How long patients with advanced breast cancer can live is a relatively complex issue: it is related to the metastasis site and treatment plan of advanced breast cancer.
This article discusses the metastasis sites separately:
What is late-stage breast cancer:
Late-stage breast cancer refers to: distant organs, such as liver and lungs Breast cancer that metastasizes to , bone, brain, etc.
1. Bone metastasis of advanced breast cancer:
First of all, among malignant tumors with bone metastasis, breast cancer is the most common cause.
Breast cancer bone metastases are most common in the thoracic spine, lumbar spine, and pelvis, followed by ribs, femur and other locations. The discovery of bone metastases is often due to pain in a fixed position or unexpected findings such as fractures.
Examination of breast cancer bone metastasis: radionuclide bone scan (ECT), CT, X-ray, etc. If necessary, magnetic resonance imaging can be performed to understand the compression of spinal nerves.
Prognosis of bone metastasis: Patients with simple bone metastasis (without metastasis to other organs) can survive for a long time, and bisphosphonate drugs (zoledronic acid) can be used for symptomatic treatment.
2. Liver and lung metastasis of late-stage breast cancer:
Lung metastasis: Typical symptoms are cough, chest tightness, and occasionally coughing up bloody sputum. However, many patients are clinically asymptomatic and discover pulmonary nodules during regular chest CT or chest X-ray examinations.
Liver metastasis: It may be asymptomatic in the early stage, or there may be a series of non-specific symptoms such as pain and discomfort in the liver area, abdominal distension, jaundice, loss of appetite, fatigue, and weight loss. In the late stage, there may be severe pain in the liver area, cirrhosis, ascites, etc.
The prognosis of liver and lung metastasis: It is related to the nature of the metastasis. If it is hormone receptor positive and a single metastasis, it can be relieved by rescue chemotherapy, radiofrequency ablation, or even surgery, or by fluorine With endocrine therapy such as Siqun, patients can achieve long-term production.
However, the effect is poor for multiple metastatic lesions in the liver and lungs, and the natural course of the disease is about 6-12 months. Therefore, it is recommended that patients undergo regular liver and lung CT examinations.
3. Brain metastasis:
Brain metastasis from breast cancer has the worst prognosis. Due to the existence of the blood-brain barrier, chemotherapy is ineffective and is mostly treated with radiotherapy.
The natural course of the disease in patients with brain metastasis is usually within half a year.
Regular review items after breast cancer surgery: blood test for tumor markers, color ultrasound of breast and axillary lymph nodes, color ultrasound of liver and gallbladder, chest X-ray, etc.
The survival time of late-stage breast cancer cannot be generalized. The survival time varies greatly depending on the location of metastasis, pathology and genotyping.
Although all breast cancers are late stage, according to medical staging, as long as distant metastasis occurs, it is considered late stage. Therefore, there are single distant metastasis and multiple distant metastasis; There are intracranial metastases and extracranial metastases.
1. Depending on the condition of the metastasis
Generally speaking, single metastasis, or "oligo-metastasis", can be treated with local combined systemic treatment through local surgery because the lesion is limited. , radiofrequency ablation, gamma knife and other treatment methods to destroy metastatic lesions, and subsequent systemic treatment is still expected to achieve complete remission and long-term survival.
But if there are multiple metastases, the chance of eradicating all the metastases will be lost. The survival time will be much worse than those with few metastases, but the length of survival depends on the pathology and genes of the tumor. Type.
Multiple intracranial metastases have the worst prognosis, because brain metastases directly threaten the patient’s life. Therefore, multiple brain metastases generally have a shorter survival period.
2. Pathology and Genotyping
Triple-negative breast cancer has the worst prognosis because there is a lack of effective treatments other than chemotherapy, so the survival period is short.
For breast cancer that is hormone receptor positive (HR+) and Her-2 negative, in addition to chemotherapy control, there is also the opportunity for endocrine therapy. Therefore, even if distant metastasis occurs, there is still hope for a longer period of time. control.
For patients with Her-2 overexpression (Her-2+), because powerful anti-Her-2 targeting drugs are available, advanced patients can still hope to control their disease for a longer period of time.
