Breast Cancer Incidence
Breast cancer is the most commonly diagnosed cancer among American women. In 2010, the American Cancer Society estimated about 207,090 cases of invasive breast cancer and 54,010 cases of carcinoma in situ (the earliest stage) would be diagnosed in the U.S. It’s the second leading cause of cancer death for women (lung cancer is the first). Last year, 39,840 women were expected to die from breast cancer.
Breast Cancer Recurrence
Even when cancer appears to have been successfully treated (i.e., no sign of cancer), there is a risk the disease will return. Recurrence is classified by the spread of the cancer. A local recurrence is cancer that has returned in the area of the original surgery. Regional recurrence is cancer that has spread beyond the breast, but is still nearby, like in the chest muscles and/or lymph nodes. A distant recurrence (metastasis) is cancer that appears far away from the original site. Common sites of breast cancer metastasis are the bones, brain, lungs, and liver.
The organization Susan G. Komen for the Cure, estimates that women who have a lumpectomy, radiation and negative lymph nodes (no sign of cancer) have about a 6.5 percent chance of local recurrence in the five years after diagnosis. Those with positive lymph nodes (cancer in one or more) have about an 11 percent chance of local recurrence.
For women who have had a mastectomy, the risk of local recurrence in five years depends on lymph node involvement. If lymph nodes are negative, the recurrence risk is about 6 percent. For those with one to three positive lymph nodes, risk is about 16 percent. When four or more lymph nodes are positive for cancer, the risk for recurrence is 26 percent.
Early Detection of Recurrence
Follow-up exams are very important for women with breast cancer. Experts say about one-third of recurrences are detected through mammography and one half through a physical exam. Blood tests can also be used to detect markers associated with cancer recurrence. However, these screening tests aren’t perfect. Dan Raftery, Ph.D., Researcher with Purdue University in West Lafayette, IN, says the tests may yield false positives, causing women to undergo unnecessary biopsy and worry. In addition, the recurrence still may not be detected until after the cancer has spread. By then, the disease can be more difficult to treat because cancer cells often develop resistance to previously successful chemotherapies.
Researchers are now studying a new tool for predicting breast cancer recurrence, called the VeraMarker-BCR Breast Cancer Test (developed by Matrix-Bio). It’s a blood test that combines two high-tech methods, nuclear magnetic resonance and mass spectrometry, to screen for biomarkers associated with recurrence. A recent study found in 55 percent of patients, the test correctly predicted breast cancer recurrence about 13 months earlier than standard techniques. Raftery adds, earlier detection of recurrence enables doctors to fight the cancer before it spreads further and becomes resistant to treatment.
The VeraMarker tool is also being tested as a screening tool for early detection of breast cancer and for cancer of the liver, colon and pancreas. Researchers are hopeful the VeraMarker-BCR Breast Cancer Test for breast cancer recurrence will be commercially available late this year.
American Cancer Society, http://www.cancer.org
Centers for Disease Control and Prevention, http://www.cdc.gov/cancer/breast
National Cancer Institute, http://www.cancer.gov
Susan G. Komen for the Cure, http://ww5.komen.org
Y-Me National Breast Cancer Organization, http://www.y-me.org
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Van den Beuken-van Everdingen, M., et al., “Concerns of Former Breast Cancer Patients about Disease Recurrence,” Psychooncology, November 2008, Vol. 17, No. 11, pp. 1137-1145.