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Recurrence After Adjuvant Chemotherapy

Posted 9/6/2014

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  One of the most depressing and frightening things about breast cancer is the fact that adjuvant chemotherapy does not bring a promise of  good health. We hear the statistics from our doctors, and we know that, generally, adding chemotherapy to treatment reduces the recurrence rate by approximately 50%.  This means that higher risk women get more percentage points from the chemo than do lower risk women. More explanation: If you start, after surgery, with a a 30% chance of recurrence based on the specifics of your tumor, chemo will reduce that risk by 15%, bringing the recurrence risk down to 15%. If you start, after surgery, with a 5% risk of recurrence, chemo will cut that by 2.5%. As an aside, ER positive women generally get another 50% risk reduction with the addition of endocrine therapy. Using the example here, chemo would cut the risk to 2.5% and five or more years of endocrine therapy would cut that in half, bringing it down to  1.25%.

  Clearly every situation is unique and only you and your doctor can parse out the fine print of your diagnosis and treatment and likely prognosis. The point is that nothing brings the risk to 0% and no one gets a promise. For each of us, the statistics don't matter all that much as we are each an n of one, and the only thing that really matters is what happens to us.

  Although we are no closer to promises of cure, there is increased understanding of who is at higher risk. Remeber, sadly, that nothing about breast cancer is totally predicatable; I know women who had tiny cancers and died in a couple of years and others who had very scary beginnings with big tumors and 15 positive nodes who are totally fine years later This is an introduction to a podcast from CancerNet about the current state of understanding. Don't know if reading it will help you feel better or worse.....

  New Insight on the Factors Affecting Local and Regional Recurrence from the 2014 Breast Cancer Symposium

Amy Early, MD, FACP
September 4, 2014 · Amber Bauer, ASCO staff
The 2014 Breast Cancer Symposium began today in San Francisco, California. This three-day conference brings together oncology professionals to discuss the latest advances in breast cancer research. One of these advances is the identification of two factors that may help better predict the likelihood that breast cancer will come back in the breast or nearby areas like underarm lymph nodes and the chest. These factors are the tumor’s response to chemotherapy given before surgery (neoadjuvant) and the tumor’s subtype.


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