"Prognosis" is a medical term that is used to explain how
cancer will affect a patient. In fact, prognosis represents a group of factors
directly connected with the disease.
These factors that are considered to be part of the breast cancer
prognosis are number and type of symptoms, tumor size, staging, general health
factors, age, metastasis, test results, and family medical history.
The most important factor in breast cancer prognosis is its stage.
Stage involves tumor size, local involvement, lymph node status and if there
metastasis of the original cancer. Unfortunately, the prognosis will be worse if
the classification of the stage is high. During the last years, prognosis
factors in breast cancer have been assessed carefully and pathologists have got
an important role in identifying the variety of histological and
immunohistochemical markers, which are vital for treatment and behavior of the
disease. The anatomic extent of a cancer determined through different methods is
a traditional indicator of prognosis, but nowadays there are new methods that
can provide patients and doctors with a more reliable marker.
A poor or a favorable prognosis is mostly explained by tumor size. A
favorable prognosis is usually related to non palpable invasive carcinomas.
Interest in prognosis has been encouraged by the success of adjuvant therapies
for early stage breast cancer. Larger tumors invasiveness of disease to lymph
nodes, chest wall, and skin or beyond and aggressiveness of the cancer cells
raise the possibility of a poor prognosis because they are related to high
stages. On the other hand, smaller tumors, cancer-free zones, and close to
normal cell behavior (grading) lower it.
Grading is directly connected with the appearance of the cancer cells
under the microscope. The grade of breast cancer provides an idea about how fast
the cancer may develop. There are three grades: grade 1 (low-grade), grade 2
(moderate or intermediate grade) and grade 3 (high-grade). In grade 3 cells look
very abnormal and in this case cancer is more likely to spread and patients will
have a poor prognosis.
Young women may have a tendency to receive a poorer prognosis than
post-menopausal women because of different factors such as active breast through
their cycles, nursing and they may be unacquainted of their breast
changes.
The finding of estrogen and progesterone receptors in the cancer cell
is crucial in guiding treatment because patients with negative results in tests
related to these hormones will not respond to hormone therapy.
HER2/neu is a protein giving higher aggressiveness in breast cancer
also guide the future of a breast cancer treatment. Patients whose cancer cells
are positive for HER2/neu have more aggressive disease and may be treated with
trastuzumab, a monoclonal antibody that targets this protein.
At present, researchers have learned more about how tumors
progress, so they hope to be able to discovered more effective target
treatments.
