How to Understand Late Recurrence of Hormone Receptor-Positive Breast Cancer
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- čas přidán 20. 01. 2024
- What is late recurrence of hormone receptor-positive breast cancer, and how is it treated? Join Dr. Jennifer Griggs as she unravels the complexities of late recurrence, its treatment options, and the potential factors influencing its onset.
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For context, what percentage of HR + breast cancers never recur after treatment? Thanks for covering this important topic!
Love this question!
Most people (90%) with Stage I ER-positive never have a recurrence. For people with Stage II disease, about three-fourths of people never have a recurrence. For people with Stage III disease, the risk of recurrence is higher. All of these figures assume that people receive currently recommended treatment. Thank you for watching!
Thank you, Dr. Griggs! The phenomenon of sleeping tumor cells is one of the most terrifying aspects of this lousy disease! 😢 Please take care!
It really is scary, we understand. They key thing is that most people will never have a late recurrence. In addition, worrying about it won't keep it from happening.
Recurrence can happen in the thin layer of fat after mastectomy. I have no breast tissue, but 7 years after my first diagnosis I was diagnosed with a small early stage tumor in the fat layer. This was 2 years after my doctor stopped my Anastrozole. I had not needed chemo with the first cancer due to low Oncotype Dx score. And radiation was not needed due to the mastectomy. This time around the nodes were clear again, and it was early stage with another low Oncotype score, but I had radiation after the lumpectomy. I’m back on an aromatase inhibitor, this time for life according to my doctor. If I’m blessed to live another 10- 15 years, that will be a very long time to be on the medication.
Katsem - How was your recurrence discovered, if I may ask? Were you experiencing certain symptoms?I had my single mastectomy two years ago, ever so often I would feel a sharp pain under th skin where my breast used to be, just for a second or so each time. I mentioned it to my gp, she told me it's "not unusual" to feel such sensation there after mastectomy. I wonder if I should pursue it more aggresively. Your insight would be greatly appreciated.
@@theresa94010I discovered it. I already also previously discovered another small firm nodule right under the skin which was being watched by my cancer surgeon and scanned every six months. It appeared to be from fat grafting done during reconstruction surgery. Then I discovered the second small nodule which we also started to watch. That one changed and within a year came back as suspicious on the ultrasound, and was cancer. When it was removed, the other one which was discovered first was also removed and it was actually benign.
I also had a single mastectomy. Mine was 1.5 years ago. I also sometimes have sensations -lately some itching. My oncologist explained it as nerves trying to repair after surgery and radiation. I’ve been told a recurrence in this area would present as a lump of bump or change in the scar. I’m having regular physical exams, annual mammogram for other side and MRI due to dense tissue.
That's correct. After mastectomy, there is still skin and, for some people, some fat under the skin. Recurrence can happen after mastectomy in these areas. Radiation therapy may be an option for people if they either did not have radiation therapy before or if it's been several years or more since their previous radiation therapy. In people whose tumors are estrogen receptor positive, the general approach is to offer long-term treatment with endocrine therapy.
@@theresa94010I thought I had posted an answer to your question, but don’t see it.
I found it. It was on the surface and easy to feel. I had another similar lump that my surgeon had been watching for a year when the second one became palpable. So we started watching this new one as well. It seemed both were probably fat necrosis from reconstructive surgery. The ultrasounds were benign, but after a year the second one looked suspicious and a biopsy confirmed it was cancer. So I had a lumpectomy to removed both cysts. The first one was still benign. I also had the radiation, 3 weeks with a boost throughout. I have had some chronic pain issues over the years and understand your concern regarding your pain. But, when staging was done for the new cancer, none of the scans showed any other cancer, so my pain was not from cancer, thankfully.
Thank you for the way you present information. I am a cancer survivor and oncology nurse and i know how valuable your channel is❤
Thank you so much for your kind words! It's wonderful to hear from someone who has both personal and professional experience in oncology. We truly appreciate your feedback and are glad that our channel can provide valuable information. Your support means a lot to us!
Thank you, Dr. Griggs, for informative medical advice.
Thanks for watching! We're glad you found this video helpful.
Dr. Griggs, thank you for your informative videos.
Thanks for watching! We're glad you found this video helpful.
I had triple negative breast cancer had chemo radiation and reconstruction was lucky I was 31 and stayed clear for 11 years now it’s back but it’s hr and pr positive… hit me like a tone of bricks had chemo radiation to collar bone and neck mastectomy it had spread to my skin and lymph nodes and say I’m very high risk on hormone treatments and targeted therapy 😢I’m fatigued all the time cancer really sucks … thank you so much for explaining things love to all fellow cancer buddies ❤ it effects your life in every way
This sounds really challenging. Please keep coming back, and let us know if there are videos that you would find helpful. In addition, it is worthwhile telling your medical team just how fatigued you are and how it affects your life. There are things that can be done to help with fatigue depending on the specific causes.