In short, the survival time of patients with advanced breast cancer, depending on the situation, can be 1-2 years or 3-5 years. Some patients can even reach more than 10 years. It depends on the patient’s condition. The specific situation, the number of treatments, the patient's sensitivity to treatment, and the financial status of the patient's family are all factors that affect the patient's survival.
Back to this question, how long can patients with advanced breast cancer live? If we give a rough answer to this question, there are various possibilities, including one month, several months, half a year, one year, three years, five years, or even ten years or more. You see, saying this means not saying it yet. Because it is the same late-stage breast cancer, the conditions of different patients are different. For example, the same distant metastasis, but bone metastasis, is certainly not the same as liver metastasis and brain metastasis. Brain metastasis is much worse than bone metastasis. For example, breast cancer that also metastasizes to the liver, ER-positive breast cancer, is better than triple-negative breast cancer, with more treatments and better prognosis, and sometimes the survival time is very different.
Of course, whether the treatment is aggressive and standardized also affects the length of survival.
As I said before, don’t just think about how long you can live as soon as you hear it is late stage. Find a reliable doctor to evaluate the condition and treat it actively. Many breast cancers can survive for a long time. Of course, Not all patients, so it depends on the specific condition.
Survival period after surgery for various stages of breast cancer: How long can one survive with breast cancer?
Breast cancer is one of the most common malignant tumors in women. Its incidence rate is increasing day by day, and the incidence rate is also trending at a younger age. Breast cancer still cannot achieve primary prevention. Therefore, early detection, early diagnosis, and early treatment are very important to reduce breast cancer mortality and improve patient survival rate. Typical manifestations of breast cancer include: a painless mass that can be palpated in the breast, with blurred edges and low mobility. Sometimes there is nipple discharge, nipple inversion, or orange peel-like changes in the skin. If patients experience the above symptoms, they need to go to the hospital for medical treatment in time, which will help detect early lesions. So, how should breast cancer be treated?
Surgery plays an important role in the diagnosis, staging and comprehensive treatment of breast cancer. Generally speaking, doctors will use surgery as the basis and other radiotherapy and chemotherapy methods based on the patient's specific conditions to achieve radical cure for breast cancer and avoid recurrence. In recent years, due to the in-depth understanding of breast cancer, it has been discovered that breast cancer is a systemic disease, and the size of the surgical range does not seem to affect the therapeutic effect of breast cancer. Therefore, breast-conserving surgery has also emerged. For stage I and II breast cancer, breast-conserving surgery can be selected under the premise of strictly controlling the indications. For patients who are not suitable for breast-conserving surgery, breast reconstruction can be performed after mastectomy to improve the patient's quality of life and confidence. At the same time, axillary sentinel lymph node biopsy can help doctors determine whether a patient's axillary lymph nodes have metastasized, allowing patients without axillary lymph node metastasis to avoid traditional axillary lymph node dissection, and reducing the occurrence of postoperative complications such as upper limb edema and dysfunction.
Radiochemotherapy is an important auxiliary method in the treatment of breast cancer. At the same time, neoadjuvant treatment can also be performed before surgery. Neoadjuvant therapy only requires systemic therapy as the first step in the treatment of breast cancer before surgical treatment for breast cancer patients with no distant metastasis. Neoadjuvant therapy includes adjuvant chemotherapy, adjuvant targeted therapy and adjuvant endocrine therapy. Current evidence-based medicine shows that the efficacy of neoadjuvant therapy and adjuvant therapy (postoperative) with the same protocol and course of treatment are similar, but it can give some inoperable patients the opportunity to undergo surgery and allow more patients to obtain breast-preserving options. possibility.
What is the postoperative cure rate for each stage of breast cancer?
