| Predictive factors |
Although nobody can predict what is going to happen to a patient after a diagnosis of breast cancer, there are features which place patients into a high , intermediate or low risk of relapse (cancer returning in another part of the body). These factors help to decide which patients require extra treatment such as hormone therapy and chemotherapy.
The most commonly measured factors include:-
1. Age of patient
2. Lymph node involvement in the armpit (axilla).
3. Tumour grade (how aggressive it looks).
4. Pathological tumour size.
5. Lymphatic or vascular invasion.
6. Lack of oestrogen receptor status
6. HER-2 status
Some organisations have developed formulas which actual give the statistical risk of relapse. They are based on the results of treatment in the last ten years not the next ten years - so hopefully the results would be much better.
THE NOTTINGHAM PROGNOSTIC INDEX
0.2 x path tumour size (in cm) + stage + grade
where stage is defined by triple node biopsy:
1. Tumour absent in all 3 nodes.
2. Tumour present in low axillary.
3. Tumour present in apical or internal mammary node and
Grade I=1, II=2, III = 3.
The index defines 3 groups but does not take into account age:
| 5 yr survival | 10 yr survival | ||
| Good | 1 < 3.4 | 84% | 66% |
| Intermediate | 3.4 < I < 5.4 | 69% | 50% |
| Poor | 1 > 5.4 | 48% | 30% |
YORKSHIRE BREAST CANCER GROUP PROGNOSTIC INDEX
0.1 x clinical tumour size cm + (0.5 x grade) + (0.6 x nodal involvement)
where lymph node involvement N0 = 1, Yes = 3 and grade I =1 and II and III = 2.
Defines 3 groups but does not take into account age:
| 5 yr survival | 10 yr survival | ||
| Good | I < 1.21 | 84% | 65% |
| Intermediate | 1.21 < I < 1.82 | 71% | 52% |
| Poor | l > 1.82 | 47% | 29% |
Further general information Your doctors and specialist nurses are in an ideal position to give you relevant information on your disease and treatment as they know your individual circumstances. Cancerbackup has a help line (0808 800 1234) and a prize winning video available in English, Italian, Urdu, Bengali, Gujarati & Hindi explaining Radiotherapy & Chemotherapy. Cancernet.co.uk has over 500 pages describing cancer, its management, practical tips and tool which patients, their carers and their doctors have found helpful during the cancer journey.