Thank you for these videos. They are very helpful. I would love to see a video on how to deal with hot flashes during breast cancer treatment.
Thank you for the video suggestion! We'll certainly add it to our list. We're glad you find our videos helpful. Stay tuned for more informative content.
Could you please do a video about the Breast Cancer Index and how it is used to make decisions about extended hormone therapy?
Thanks for the idea! Will add it to our list.
Thank you for this video. It actually happened to me. Lumpectomy HR positive, w/radiation and tamoxifen, 23 years ago. Last April, cancer returned, same breast, HR positive, mastectomy and heaven help me, Letrozole for 5 years. I can’t prove it but my second cancer occurred 9 months after a Covid vaccine. Recurrences happen, it’s unnerving when it does, but you put one foot in front of the other and press on.
Bless you for having to do this twice! Is the thought that a cell from your first cancer survived through treatment then woke up this many years later or that it’s a new cancer of the same type? No way to know? Best to you!!
your tumor was diagnosed HR+ ??? and what was your cancer stage 23 years ago...?
thank you
My breast cancer show up two months after I had my Covid vaccine I often wonder if that was the cause
My second breast cancer showed up after Covid vaccine
Thank you for sharing your experience with the Yerbba community.
Mine came back 5 years later as soon as I stopped tamoxifen 😢 now I’m on astrozole and Kisqali. I hate taking medications because I live such a healthy lifestyle. Fitness and yoga instructor, vegetarian now trying keto and feeling great.
I have seen your CZcams channel before,you look amazing 😊 I was so active too but after early induced menopause my joint and muscles are so painful, have you experienced any of it? Does it ever go away and does movement help? X
@@aggigreen7603 keep moving! That will help so much. I haven’t feel any yet but I did get that a little on tamoxifen. I think exercise fixes a lot of it! And thank you!
We're so sorry to hear about your recurrence, but it's great to hear that you're taking proactive steps to maintain a healthy lifestyle. Staying active and making dietary adjustments can certainly complement your treatment plan. Your dedication to your health is commendable!
Thanks for this informative video . I am a breast cancer survivor, ER+ PR+ HER 2 negative stage 1/ grade 1 IDC , lumpectomy/radiation (2022) and Anastrozole 1mg daily since diagnosis. It’s terrifying to know that there are dormant cancer cells that may wake up. Doctor, my recent Cholesterol level went up, and I’ve read from the leaflet that Anastrozole can cause this. What can be done for this?I still see my Oncologist annually.
Thanks for writing. You're doing everything you can to keep those little cells at bay, and recall that most people do not have dormant cells. This video is focused on how it happens when people do have a recurrence. Anastrozole, by lower estrogen, is associated with higher cholesterol, especially low density lipoproteins (LDL). The way this is treated is first with diet and exercise (exercise will increase so called "good" cholesterol, HDL and thus improve the ratio between "good" and "bad" cholesterol. If diet and exercise are not effective, then medications can be used to decrease cholesterol.
Thank you so much for another great topic dr Griggs, its very frustrating to understand cells wake up many years after, how far we are curing hr positive breast cancer once be come metastatic roughly? Or will ever be cure?
Can chronic stress wakes ups dormant cells?
Thank you so much for your valuable time❤
Thanks for the questions. Breast cancer and several other cancers can come back after many years. It's helpful to know that people can have late recurrences only because they are still alive and free of disease those many years later. While this may not be a comfort when it does occur, most people with a late recurrence have lived normal lives until the time of recurrence and that many people live rich and fruitful lives even after a recurrence.
Very grateful for your answers dear dr Griggs ❤
I went 29 years cancer free. The first time I was diagnosed with stage 2 breast cancer Hormone receptor postive. The second time they found it in the milk ducks on the other breast. In calcifications. They said it was stage 0. I did not have radition or any medicine. They did give me medicine but I had a side effect so I could not take it.
Thanks for writing. It's important to distinguish between a second cancer and a cancer recurrence. Your more recent cancer is not a recurrence of the first one but rather a second "event." The treatment will not be based on previous treatment you received, and the prognosis, particularly with DCIS, Stage 0, is excellent.
Hi, can you cover next topic: Influence of Tamoxifen on liver? 😊 Is it safe to take 10 years?
Tamoxifen can be taken for many years and has some benefits on things such as bone density. The risk of the rare but serious side effects (blood clots and cancer of the uterus) increase the longer people are on tamoxifen, so the benefits and risks need to be weighed against one another.
hello.im breast cancer what is the best food keto diet or low carb and also im done all treatment chemo,radiation even trastuzumab.i eat food but not processed and not always eat sugar and white rice is half cup is okay to eat like that.thank you for answering my question😊
Great question. You may find our video on the best diet helpful: czcams.com/video/OImlGPlywQs/video.html.