Breast cancer is divided into four stages. Stage I refers to a corresponding mass in the breast, where cancer cells have appeared but have not spread, and the breast mass is 2cm. At this time, the cure rate of breast cancer can reach 95%; Stage II Stage breast cancer has a cure rate of about 75%. A breast mass of 2cm to 5cm has begun or is preparing to invade lymph nodes. If diagnosed and treated in time, the breast cancer can be controlled starting with local treatment. For stage III breast cancer, a breast mass of 5cm to 5cm has already begun to invade lymph nodes. If it spreads to the lymphatic system or even to the skin, total mastectomy and systemic treatment are required at this time. The cure rate is generally about 55%. Stage IV breast cancer is the most advanced stage. At this time, the cancer cells have spread throughout the body, and only 10% about the cure rate. After breast cancer is cured, there will be a recurrence period of five or ten years. If there is no recurrence within five or ten years, the breast cancer has been cured and there is no need to worry.
What should you pay attention to after breast cancer surgery?
The 5-year survival rate of female breast cancer patients in my country is about 73% (71.2%-774.9%), and can reach 80% in cities with better medical conditions. The overall survival rate of breast cancer is better than that of other breast cancer patients. malignant tumors. Research reports that the lifestyle of breast cancer patients can affect prognosis. Patients' personal lifestyle factors such as dietary influences, weight changes, smoking and drinking are closely related to tumor metastasis and recurrence.
1. Timely radiotherapy and chemotherapy after surgery: Radiotherapy and chemotherapy can further help remove residual cancer cells. Patients should make reasonable choices based on the specific surgical method, tumor stage, pathological type, etc.
2. Relax mentally: Breast cancer is a serious disease, but it is not an incurable disease. Relatives should give the patient the greatest consideration and love, so that the patient can bravely express his fears and thoughts. The depression can be combined with comfort to eliminate the patient's fear of cancer and mental pressure, maintain a stable and optimistic mood, and improve the patient's confidence and joy in life. A good attitude can help improve the treatment effect.
3. Nutritional supplementation: Patients should supplement nutrition appropriately after surgery, which can help the body to successfully survive the surgery and promote wound healing, but it should not be too greasy or overeating. Malnutrition and the resulting obesity are detrimental to breast cancer recovery. Patients who still need radiotherapy and chemotherapy after surgery may experience gastrointestinal reactions such as loss of appetite, nausea and vomiting. At this time, they should insist on eating easily digestible, non-greasy food to provide sufficient energy for the body.
4. Moderate exercise: Breast cancer patients may have varying degrees of functional impairment in their upper limbs due to the impact of surgery, such as limited lifting. Therefore, patients should carry out postoperative rehabilitation exercises under the guidance of medical staff as soon as possible. It should be noted that activities should be done gradually to avoid excessive force that affects wound healing.
Patients should not engage in strenuous activities in the upper limbs for one week after surgery. Patients with fluid accumulation should suspend activities, but try not to stop exercising.
5. Good living habits: do not smoke or drink, stay away from smoking environments, drink less coffee, tea, etc., avoid high-calorie and high-fat food intake, and keep bowel movements smooth.
6. Follow-up: Breast cancer patients should insist on follow-up and re-examination. Generally, the first re-examination is within half a year after the operation. It is recommended to re-examine once every six months within 2 years after the operation. If there is no change, it will be extended to 1 year. once.
How long can one live with late-stage breast cancer? On this issue, since everyone's individual situation is different, it is impossible to predict how long an individual will live. Depending on each person’s physical condition, cancer stage, type, and treatment response, some people may achieve long-term survival or even be cured.
Even for advanced breast cancer, with the development of modern treatment technology, many patients can achieve long-term tumor-bearing survival or even long-term tumor-free survival. According to statistics from the American Society of Clinical Oncology, even for breast cancer patients with advanced metastasis, the 5-year survival rate can reach more than 20% (meaning that for every 100 newly diagnosed patients with advanced breast cancer, more than 20 patients will survive More than 5 years. )
The treatment level of many large tertiary hospitals in China is very close to the international level, and this data also statistics on the survival rate of patients 5 years ago. In recent years, new drugs have been continuously launched for patients with advanced breast cancer, such as the CDK4/6 inhibitor Aibosin (palbociclib capsules), combined with aromatase inhibitors (such as letrozole, anastrozole, exemestane ) is used for hormone receptor-positive, HER2-negative postmenopausal advanced breast cancer, which can significantly extend the tumor control time (prolonging progression-free survival by 10 months). Other new drugs including PAPR inhibitors and immunotherapy are also actively undergoing clinical trials. It is believed that more and more late-stage patients will survive for more than 5 years or even longer.
