Up to the present, nobody including breast specialists can predict the course of the breast cancers.
The course of a breast cancer depends on the biologic behavior of the cancer cells of the individual patients. Some are slow growing and some are fast growing. At the moment, there is no 100% accurate way to predict the biologic behavior of the individual breast cancer.
The most that physicians can do is to go by probability based on historical records and based on certain parameters like stage of the breast cancer. For example, the 5-year survival rates from Stage 1 to Stage 4 are quoted in a decreasing order, meaning highest probability of survival for Stage 1 and lowest for Stage 4. However, the probability of survival rates does not include 0% or 100%. This means, even for Stage 1 breast cancer, there is a small percentage of patients not surviving 5 years, meaning they still die from the disease from metastasis. (I can vividly remember a teacher many years ago with stage 1 breast cancer who after one year died of liver metastasis.) For Stage 4 breast cancer, there is also small percentage of patients surviving for more than 5 years.
In the literature, we have studies on the natural history of the breast cancer. It is said that the duration of life is usually about 3 years but the range varies from a few months to over 30 years.
Another thing that will support the statement of unpredictability of breast cancer – no breast specialists will talk of cure, just in terms of remission. Complete remission means all signs and symptoms of cancer have disappeared, although cancer may still be in the body. As mentioned above, cancer can recur even 20 to 30 years.
Here are some quotations that I lifted from the literature containing statements on unpredictability of breast cancers.
“However, unpredictable breast cancer recurrences and deaths occur also among the group of patients with T1N0M0 breast cancers.”
“It follows an unpredictable course with metastasis presenting up to 20 years after initial diagnosis.”
So, breast cancers are unpredictable in terms of natural history, recurrence and metastasis.
Despite this, the advice is to still to have early detection and early treatment as this carries a higher probability of no recurrence and metastasis or complete remission.
Recurrence and metastasis in breast cancer can occur in various forms and combinations:
- Local recurrence in the chest area
- Regional recurrence in the lymph nodes in the axillary and neck areas
- Distant metastasis to the bone, lung, brain, liver, skin and soft tissues, etc.