Stage 4 Breast Cancer Prognosis Factors

There are four stages of breast cancer, from stage 1 to stage 4. In stage 1, the cancer is least severe and the chance of recovery is still high. However, at stage 4, the malignant tumor has spread to other parts of the body (such as the lungs, skin, bones, liver, brain, or distant lymph nodes) and is very difficult to cure. Thus, this stage is also known as advanced or metastatic stage. The cancer might be already at the advanced stage when it is first discovered, but it can also be a reappearance of previous breast cancer that has already affected other parts of the body. It is a very serious condition and requires focused treatments. Stage 4 breast cancer prognosis involves the prediction of outcome and the chance of survival that are based on other patients' experiences. Here are the prognosis factors of a stage 4 breast cancer:

1. The first factor is the survival tendency. As a matter of a fact, the five-year survival rate for patients suffering from metastatic breast cancer is only 20 percent. Thus, the aim of the treatment is a long term survival of the patient, since the cancer at this stage is incurable.

2. Hormonal factors also play an important role. Estrogen and progesterone that can be found in birth control medications or hormone replacement therapy can actually cause the cancerous cells to grow. A hormone receptor status test will show whether or not any of these hormones are causing the growth of the malignant tumor. If the patient is estrogen receptor positive (ER+) or progesterone receptor positive (PR+), the cancer should respond well to hormone suppression treatments. Moreover, the three-year survival rate for ER+/PR+ patients reaches 97 percent while the survival rate for ER-/PR- patients is only 83 percent.

3. Histology is another important factor since it determines the degree of aggressiveness of the disease by identifying the types of cancer cells found in the tumor. For instance, the type of breast cancer known as tubular adenocarcinoma is considered as the most survivable. On the other hand, inflammatory breast cancer is very aggressive and the five-year survival rate for stage 4 is only about 11 percent.

4. Other factors that affect the stage 4 breast cancer prognosis and survival rates are the areas in which the cancer has spread, the size of the tumor, age and race factor, genetic history, response to treatment such as chemotherapy, biological therapy, clinical trials, medications, radiation therapy and surgery.

Stage 3 Breast Cancer Survival Rates - Be Informed

Stage 3 breast cancers occurs when the cancer cells in the breast have spread outside the regions of the breast and have affected the surrounding lymph nodes of nearby muscles but have not expanded well enough to affect distant organs and systems of the body. Breast cancer survival rates for this stage in a five-year period ranges at 54 to 67 percent chance of cure.

There are different forms of stage 3 breast cancer according to Ms. Christy Russell who is a professor of medicine at the Keck School of Medicine in the University of South Carolina and co-director of the USC/Norris Breast centre. She is the spokeswoman of the American cancer society as well. According to her stage 3 breast cancers varies upon the number of lymph nodes involved or the malignant cancer cell invasion within the chest and skin of the patient.

All types of stage 3 cancer of the breast except for where the malignant tumor have affected the lymph node above the collarbone are considered operable. Breast cancer survival rates are greatly adjusted into the type of stage 3 cancer of the breast for there are types that are more aggressive than the others.

Stage III - A cancer of the breast is subdivided into two parts. The first type is where the tumor has grown more or less 5cm and the cancer cells have moved that it infected the lymph nodes in the armpit or the sternum. The Second type is when the tumor has grown within 5cm but has not infected any lymph nodes.

Stage III - B is an indication wherein the tumor regardless of the size, have invaded the chest muscles and have spread among the skin as well. Lymph nodes may also be affected by the cancer tumor. A rare type of aggressive cancer called inflammatory cancer of the breast is considered by many professionals to be a stage III b cancer of the breast because of the involvement of the skin infection of cancer cells. This type of cancer is considered to be aggressive in nature and breast cancer survival rates would drop immediately because of the aggressive type of malignancy.

Stage III - C cancer of the breast occurs when the malignant cancer cells have spread to the lymph nodes of the armpit and breast bond and have infected the lymph nodes in the neck or collarbone as well. This type is considered to be inoperable and has the most drastic survival rate among stage 3 cancer of the breast.

What is the Breast Cancer Survival Rate?

You must accept the fact that not all patients who undergo breast cancer treatments are able to survive. It is but natural for you to want to know about the breast cancer survival rate before you decide to go for a particular treatment.

Survival rates differ and it would depend on the stage of the cancer you're currently in. What is this rate all about?

You can describe the survival rate in several ways such as:

1. Time - upon diagnosis, a patient is given 5-10 years to survive

2. Recurrence - there are times when recurrence take place after the cancer cells have been removed

3. Death risk as compared to other people with the same health condition

Survival rate is usually categorized based on the breast cancer stages. Stage '0' means that the cancer is still non-invasive. The cancerous cells can only be found in the walls of the lump or mass inside the breast.