When I saw this question, I was really moved. It is a question that is often faced and difficult to answer.
There are several common questions about this question. It is the question most often asked by patients with advanced cancer to doctors. It is also the question most frequently asked by patients’ families behind their backs to doctors. It is a question that no expert, no matter how famous, can give an accurate answer. This is the question that doctors are most unwilling to face, and it is also the question that medical researchers most want to prevent the answer from being extended indefinitely.
I don’t know what role the questioner is, a patient or a family member. Generally, for patients, doctors will try to speak as long or vaguely as possible to give patients hope, while for family members, they will speak as short as possible. , let the family members be psychologically prepared, let the family members understand as much as possible the peace and face the terminal state of advanced cancer patients, and let the family members have behavioral preparations, such as helping the patients fulfill some wishes, trying to let relatives accompany them and other humane help.
To be honest, for advanced cancer, an experienced doctor can probably judge how much time the patient has to survive based on the response to treatment and the progression of the disease. Although this judgment is generally based on It is not so precise, for example, it will be expressed as 1-2 months/4-6 months/no more than half a year, etc. But when the doctor told the time, he felt helpless and depressed.
Despite this, we still encounter some unexpected surprises from time to time. People who thought they would live for up to three months ended up living far longer than this time limit. Therefore, for patients and their families with late-stage breast cancer, there must be hope. First of all, there are various treatment methods for breast cancer, just like there are eighteen kinds of martial arts. In the end, various methods can be used interchangeably, and sometimes they will be effective. Secondly, the research on breast cancer has far higher effectiveness among various solid cancers. Leading and various advanced treatment concepts and methods can be used, especially when economic adjustments allow. In addition, we call distant metastasis of breast cancer as advanced breast cancer, but the survival period is also very different depending on the location of metastasis. The survival time of brain metastasis is very short. It seems that a young singer named Yao died of brain metastasis. , but if it is bone metastasis, it can survive for a long time, several years is very common. It also depends on the type of breast cancer. If you are sensitive to the drug, you can get better results.
What we call the survival time of advanced breast cancer is the average time. That is to say, in the past period of time, under the current technical level, the average survival time of several breast cancer patients with metastasis to a certain organ was How long the patient survived is a retrospective statistical result, so this time indicator has no effect on the individual, because no one can predict whether the patient's survival time will be above or below the average number. For the same person, one One drug regimen is 20% effective, and one is 30% effective. If the price difference is huge, which one should you choose? If you choose the expensive one, you can guarantee that it will be among the 30% effective. Within? Therefore, this probability, including the prediction of survival time, has no meaning to the individual. Therefore, doctors are not fortune tellers, nor are they in charge of the book of life and death. They cannot tell how long anyone can live.
Therefore, for patients with advanced cancer, there is no need for the patient or his family to ask this question. For the patient himself, the more important thing is not to find out how long he can live, but to find out how long he can live while he is still awake. Feel the sunshine every day, breathe every breath of fresh air, and think clearly about your plans, because the choice of treatment plan is in your own hands. Whether you choose to give it a try or let it go, whether you choose to live comfortably for a short period of time, or go through it all To gain the maximum length of life through hard work, it depends on whether you listen to your heart, accept the arrangements of your family, give yourself enough rest, or work hard to complete your unfinished wishes or career, etc. For family members, don’t secretly ask the doctor how long your family member with cancer can live, and often show concern behind the patient’s back. The important thing is how to choose between spending time with your family and being busy with your own work and life. This is a waste of money. To use all treatment methods at all costs to save the family, it is better to first figure out how the patient wants to walk the rest of the way, and whether he can calmly face the situation of spending money like water, or even going bankrupt and borrowing debt. My condition is still getting worse. Can I calmly face my family members who are constantly moaning in pain and do a good job of nursing? These questions seem simple, with only yes or no answers, but who can answer these questions instantly? As a doctor, it is difficult for me to answer. This is not a purely medical issue, but a social, ethical, moral, and belief issue. , is a question of life, values, and pain. Perhaps, for some people, it is an unsolvable question, a question that has nothing to do with right or wrong.
