know the specifics.  Might ruin my day at
> the beach. (grin)

Can't have that!  <return grin>  Enjoy the beach, and best to you & your
daughter!

Ann T.
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allan_grossman@hotmail.com - 27 May 2005 14:55 GMT
Ann wrote:
> Chemotherapy:
>
[quoted text clipped - 4 lines]
> 1yr   2yr   3yr   4yr   5yr   6yr   7yr   8yr   9yr   10yr
> 92    78    69    63    58    55    54    52    50    48

Interesting numbers  ;-)

On a side note (and mainly because I didn't want to start a new thread)
it looks like Deborah and I are back in the fight and about to do Round
3 with the beast.

Test results show her CA15-3 is rising even though she's on Herceptin
now.  Her last bone scan showed a hot spot on her spine (but an MRI
revealed it was just degenerative disk disease) but the last pile of
tests show her markers are on the way up and a touch of emphysema that
we've never seen in a chest x-ray.  Deborah has been a nonsmoker for
almost 20 years, so WTF?

Anyway, her markers always run low (I don't think they've ever been
above 60) but have increased from 27 to 47 in the last four weeks.  The
part that's making me nervous is that her lungs and abdomen are clear -
and knowing how I tend to panic at stuff like this and because she's
doing Herceptin it's about everything I can do to keep from demanding a
skull CT.  No sense looking for trouble when she's still asymptomatic,
though.  I'll calm down in a few days, I think  ;-)

Anyway, Dr. Smiley wants to wait until July 6 to make a decision, but
has told her if her markers continue to rise that it'll be time to
start chemo again.  He's recommending that we try adding Navelbine to
the Herceptin again since the combination's worked well before.  I'm a
little skeptical because it's the Herceptin that's been keeping her
alive all this time and now there's some question whether it's still
effective.  In preparation for this stuff she's doing a bone density
test and a MUGA scan and I'm looking for a Lapatinib trial just in
case.  I haven't mentioned this to Deborah yet, though  ;-)

Y'all have known me for almost six years - and when the nasties start
growing again I panic for a bit and then settle down and do what needs
to be done, I think.  Right now I'm still in the 'oh, crap' mode.

Anyway, Dr, Smiley gave Deborah 6-12 months in August, 1999 - almost
six years ago.  We've beaten the odds and then some and I think we can
do it for awhile more.

Anyway, I'll know a lot more on July 6.

hugs to all -
Tim Jackson - 27 May 2005 19:03 GMT
> and when the nasties start
> growing again I panic for a bit and then settle down and do what needs
> to be done, I think.  Right now I'm still in the 'oh, crap' mode.

Easy there, cowboy.

Tim
allan grossman - 27 May 2005 21:16 GMT
>Easy there, cowboy.

Thanks, Tim.  I'll have my feet on the ground in a bit.

cheers -

Signature

allan

we don't see things as they are, we see them as we are.
-- Anais Nin

alex - 28 May 2005 14:01 GMT
Allan give your wife a hug for all of us, Dr Smiley ( I still get a kick out
of that name) will take good care of her. Alex
Chris - 30 May 2005 20:05 GMT
I was thinking the same thing, Dr. Smiley has been right so far, so I
would keep the faith.

Chris

> Allan give your wife a hug for all of us, Dr Smiley ( I still get a kick out
> of that name) will take good care of her. Alex
allan grossman - 30 May 2005 22:59 GMT
>I was thinking the same thing, Dr. Smiley has been right so far, so I
>would keep the faith.

Yup.  He's done well so far and faith is a lot higher than it was last
week.  Thanks, Chris  :-*

Signature

allan

we don't see things as they are, we see them as we are.
-- Anais Nin

Chris - 28 May 2005 00:42 GMT
Hang in there and enjoy the long weekend. I hope the panic goes away
soon.

Chris

> Ann wrote:
> > Chemotherapy:
[quoted text clipped - 48 lines]
>
> hugs to all -
 
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