Breast cancer, like the one that this Tuesday announced publicly that the presenter Ana Rosa Quintana suffered , is one of the most frequent in the West and in the world; approximately, it represents a third of all malignant neoplasms in women that occur on the planet.
Fortunately, it is also one of those with the best prognosis: in Spain, the five-year survival rate (that is, the probability that exists of remaining alive five years after receiving the diagnosis) is 82.8%. global and higher than 99% in people who are detected exclusively breast cancer, according to the AECC .
The differences in each specific case
Keep in mind that these figures are drawn from large statistics, so they are not necessarily applicable to all cases. In fact, when issuing a prognosis for a specific patient (something that a doctor should always do), their specific characteristics and those of their cancer must be taken into account .
Thus, expectations vary according to the size of the tumor mass, axillary involvement (cancer involvement of one or more lymph nodes in the armpit), tumor stage (the stage in which the cancer is found), histological type (definition of the tumor according to the degree of abnormality and the speed of reproduction and spread of cancer cells), the presence or absence of HER2 (a hormone that intervenes in the growth of cells and that is more abundant when there is a mutation in the gene of the same name), proliferation index (speed at which cell division occurs), hormone receptors present and lympho-vascular invasion (involvement of lymphatic channels or blood vessels).
Regarding the patient , the three factors that have the greatest influence on prognosis are previous medical history (and especially comorbidity with other forms of cancer), age, and race. Some statistical differences have also been found depending on whether one has been a mother or not, the age of the onset of menstruation, the age of the first pregnancy, if there has been one, the consumption of contraceptives, estrogen replacement therapies, diet high fat, obesity, history of clinical depression, alcohol and tobacco use, lack of vitamin D or sun exposure, and family history.
What points to a better prognosis?
Thus, the profile of the breast cancer patient with the best prognosis is that of a woman who receives the diagnosis when she is over 40 years of age and of a race other than black, without previous or coincident cancers and without a family history of the types of cancer more severe breast (more generally, no family history of any cancer).
Other conditions that would occur in this prototypical case (although the scope and nature of its influence on the prognosis are much less clear) is having been a mother several times, that the first pregnancy, if any, was in the decade of the 20 to 30 years of age, that there has not been an early onset of menstruation, that they do not consume or have regularly consumed alcohol or tobacco, that they are at their normal weight, that they eat a balanced diet, that they have not received estrogen replacement therapy, has not used oral contraceptives, has normal levels of vitamin D and has not suffered from depressive disorders.
For their part, as stated in a review work published in the Cuban Journal of Surgery , the tumors that have better expectationsare those that are detected in the early stages of the disease; whose mass is small; that are located; in which there is no metastatic involvement in the axillary nodes; that are non-invasive histological type (approximately 10% of all those detected) or are tubular, cribriform, colloid and papillary carcinoma (those with, on the other hand, a worse prognosis are medullary carcinoma, acute breast carcinoma , Paget’s disease and infiltrating ductal carcinomas); HER2 negative; with low proliferation index; no estrogen (ER-negative) or progesterone (PR-negative; together, HR-) receptors; and without lymphatic or vascular invasion.
How to know all these signs
As we can see, many of these factors are known as a result of various medical tests , so it must be emphasized that the evaluation of the tumor and the issuance of a prognosis must always be in the hands of a specialist.
Be that as it may, what is important is, even if there is no reason to suspect anything, to maintain a certain vigilance by acquiring the habit of routinely palpating the breasts in search of any signs and of having regular mammograms.
In the same way, it is important to adopt behaviors aimed at minimizing the risk in those factors that are modifiable , avoiding, for example, the consumption of alcohol and tobacco and adopting a healthy and balanced diet.
