Stage IV Breast Cancer
Friday, August 29th, 2008Stage IV breast cancer has traditionally been considered an incurable cancer. In the mid to late 1980’s the average patient with stage IV breast cancer treated with low-dose chemotherapy survived 8-10 months before their cancer relapsed and less than 5% of patients could expect to survive 5 years without their cancer recurring. In 1988, the results of a small clinical trial treating 22 women with stage IV breast cancer treated with high-dose chemotherapy and autologous stem cell transplant were published. Fourteen percent of these patients treated with high-dose chemotherapy survived without their cancer recurring beyond 5 years.
Over the years since the original publication describing high-dose chemotherapy for the treatment of stage IV breast cancer, thousands of women have been treated. All of the more recent publications demonstrate that the complete remission rate for high-dose chemotherapy as initial treatment for stave IV breast cancer is 40%-60%, the mortality from therapy has decreased to 1%-5% and the number of patients alive without evidence of cancer recurrence is 15%-25% 4-5 years from treatment. The results from two clinical trials comparing high-dose to lower dose chemotherapy have also been published.
In general, women who have advanced breast cancer at the time of diagnosis live approximately 18 months after diagnosis (median survival rate). Those who are still alive five years after their diagnosis of advanced breast cancer can live an additional 3.5 years (median survival rate) according to the American Cancer Society.
This study suggested that there were no differences in survival between the standard-dose and high-dose chemotherapy regimens in women with metastatic breast cancer who had a complete or partial response to initial standard-dose therapy. However, the number of women treated in this trial does not allow the identification of any subsets of women that might benefit more than the overall group from the high-dose regimen.
Additional clinical trials directly comparing conventional chemotherapy treatments to high-dose chemotherapy treatments are currently ongoing to help determine which patients may benefit most from high-dose chemotherapy treatment.
Early detection procedures must include monthly self-examinations done at the same time each month. From age 20-40, healthy women should have clinical breast exams performed by their health care providers every three years. After age 40, the breast exams should be annually and should include a mammogram or similar procedure.
North American white women have the highest rates of breast cancer in the world, but the 5-year survival rate for all stages (Stage 1, Stage 2, Stage 3, and Stage 4) combined is 88% for the U.S. A recent study found European countries have lower 5-year breast cancer survival rates, with England at 77.8% and Ireland at 76.2% (Lancet Oncology).
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