I was diagnosed with idc in 1996 and then diagnosed with ilc in 2014. Does this happen often
While it's not extremely common for someone to have both invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC), it's not unheard of either. Breast cancer can manifest in various forms, and sometimes people develop different types of breast cancer at different times in their lives. The treatment and management of these cancers can differ based on their specific characteristics and how they respond to various therapies.
I wonder if ER receptor has signaling 100% is it worse than p.e. signaling of 60 or 70% ? Or that does not matter for the increased risk of reccurence but 100% might have a better response to hormone blockers therapy? I always wonder about it and your reply would be greatly appreciated. Thanks in advance !
High levels of estrogen receptors does not mean cancer is more likely to come back. In fact, it's associated with a better prognosis, and endocrine therapy is more effective. Hoping this is helpful.
@@yerbba Thank you so much! You took a big part of my fear away !
T2nomo.....er negative pr(11. 20) parsent her2 negative... daily 1 teblet tamoxifen . . Risk
Without being part of your medical team, it is not possible for us to provide an estimate of the risk of recurrence in a given person. In a tumor such as this, the goal of treatment is cure. The vast majority of people with a tumor such as you describe are cured. Wishing you the best.
I cannot find any information on multicentric tumors that have different makeup. My oncologist infers that reoccurance is higher chance. I was stage 1 grade 3 (adding the 3 tumor sizes together). Dr Google says indicative of poorer prognosis. I need some facts.
If the foci of cancer are in the same quadrant, some people do add them together. If they are in different quadrants, they do not get added together. The risk of recurrence is a little higher in the breast but not throughout the body. The prognosis of Stage I (1) breast cancer is excellent even with multi centric disease.
So, recurrence happens in the breast tissue? And if it’s a late distant recurrence is metastasis/stage 4?
My breast cancer recurred 9 years after my initial stage 2b diagnosis. In 2013 I had a mastectomy, chemo & radiation. In 2022, we found it in my bones but it is breast cancer so they treat it with hormone therapy (and other medications). It is stage 4.
There are two main categories of recurrence. Local recurrence is in the breast or neighboring lymph nodes. Distant recurrence is metastatic disease and is referred to as Stage IV (4) cancer. You may find our video on recurrence helpful: czcams.com/video/tYmFU6FRfu8/video.html.
hello. What are the chances of getting cancer back if we do not opt for chemo and Herceptin in early invasive DCIS with no lymph node involvement and weak hr+ and her2 + after d-dish confirmation after mastectomy or lumpectomy in 65 yrs old with schizophrenia from 40 years.
Just for our other readers, DCIS is not treated with chemotherapy. For early invasive cancer that is HER2-positive, chemotherapy and targeted therapy can reduce the risk of recurrence, but the benefit may be smaller in Stage I disease. For every patient, we look at the person's other conditions and weigh the risks and benefits of treatment. It is difficult to estimate the extent of benefit without having all the information about such a cancer.
Im confused about Stage 1 which is what I have. You said after 5 years there could be a reoccurrence? Or unlikely. Im 78. Tumor is small. Genetic. Not Her2. Having a lumptectomy and radiation in Mx where I live. Thank you for your videos.
While it is rare for Stage I (1) breast cancer to recur, it can happen. It sounds as if your tumor was low risk, however, and it is much much more likely that yours will not recur.
Thank you. I had the lumpectomy two days ago and the sentinel node was clear as is the area surrounding the removal of the tumor.
@@yerbbai now wonder if radiation is necessary
Do you mean the hormone respter type is more likely to come back rather than HR2 + or TRP- ?
That’s what I understood as well! Commenting to see if you get a response! Also, does age have anything to do with reoccurrence meaning if a woman gets BC in her mid 30s-40s, are reoccurrences happening more to them than for women who had BC First time in their 50s-60s. Is there an average age for reoccurrence?
No, it's not more likely to come back. Rather, triple negative, and ER/PR-positive, HER2-positive is likely to come back earlier.
Can immunotherapy stop Reccurance
Immunotherapy along with chemotherapy can, for some people, reduce the risk of recurrence.
@@yerbbaevery person is different right
Well then why did Suzanne Somers and Olivia Newton John die when their breast cancer came back 20 years later?
Didn’t they refuse medications and conventional treatments? Or at least Suzanne S did
Local or regional recurrence can still be an early stage breast cancer (versus distant recurrence)
A distant recurrence of breast cancer can go to your liver, bones or brain. Those are more difficult to treat.
@@annielucemine went to my chest wall (pleura). 🙏🏼 oh and don’t forget the lungs.
Both celebrities had recurrence of their cancer or a second breast cancer. This can happen, which is why we made this video.
Doc please rest you look over worked
Oh dear! Thanks!