When you reach Stage 1, the tumor has already grown about 2 cm long and it is already considered invasive. Stage 2A happens when the tumor is already 2 to 5 cm long.

The Stage 2B refers to tumors more or less 2 cm long but some of the auxiliary lymph nodes are already affected. When the tumor reaches above 5 cm and has already affected the lymph nodes, it is already classified as Stage 3A breast cancer; and when the tumor invades the skin of the breasts, the cancer is in Stage 3B. The advanced breast cancer is classified under Stage 4 wherein other organs of the body are already infected with the cancer cells.

The different stages can also be divided into the early stage (0 to 2A), the later stage (2B to 3A and B), and the advanced stage (stage 4). The treatment plan is generally based on the stage of the breast cancer.

Today, the survival rates for breast cancer are 86% (for the 5-year period after diagnosis) and 76% (for the 10-year period).

Breast cancer patients without metastatic has a rate of survival of 96% while those with metastatic has a rate of 21%. The percentage is based on the 5-year period after diagnosis.

There are also established survival rates for each stage of breast cancer within the 5-year period. The following are the rates: Stage 0 - 100%, Stage 1 is 100%, Stage 2A is 92%, Stage 2B is 81%, Stage 3A is 67%, Stage 3B is 54%, and Stage 4 is 20%.

As you can see, if you're still in the 0 and first stage, you have a 100% chance to recover from the disease. It is therefore very important to detect breast cancer during these stages. Besides, the medications used for the early stages are more affordable as compared to the medications or treatments given to the late stages.

Now, aside from the stages of breast cancer, the survival rate is also affected by other factors like lifestyle, exercise, psychological therapy, and smoking. Did you know that some breast cancer patients are able to live longer because they made changes in their lifestyle?

If you want to determine if you have breast cancer or if this disease runs in the family, it would be best to undergo a mammogram or you can also conduct self examinations. This is one way of discovering mass or lumps in your breast. The breast cancer survival rate is quite high but you'll need to detect the cancer at an early stage.

Breast Cancer Death Symptoms

The most advance form is metastatic or stage IV breast cancer that is extremely life-threatening. Many patients in that phase ultimately depart this world, since it then becomes incurable almost in all of the cases. As the studies reveal, about 1 to 3 percent of the patients in this stage recover. What about the remaining? They eventually rest in peace. It shows these obvious signs before killing:

Severe pain

Several body parts can feel pain especially those where the tumor has spread. One that metalizes in the bones causes joint pains and bone aches that are so deep. In case it has attacked the liver, a vital body organ, it results in frequent abdominal pain. Chest pain is occurred when metastatic breast cancer has spread to the lungs, which is very likely since it is a neighboring organ. According to a research of European Journal of Cancer Care, most of the women affected with this disease had good control over the pain in the last stages of death. This means pain is not the worst symptom ever experienced by such patients.

Psychological disturbances

Women are especially sensitive and are readily affected by any malignant disorder such as metastatic breast cancer. Depression, restlessness and anxiety are a common occurrence as published in European Journal of Cancer Care. They conducted a study on 44 affected individuals with stage IV breast cancer. The findings in the report are briefly described below:

• About 50 percent of the patients suffered from depression


• 66 percent of them had got anxiety before death due to this disease. It was observed while interviewing them all for the purpose of research.


• Other physical symptoms were not correlated with the occurrence of these emotional imbalances in the patients. This implies to the fact, no matter the signs are mild or severe, the presence of psychological problems remain unaffected. They just occur in the last stage regardless of other unstable medical problems involved.


• In the study, the concerned group of people is provide a psychological support and emotional security to the patients who are now about to say good bye to their loved ones.

Gastrointestinal abnormalities

There are some signs such as constipation, involuntary urination and defecation, in which the patient loses control over bowel and urinary excretion. Nausea and vomiting are also frequent with fatigue or tiredness. Anorexia, loss of appetite is a common occurrence that subsequently causes an unintentional weight loss. The study reveals in the European Journal that these kinds of disturbances along with fatigue were the most severe symptoms of all in the patients before their death.

Swollen body organs

A serious signal is swelling of the abdomen, feet and legs. The exact reason however is not known. Abdominal area may be so due to infection, presence of a lump or inflammation. There can be difficulty walking in such a condition; the pain being another outcome of it. Breast swelling is there from almost the beginning of the disease since the person developed tumor inside. As it grows in volume, the swollen part is enlarged to accommodate.

