How long can patients with advanced breast cancer live?
This paper holds down the transferred part and tells them respectively:
What is advanced breast cancer:
Advanced breast cancer refers to breast cancer with distant organs, such as liver, lung, bone and brain metastasis.
I. Bone metastasis of advanced breast cancer:
First of all, breast cancer is the most common cause of bone metastasis of malignant tumor.
Bone metastasis of breast cancer: thoracic vertebrae, lumbar vertebrae and pelvis are the most common, followed by ribs and femur. Bone metastasis is found: it is often found accidentally due to pain in the fixed part or fracture.
Examination of bone metastasis of breast cancer: radionuclide bone scan (ECT), CT, X-ray film, etc. Magnetic resonance imaging can be done when necessary to understand the compression of spinal cord nerves.
Prognosis of bone metastasis: Patients with simple bone metastasis (no other organ metastasis) can survive for a long time, and bisphosphonates (zoledronic acid) can be used for symptomatic treatment.
Second, liver and lung metastasis of advanced breast cancer:
Lung metastasis: Typical symptoms are cough, chest tightness, occasional hemoptysis and phlegm. However, many patients have no symptoms in clinic, and pulmonary nodules are found by routine chest CT or chest X-ray.
Liver metastasis: there may be no symptoms in the early stage, and a series of nonspecific symptoms such as swelling and discomfort in the liver area, abdominal distension, jaundice, anorexia, fatigue and emaciation may also occur. In the late stage, there may be severe pain in the liver area and ascites due to cirrhosis.
Prognosis of liver-lung metastasis: related to the nature of metastasis. If the metastasis is hormone receptor positive, a single metastasis can be relieved by rescue chemotherapy, radiofrequency ablation or even surgery, or it can be given to the patient by endocrine therapy such as fulvestrant for a long time.
However, for multiple liver and lung metastases, the effect is poor, and the natural course of disease is about 6- 12 months. Therefore, it is suggested that patients should have regular liver and lung CT examinations.
Third, brain metastasis:
Brain metastasis of breast cancer is the worst prognosis. Because of the existence of blood-brain barrier, the effect of chemotherapy is poor, and radiotherapy is often used.
Most patients with brain metastases have a natural course of disease within six months.
Regular review items after breast cancer surgery: blood tumor markers, breast and axillary lymph node color Doppler ultrasound, hepatobiliary color Doppler ultrasound, chest radiograph, etc.
The survival time of advanced breast cancer can not be generalized, and it varies greatly according to the location of metastasis, pathology and genotyping.
Although they are all advanced breast cancer, according to medical staging, as long as there is distant metastasis, it is advanced, so there are single distant metastasis and multiple distant metastasis; There are intracranial metastasis and extracranial metastasis.
First of all, according to the tumor metastasis
Generally speaking, a single metastatic tumor, or "oligometastatic tumor", can be treated locally combined with systemic therapy due to the limitations of the lesion. After local surgery, radiofrequency ablation, gamma knife and other treatments, the metastatic lesions can be destroyed and then treated systematically. It is still expected to achieve complete remission and long-term survival.
However, if it is multiple metastasis, the chance of destroying all metastatic tumors will be lost, and the survival time will be much worse than that of rare metastasis, but the survival time depends on the pathology and genotyping of the tumor.
The prognosis of multiple intracranial metastases is the worst, because brain metastases directly endanger patients' lives, so the survival time of multiple brain metastases is generally short.
Two. Pathology and genotyping
The prognosis of triple negative breast cancer is the worst, because there is no effective treatment except chemotherapy, so the survival time is short.
However, breast cancer with hormone receptor positive (HR+) and Her-2 negative has the opportunity of endocrine therapy besides chemotherapy control. So even if there is distant metastasis, it is still expected to be controlled for a long time.
For patients with over-expression of Her-2 (Her-2+), it is still expected that the advanced patients will control their disease for a long time because of the powerful anti-Her-2 targeted drugs.
In short, the survival time of patients with advanced breast cancer can be 1-2 years or 3-5 years, and some patients can even reach 10 years. It depends on the specific situation of patients, the number of treatment methods, the sensitivity of patients to treatment, and the economic situation of patients' families.
