Age and
Associated Fibrocystic Changes are Prognostically Significant in Patients with
Small Node-Negative (T1a,bN0) Invasive Breast Cancer
http://web.b.ebscohost.com/ehost/pdfviewer/pdfviewer?sid=64e5c2ea-ced8-406d-95e6-52f225700724%40sessionmgr103&vid=16&hid=125
There are
many types of breast cancers and other benign breast diseases that affect men
and women. This article is specific to small node-negative invasive breast
cancer. This long name means the tumor is small(<1cm), there is no
metastasis to the lymph nodes and it is invasive, in that the cancer started in
the milk ducts or lobules and has broken through to the nearby breast tissue.
There are many different factors that contribute to a good prognosis of breast
cancer such as low-grade tumor (highly differentiated from surrounding cells),
has not metastasized to other areas of the body, your age, and whether it
responds to hormones or not, as this determines what drug therapy can be used.
Fibrocystic
breast disease is common and simply means that the person’s breasts are either
more fibrous/dense or they have fluid filled cysts. Fibrocystic breast disease
does not increase a person’s risk of developing breast cancer. However, a
person with invasive breast cancer that has fibrocystic changes that occur has
a higher chance of recurrence of breast cancer than someone with no fibrocystic
changes. A fibrocystic change that can occur in the breast is proliferation, or
the increase in size of a lesion/tumor in the breast. The article stated that
there was a correlation with non-proliferating and proliferation without atypia
and the overall survival of the patient. This means that the tumor either did
not grow in size or that it stayed symmetrical and the patient lived longer
than that of a similar person who had proliferation and atypia where the tumor
changed shape. Further research needs to be done involving fibrocystic changes
in invasive breast cancer as it is not usually monitored, because there may be
a relation between the benign lesion and the way the cancer reacts to treatment
and behaves. Invasive breast cancer that arises in patients that had
fibrocystic breast disease may be biologically different and act or react
differently than that of one that arises with relation to fibrocystic disease.
The
article stated that this type of cancer has been diagnosed at varying ages and
was split into two different categories of <40 and >40 years old. The
category of <40 years old had a poorer prognosis of recurrence and length of
overall survival than that of the >40 years old group. The article also stated
that the younger group showed that this cancer was more aggressive in terms of
treatment. Patients with higher grade tumors, younger than age 50 at diagnosis,
and negative estrogen and progesterone receptor status had an increased rate of
death specifically related to breast cancer.
If a
person notices changes in their breast they need to see their health care
provider to rule out any possible chance of breast cancer no matter what their
age is, as invasive breast cancer is more aggressive with younger age. The change
may be fibrocystic related and completely benign or it could be worse. If a
younger person is treated for invasive breast cancer and they have fibrocystic
changes that are not monitored closely and later in life they have a
recurrence, what is to say they are not related? For a best case scenario, I
feel that all changes should be closely evaluated and monitored. With detection
being difficult in dense breast tissue it may be at a later stage and grade
that causes an even bigger hurdle to pass in treatment. For younger patients
adjuvant therapy consisting of surgery, chemotherapy and/or radiation should be
an absolute must with how aggressive this form of cancer is.
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