Neurological malfunctioning

In case the metastatic breast tumor has affected the brain it leads to headache, impaired or poor vision, amnesia (the loss of memory), and confusion, inability to take decisions, cognitive problems and difficulty to make movements and walk normally.

Shortness of breath is also an alert that death is near.

How to act?

Although, metastatic cancer in 97 to 99 percent cases is incurable but still the hope remains alive, take care of the patient as much as possible with the best treatment procedures available without letting her/him know the final consequences; for this is the only option left.

Survival Rates Of Breast Cancer At Different Stages

Where the disease has not metastasized, the five-year survival rate for women suffering from breast cancer is about 86%. That percentage means that 86% of women who develop breast cancer live for at least five years after diagnosis. The good news is that depending on the stage it is discovered, the survival rate can be even higher than the overall average.

As with most cancers, breast cancer, develops in stages. A standard classification of letters and numbers is used to describe the stages - T, N and M and 0-IV. The alphabet T denotes the size of the tumor while alphabet N denotes that it has spread to the lymph nodes and the alphabet M means distant metastasis. When a primary tumor spreads to another area/s and forms more tumors, it has metastasized.

When a tumor cannot be assessed, it is designated the classification of TX. Where there is no indication of cancer, T0 is used. If one of the following forms is suspected - DCIS (ductal carcinoma in situ), LCIS (lobular carcinoma in situ) or Paget's disease (where the nipple and/or areola is cancerous) - Tis is used.

Stage 0 indicates that the cancer is in its earliest stage. Stage I indicates that tumors have not spread and are less than 2cm in size. A tumor that is 2-5cm in diameter is classified as Stage II, and a tumor larger than 5cm is considered Stage III. When a tumor has attached to the chest wall and spread to the lymph nodes it is considered to be Stage IV.

Today, due to medical advances, many breast cancers are diagnosed and treated during the early stages.

When treatment is given to patients who are at Stage 0 or 1, the survival rates are almost 100%. And yes, men can develop breast cancer, though at a far lower rate of 1/133 when compared to women. For those with cancer in Stage II, the survival rate is at 81% to 92%. At Stage III the rate lowers to 67%, and then drops substantially to 20% at Stage IV.

Although it is a very serious illness, breast cancer is seldom life threatening. Women who have advanced stages of cancer have been known to live for more than seven years. As technology and medicine advance, survival rates increase. Even later stage cancer survival rates are rising as medical and treatment methods improve.

A fairly new method of diagnosing cancer is the QM-MSP (quantitative multiplex methylation-specific PCR) method. It was invented in 2001 and it involves tests done on fluids taken from the breast area. The chemical analysis undertaken during this test allows cancer to be detected with 86% reliability, and cancer clumps with as little as 50 cells can found. Treatment given in the early stages is highly effective, and new methods like this allow cancer to be diagnosed at the earliest possible stage.

Treatments are also improving, with hormone therapy, targeted radiation and molecule specific drugs now readily available.

Breast cancer is no longer the death sentence it used to be. Although the disease is still a matter of serious concern, the chances of survival are high and treatments are now less invasive.

Identifying Breast Cancer Stages For a Proper Treatment

Cancer stages are established on the size of the tumor, whether the cancer is invasive or non-invasive, whether lymph nodes are involved, and whether the cancer has extended outside the breast.

The intention of the coordination of stages is to assist organize the various factors and a number of the personality characteristics of the cancer into groups, so as to:

* best comprehend your prognosis (the most probable result of the disease)

* direct treatment choices (in common with other parts of your pathology information), because clinical studies of breast cancer treatments that you and your doctor will regard as are partially controlled by the staging coordination

* give a general way to explain the extent of breast cancer for doctors and nurses all over the world, in order that effects of your treatment could be evaluated and comprehended

Doctors categorized breast cancer into four number stages. 'Staging' allows for a variety of reasons, like the size of the tumour, whether cancer cells have extended into the close lymph glands (lymph nodes), whether the cancer cells contain receptors for hormones or other proteins, and whether the tumour has extended to any other organ of the body. The word tumour denotes either a breast lump or the part of cancer cells brought into being on a scan or mammogram.

Once the surgery is finished, your doctor could settle on the stages of your cancer. There are five fundamental stages, 0 through IV, and a number of sub-stages. Lower numbers point to earlier stages of cancer, while higher numbers reveal a late-stage cancer. Doctors assess a woman's breast cancer partly by settling on how big the tumor is and how far it's extended. This is called staging. It's only a way of reviewing your present condition.