At this point, it feels a little heavy. Let me tell you a story. I have a young breast cancer patient, less than 30 years old. When lung metastasis was discovered after the operation, the child was still in kindergarten. She asked me if I could survive until the child went to elementary school. Even if I left, I felt relieved. When my child went to elementary school, she asked me if I could live to see her tenth birthday. She was still so young, and I really wanted to stay with her until she was ten. . . . . .
Therefore, the question in the title is meaningless. What is important is to have hope, feel the love of relatives, and make a unique farewell to the world, a farewell that everyone must face.
The survival time of patients with advanced breast cancer is related to the pathological type, molecular type, lymph node status, metastatic sites and lesions of the primary tumor. In addition, age factors, patient compliance, and tolerance to treatment must also be taken into consideration. Some months, some years, and some can almost reach a normal life after treatment. Statistics show that the overall median survival time of patients with advanced breast cancer is 2 to 3 years, and the situation is different for different molecular subtypes.
Of the new breast cancer cases each year, 3% to 10% of women have distant metastases at the time of diagnosis. 30% to 40% of early-stage patients can develop into late-stage breast cancer, and the 5-year survival rate is about 20%. The treatment of advanced breast cancer is a complex process, which requires comprehensive consideration of multiple factors such as the tumor itself, the patient's physical condition, and existing treatment methods. In short, the treatment principle of advanced breast cancer is to control the development of the disease, improve the quality of life, prolong survival time, and allow patients to achieve quality long-term survival.
According to different molecular types, the treatment options for advanced breast cancer are also different. For patients who are hormone receptor (ER/PR) positive (Luminal type), endocrine therapy or chemotherapy may be considered. Usually, endocrine therapy should be the first choice for patients with slow disease progression, tumor metastasis in bone or soft tissue, or patients with small visceral metastases, mild symptoms, and a high ER/PR positive ratio, whereas chemotherapy should be the first choice. For HER-2-positive patients, anti-HER-2 treatment should be the first choice. Usually anti-HER-2 targeted therapy combined with chemotherapy can also be considered for a small number of patients with very slow disease progression and low tumor burden. Anti-HER-2 targeted therapy combined with endocrine therapy. Patients with triple-negative breast cancer should undergo chemotherapy. For patients with visceral metastasis who need rapid disease control, rapid disease progression, and obvious symptoms, two-drug combination chemotherapy should be considered; conversely, single-agent chemotherapy should be considered for patients with relatively slow disease, bone or soft tissue metastasis, and indistinct symptoms.
There are different types of advanced breast cancer. The prognosis of patients with multiple metastases throughout the body is indeed poor. Why are they prone to recurrence and metastasis? This shows that the clinical stage of the tumor itself is relatively late and the tumor's invasiveness is relatively high, so this treatment is relatively troublesome. For a small number of patients with metastases, there is still a possibility of cure. I have a patient with bone metastasis and lung metastasis. After endocrine treatment, the bone metastasis has been basically cured. Lung metastasis was a concern. After surgical treatment and radiotherapy, the effect was very good. Local treatments such as surgery and radiotherapy have been used in advanced breast cancer, especially in a small number of patients with metastasis. In recent years, the results have been very good. Some patients can achieve long-term disease-free survival after standard treatment. Therefore, treatment cannot be given up at any time.
How long patients with advanced breast cancer or other types of advanced cancers have to survive depends on the patient’s various circumstances. To put it simply, the following three aspects can be considered:
1. The patient’s overall health status. If the patient’s overall health status is good, the survival period will be long. If the patient’s overall health status is poor, the survival period will be short. Especially the patient’s own psychological state, As long as the mental state is good, the survival period will be long; if the patient's own mental state is poor, and even if he only wants to leave this world as soon as possible every day, the survival period will be short. Although in our country, the party and the country are in order to safeguard the interests of the broad masses of the people. The scope of social medical insurance is constantly expanding, including medical insurance for serious illnesses. However, some families and individuals are still trapped and impoverished due to illness. Therefore, some patients take the initiative to give up on their own health out of unwillingness to burden their families or relatives. effort! This is also the saddest!