Back to this question, how long can patients with advanced breast cancer live? If you answer this question roughly, there are various possibilities, one month, several months, half a year, one year, three years, five years, or even more than ten years. You see, if you say it, you won't say it. Because it is also the late stage of breast cancer, the condition of different patients is different. For example, it is also distant metastasis, but bone metastasis is definitely not the same as liver metastasis and brain metastasis. Brain metastasis is much more serious than bone metastasis. For example, breast cancer with liver metastasis and er-positive breast cancer are better than triple-negative breast cancer, with more treatments and good prognosis, and sometimes the survival time varies greatly. Of course, whether active treatment and standardized treatment also affect the survival time.
Again, don't start to think that you can live for a long time as soon as you hear that it is advanced. Find a reliable doctor to evaluate the condition and actively treat it. Many breast cancers can survive for a long time. Of course, not all patients, so it depends on the specific condition.
Postoperative survival of different stages of breast cancer: how long can breast cancer live?
Breast cancer is one of the most common malignant tumors in women, and the incidence rate is on the rise, and the incidence population is also showing a trend of younger age. Breast cancer is still unable to achieve primary prevention. Therefore, early detection, early diagnosis and early treatment are very important to reduce breast cancer mortality and improve patient survival rate. The typical manifestations of breast cancer are: painless lump can be felt in the breast, the edge of the lump is blurred, the activity is low, and sometimes nipple discharge, nipple invagination or orange peel-like changes appear in the skin. If patients have the above symptoms, they need to go to the hospital in time, which is conducive to finding early lesions. So how to treat breast cancer?
Surgery plays an important role in the diagnosis, staging and comprehensive treatment of breast cancer. Generally speaking, doctors will combine surgery with other radiotherapy and chemotherapy methods according to the specific situation of patients, so as to achieve the goal of radical cure of breast cancer and avoid recurrence. In recent years, due to the in-depth understanding of breast cancer, it is found that breast cancer is a systemic disease, and the size of the surgical scope does not seem to affect the therapeutic effect of breast cancer. Therefore, breast-conserving surgery also came into being. For stage ⅰ and ⅱ breast cancer, breast-conserving surgery can be chosen on the premise of strictly grasping the indications. For patients who are not suitable for breast conservation, breast reconstruction can be performed after mastectomy to improve the quality of life and confidence of patients. At the same time, axillary sentinel lymph node biopsy can help doctors judge whether the axillary lymph nodes of patients have metastasis. For patients without axillary lymph node metastasis, traditional axillary lymph node dissection can be avoided, and postoperative complications such as edema and dysfunction of upper limbs can be reduced.
Radiochemotherapy is an important auxiliary method for the treatment of breast cancer. At the same time, neoadjuvant therapy can be performed before operation. As long as neoadjuvant therapy is aimed at breast cancer patients without distant metastasis, preoperative systemic therapy is the first step in breast cancer treatment. Neoadjuvant therapy includes adjuvant chemotherapy, adjuvant targeted therapy and adjuvant endocrine therapy. At present, evidence-based medicine shows that the curative effect of neoadjuvant therapy is similar to that of adjuvant therapy with the same scheme and course of treatment (postoperative), but it can make some patients who can't operate get surgery opportunities and make more patients have the possibility of preserving their breasts.
What is the postoperative cure rate of breast cancer at all stages?
Breast cancer is divided into four stages, in which the first stage means that there is a corresponding lump in the breast, cancer cells appear but have not spread, and the breast lump is 2cm, at which time the cure rate of breast cancer can reach 95%; The cure rate of stage ⅱ breast cancer is about 75%, and the breast masses are 2cm and 5cm, which have begun or will soon invade lymph nodes. At this time, if diagnosed and treated in time, breast cancer can be controlled from local treatment; The breast mass of stage ⅲ breast cancer is 5cm, and the cancer cells have spread to the lymphatic system and even to the skin. At this time, total mastectomy and systemic treatment are needed, and the cure rate is generally around 55%. Stage ⅳ breast cancer is advanced. At this time, the cancer cells have spread to the whole body, and the cure rate is only about 10%. After breast cancer is cured, there is still a recurrence period of five or ten years. If it doesn't recur within five or ten years, then breast cancer has been cured, so don't worry.
What should I pay attention to after breast cancer surgery?