Identifying the stages of your cancer assists your doctor make a decision on a proper treatment plan. The stages assist forecast as well how well you may do, whether the cancer will reappear (recurrence), for example. Established on statistics composed from other women's experiences, scientists could approximate the five-year disease-free survival rate.

The breast cancer stages aren't the simply reason doctors regard as when settling on treatment. Other important information consists of: the tumor grade and size, the presence or absence of receptors for the hormones estrogen and progesterone, the amount of a protein called HER-2 created by the cancer cells, your menopausal condition, and your general health.

Staging Breast Cancer

Knowing the stage of your breast cancer helps your medical team determine how big the cancer is and if it has spread. This helps them guide your therapy and provide reliable prognostic information.

In general, staging is done following your surgery, either after lumpectomy or mastectomy. It usually includes evaluation of the lymph nodes in your armpit (axillary lymph nodes), and possibly other radiology tests and blood work.

All breast cancers are staged using a system defined by the American Joint Committee on Cancer based on the "TNM system." TNM refers to tumor size (T), number of lymph nodes involved (N), and whether your cancer has metastasized (or spread) to other parts of your body (M). The newest edition was released in late 2009 and took effect Jan 1, 2010.

The following is an overview of the updated TNM staging system for breast cancer. Interestingly, due to the increased use of neoadjuvant chemotherapy, recommendations are now also given for staging of patients who have undergone such therapy. I have tried to highlight some of the more major changes in the 2009 edition, but there are many smaller changes that are beyond the scope of this article.

T: The size of the cancer.

Tx: The primary tumor size cannot be assessed

T0: No cancer is present.

Tis: Non-invasive cancer, also known as carcinoma in situ, is present (DCIS or LCIS or Paget's disease alone).

T1: Invasive cancer measuring 2 centimeters or smaller is present. This is further sub-divided into four groups:

Tmic: microinvasive cancer, meaning the invasive cancer is 1 millimeter or smaller.

T1a: the invasive cancer measures greater than 1 millimeter but not greater than 5 millimeters.

T1b: the invasive cancer measures greater than 5 millimeters but not greater than 1 centimeter.

T1c: the invasive cancer measures greater than 1 centimeter but not greater than 2 centimeters.

T2: Invasive cancer is present, measuring greater than 2 centimeters but not greater than 5 centimeters.

T3: Invasive cancer is present, measuring greater than 5 centimeters.

T4: Invasive cancer is invading the chest wall or skin; also includes inflammatory cancer. In the 2009 edition, the diagnosis of inflammatory carcinoma is more clearly defined and the finding of carcinoma merely invading the dermis of the skin alone was not felt to represent T4 disease.

N: The number of lymph nodes involved by cancer.

Nx: Lymph nodes cannot be assessed.

N0: No cancer found in lymph nodes. In 2002 and again in the 2009 edition, an addition was made for the diagnosis of isolated tumor cells (ITCs) but changes to the definition were added in 2009 as well as an addition for findings by molecular studies:

N0(i+): Cells found in the lymph node measuring 0.2 millimeters or less, found either on routine pathology or using immunohistochemistry. In 2009, the following addition was made: if more than 200 cancer cells are found in a particular node, that node should be classified as a micrometastasis (N1mic) not isolated tumor cells.

N0(mol+): Positive molecular findings using RT-PCR but negative nodes histologically or by immunohistochemistry.

N1: Cancer is present in 1-3 lymph nodes in the armpit area (also known as axillary lymph nodes).

N1mic: The cancer present in the lymph node measures greater than 0.2 millimeters but not greater than 2 millimeters. This is also known as a micrometastasis.

N2: Cancer is present in 4-9 axillary lymph nodes.

N3: Cancer is present in 10 or more axillary lymph nodes.

M: The presence or absence of distant metastases.

M0: No distant metastases are present. In the 2009 edition, a category of M0(i+) was defined for patients without evidence of distant metastases by clinical or imaging studies, but molecular studies identify foci of carcinoma in blood, bone marrow, or other body site which are no larger than 0.2 mm.

M1: Distant metastases are present.

Once you know your T, N, and M status, you can determine your breast cancer stage as follows based upon the new guidelines:

Stage 0: Tis, N0, M0

Stage IA: T1, N0, M0

Stage IB: T0/T1 with N1mic, M0

Stage IIA: T0/T1 with N1, M0 or T2, N0, M0

Stage IIB: T2, N1, M0 or T3, N0, M0

Stage IIIA: T0/T1/T2 with N2, M0 or T3 with N1 or N2 and M0

Stage IIIB: T4 with N0/N1/N2 and M0

Stage IIIC: Any T with N3 and M0

Stage IV: Any T with any N with M1

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