Medical Forum / Diseases and Disorders / Breast Cancer / May 2005
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. Remove 'dontsendspam' from address to reply by email
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. Remove 'dontsendspam' from address to reply by email
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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