Form of breast cancer is "particulary aggressive"

[question everything]

Said Joan Lunden.

What does it mean? In all the debate about mammography, we often hear - from statisticians who never meet a breast cancer patient - that most beast cancers will end up to be benign and would not kill a woman.

I've often wondered how they can determine this. If you don't do a mammography and do not do biopsy how do you even know that there is a tumor there? And if you do not biopsy it and analyze it, how do you know that it won't kill the woman? Do nothing and wait and see if it starts growing - and by then it is too late?

[840high]

1. My breast cancer was caught

on a regular mammo.

[unblock]

2. they track the size over time and they track the outcomes.

mrs. unblock is a breast cancer survivor. she just had an mri that showed a lump they found 6 months ago hadn't grown, so either it's not cancer or it's extremely slow-growing. so they'll just continue monitoring.

her original tumor was biopsied and genetically tested to determine the exact type of cancer. fortunately, hers is very unlikely to come back, though monitoring and estrogen-suppressing pills are needed.


presumably these studies take into account people who die from cancer without ever having gotten a mammogram or biopsy.

[question everything]

5. Wishing both of you many years of good health

I believe that the genetic testing are usually done to determine whether chemotherapy is advisable.

Still, they decided not to operate and to follow its growth. What if it had? And by now has spread to the lymph nodes?

Still it is good that she had an MRI or a mammogram and had a biopsy. Many of the "experts" are against even these mode of detection.

And... if people die from cancer without ever having a mammogram or a biopsy, how do they know that they died of cancer? Because it eventually spread to other organs?

[unblock]

6. yes, genetic testing helps determine if chemo (and what type) is needed

but it also serves as a recurrence rate. in mrs. unblock's case, she scored a very low number, meaning both that it's very unlikely to come back (maybe 4% over the next 10 years) and also that chemo wouldn't much affect the outcome, so she was spared that.

she did have surgery to remove it. the lump they found 6 months ago was on a follow-up test. the reason these modes of detection (particularly mri) are controversial is because of the high number of false positives in general (and she's already had several of those). mri's can help find tumors that might not be found otherwise, but these tests don't improve outcomes.

in other words, there's not much statistical difference between finding a lump early with an mri and either not finding it at all or finding it later without the benefit of an mri, at least compared to mammogram and/or ultrasound and/or palpation.


and yes, they can do autopsies to determine the cause of death for people who never got tested while alive. afaik breast cancer is not lethal unless it spreads to other organs -- lymph system, brain, liver in particular. so if it is the cause of death then it must have spread.

[question everything]

10. Now I know. It is triple negtive which is, indeed, considered aggressive

While most cancers have receptors to estrogen and progesterone and thus can be treated with enzyme blocking drugs, no such treatment is available for the triple negative. Thus, the old fashioned harsh chemo is prescribed. It either helps, or does not and then death follows relatively quickly.

I hope that she will respond.

[samrock]

3. My wife's breast cancer was detected by her in the shower in June 2001..

She had a lump removed.. a 2nd surgery to "clear the margins" on September 11th 2001.. The chemo/radiation.. and it all seemed good.. but in early march of 2008 she complained of a pain in her side.. it was the cancer coming back.. within 60 days she died.. the called the recurrence "particulary aggressive".. She did every thing the doctors told her to do.. sigh...

[question everything]

4. I am so sorry for your loss

This must have been very hard for you, to follow her fight and to finally lose.

And, again, how did they determine that it was "particularly aggressive?" After the fact, after it came back?

The sad, and alarming fact about your wife is that it came back after more than six years. Five years is usually the mark that often says that if one has survived five years, one is probably going to be OK.

[samrock]

8. About 2 months after she died I met with the oncologist

with a list of questions..

They told me that cancer coming back that strong and agressive is rare .. like 1 in 100.. Seems like she never had a chance..

[BadgerKid]

11. The recurrence isn't necessarily the same cancer as before.

Different mutation(s), different cancer.

Sorry for your loss.

[unblock]

9. "aggressive" refers primarily to the growth rate

they can simply see how fast the tumor is growing. or they can identify the specific type and then they know based on experience with other patients.

"aggressive" can also mean how likely it is to spread, although this is highly correlated with growing quickly.

[unblock]

7. my condolences. unfortunately doing everything you're told doesn't always work.

mrs. unblock quit smoking 15 years ago and about 5 years ago we cut out meat and she lost a lot of weight and started running marathons and now it's all organic and whole grains and... after all this *then* she gets the big c....