Healthcare: Cancer Care

Chances of Recurrence or Spread


Researchers have been studying breast cancer for many years to learn how best to treat this disease. They have given special attention to preventing the disease from coming back, also called a recurrence.

It was once thought that breast cancer spreads (metastasizes) first to nearby tissue and underarm lymph nodes before spreading to other parts of the body. Scientists now believe that cancer cells may break away from the primary tumor in the breast and begin to metastasize even when the disease is in an early stage. Studies have shown that adjuvant therapy (treatment to kill microscopic amounts of cancer cells that may have spread), given in addition to primary therapy (surgery and radiation), increases a woman's chance of long-term survival.

Think of cancer like a weed in your yard. Pulling the weed will kill it. Prior to pulling the weed, seeds may have dropped off and spread throughout your yard. These seeds were too small to see, but over time they will begin to grow. Therefore, therapies that will go to all parts of the body are sometimes needed.

The surgery and/or radiation therapy is the treatment for the tumor in your breast (like pulling the weed). This is called the local treatment. There are two ways the cancer cells can spread through the body: (1) In your blood stream or (2) In the lymph fluid/lymph nodes

For the cancer cells that might have spread, your doctor may recommend chemotherapy and/or hormonal therapy. This is called systemic therapy, because the chemotherapy or hormonal therapy travels to all parts of your system, not just one area.


Characteristics of Your Tumor


Factors that help your doctor determine the chance that your breast cancer has spread are the size of the tumor and the lymph nodes that are involved. Your breast cancer is:

Tumor size: cm
Lymph Nodes: positive
Cancer cell grade:
Proliferative fraction:

Other factors that may influence the treatment prescribed to you are the results of the estrogen and progesterone receptors.

Estrogen receptors:
Progesterone receptors:

Risk of recurrence after surgery and/or radiation therapy % over the next 10 years.

Reduction of this risk of recurrence by:

Chemotherapy: %
Hormonal Therapy: %


Recommended Chemotherapy


The chemotherapy is given in a vein in your arm or through an implanted catheter. This is called a cycle. You will get this chemotherapy every 3-4 weeks for cycles.


Recommended Hormonal Therapy


Hormone therapy deprives cancer cells of the female hormone estrogen, which some breast cancer cells need to survive and grow. For most patients, adjuvant hormone therapy is treatment with the drug tamoxifen (also called Nolvadex) for five years. Some premenopausal patients may have surgery to remove their ovaries, which are a woman's main source of estrogen. In postmenopausal women, a newer group of hormone therapy called aromatase inhibitors may be substituted or taken after tamoxifen.