2. The place where the patient receives medical treatment, the hospital environment, and the cancer treatment technology and methods used are all factors that need to be considered. On the premise that the patient still maintains a strong desire to survive, the doctor uses Treatment methods and drugs play a decisive role. There are a few medical institutions and medical research in China that have better medical treatment methods for various types of cancer, including late-stage cancer, which can effectively delay the survival of patients.
3. The motherland’s medical treasure house is vast and profound. Traditional Chinese medicine classics believe: “What is medicine? Clothes when cold are medicine, and food when hungry is medicine. If there is stomach qi, there will be life, if there is no stomach qi, there will be death!” Patients choose daily medicine. A good diet is also an important factor in surviving cancer and prolonging the survival period of various types of late-stage cancer patients. Choose food, beverages, and health care products that are both medicinal and edible and have anti-cancer effects that are recognized by the motherland’s medicine and produced by regular enterprises. Prolonging survival or even improving the condition may have unexpected effects!
@ Doctor Liu Yongyi No. WD405
The survival time of late-stage breast cancer varies greatly, which is related to pathological grade, hormone receptor status, HER-2 status, Ki-67 and the patient’s body Condition and treatment attitude are closely related. Some people have studied the relationship between CTC circulating tumor cells in the blood and prognosis, which is relatively accurate, and is currently only examined in some top hospitals. Patients with bone metastasis without organ metastasis have a long survival time after reasonable treatment, but the survival time of patients with visceral metastasis or combined with bone metastasis is much worse. There are also some unscientific treatments, such as patients seeking treatment from "miraculous doctors", who almost get no treatment at all.
We cannot give up easily on advanced breast cancer. We need to conduct individualized assessment. Is it initial treatment or postoperative recurrence? Organ metastasis or bone metastasis? Or do they all exist? Hormone receptor status, HER-2 status, physical ECOG score, organ function, presence of comorbidities, etc. Only with objective and correct assessment can we have an appropriate treatment plan.
In addition to chemotherapy and targeted therapy, there is also a special treatment for late-stage breast cancer, endocrine therapy! For hormone receptor-positive patients, if there is no serious, life-threatening organ metastasis, endocrine therapy is the first option. The condition will be evaluated every 2-3 months. If the condition is stable and there is no progression, treatment will be continued.
If the HER-2-positive patient's physical condition is not bad, targeted chemotherapy can be used. If the economy allows, dual-target drugs can also be used in combination, such as trastuzumab combined with pertuzumab. anti. Triple-negative breast cancer is the worst. It metastasizes quickly and easily spreads to the brain and internal organs. Currently, the main method is chemotherapy. There is news that research on targeted therapy for triple-negative breast cancer has initially achieved results.
Whether they say it or not, patients with advanced breast cancer and their families basically understand that the disease cannot be cured with current treatments, so everyone hopes that it is best for the tumor to be controlled and not develop. With slight changes in indicators, The patient immediately became agitated. We must choose an effective treatment plan with fewer side effects to reduce the discomfort caused by treatment. Quality of life is also something we should pay attention to.
Breast cancer is a relatively malignant tumor. How long a patient can survive in the late stage of breast cancer depends on the patient’s physical constitution (physical fitness), treatment methods, and the patient’s sensitivity and compliance to treatment. The later stage is determined by many factors such as the patient's nutritional status and psychological problems.
Relatively speaking, the physical condition is relatively good. Systemic treatment and local treatment are carried out for advanced tumors. In addition, economic conditions allow the addition of targeted therapy and endocrine therapy. During the treatment process, the patient is relatively sensitive to the drugs used and By actively cooperating with doctors’ treatment, even advanced breast cancer can still survive for a long time.
However, for patients with poor physical health, no treatment or failure to cooperate with treatment, and psychological pressure, breast cancer progresses faster and the life cycle is shorter.