The 5-year survival rate of female breast cancer patients in China is about 73%(7 1.2%-774.9%), which can reach 80% in cities with good medical conditions. The overall survival of breast cancer is better than other malignant tumors. According to the research report, the lifestyle of breast cancer patients will affect the prognosis. The influence of patients' diet, weight changes, smoking and drinking and other personal lifestyles is closely related to tumor metastasis and recurrence.
1, timely postoperative radiotherapy and chemotherapy: radiotherapy and chemotherapy can further help to remove residual cancer cells, and patients should choose according to specific surgical methods, tumor stages and pathological types.
2, mental relaxation: breast cancer is a serious disease, but it is not an incurable disease. Relatives should give patients the greatest consideration and care, let patients bravely express their ideological fears and depression, and then comfort them, so as to eliminate patients' fear and mental stress of cancer, maintain a stable and optimistic mood, and improve patients' confidence and fun in life. A good attitude will help improve the treatment effect.
3, supplementary nutrition: patients should be moderately supplemented with nutrition after surgery, which can help the body to survive the operation smoothly and promote wound healing, but not too greasy or overeating. Malnutrition and obesity are not conducive to the rehabilitation of breast cancer. Patients who still need radiotherapy and chemotherapy after surgery may have gastrointestinal reactions such as loss of appetite, nausea and vomiting. At this time, they should insist on eating digestible and non-greasy food to provide enough energy for the body.
4. Moderate exercise: Due to the influence of surgery, breast cancer patients may have different degrees of dysfunction, such as limited lifting. Therefore, patients should take postoperative rehabilitation exercise under the guidance of medical staff as soon as possible. It should be noted that activities should be carried out step by step to avoid overexertion affecting wound healing. One week after operation, patients should not engage in strenuous activities of upper limbs, and patients with hydronephrosis should suspend their activities, but try not to stop exercising.
5. Good living habits: don't smoke or drink, stay away from the smoking environment, and try to drink less coffee and tea. Avoid high-calorie and high-fat food intake and keep the stool unobstructed.
6. Adhere to follow-up: Follow-up review should be adhered to after breast cancer surgery. Generally, the first reexamination should be carried out within half a year after operation, and it is recommended to reexamine once every six months within two years after operation. If there is no change, it will be extended to 1 year.
How long can breast cancer live in the late stage? This problem, because everyone's individual situation is different, it is impossible to predict how long an individual can live. Depending on physical condition, cancer stage, classification and treatment response, some people may survive for a long time or even be cured.
Even for advanced breast cancer, with the development of modern treatment technology, many patients can live with tumor for a long time, even without tumor for a long time. According to the statistics of American Clinical Oncology Association, the 5-year survival rate of patients with advanced metastatic breast cancer can reach more than 20% (that is, more than 20 patients can survive for more than 5 years per1000 newly diagnosed patients with advanced breast cancer). )
The treatment level of many large domestic top three hospitals is close to the international level. And this data is also the statistics of the survival rate of patients five years ago. In recent years, new drugs have been put on the market for patients with advanced breast cancer, such as the CDK4/6 inhibitor Aiboxin (piperacillin capsule), combined with aromatase inhibitors (such as letrozole, anastrozole and exemestane) to treat postmenopausal advanced breast cancer with hormone receptor positive and HER2 negative, which can obviously prolong the tumor control time (prolong the progression-free survival time 10 month). Other new drugs, such as PAPR inhibitors and immunotherapy, are also actively undergoing clinical trials. It is believed that more and more advanced patients will survive for more than 5 years or even longer.
It's really sad to see this problem. It is a question that is often faced and difficult to answer.
On this question, there are several most common questions, which are frequently asked by patients with advanced cancer, and also by patients' families behind their backs. There are also many famous experts who can't give accurate answers. It is also the last question that doctors want, and it is also the question that medical researchers want to extend this answer indefinitely.
I don't know what role the questioner is, the patient or the family. Generally speaking, doctors will try their best to speak long or vaguely for patients, so as to give them hope, while for family members, they will try their best to be brief, so that family members can be psychologically prepared, so that family members can understand the state of patients with advanced cancer calmly facing the advanced stage as much as possible, so that family members can be prepared for behavior, such as helping patients fulfill some wishes and being accompanied by their relatives as much as possible.
To tell the truth, an experienced doctor can probably judge how much time the patient can live according to the response to treatment and the progress of the disease, although this judgment is generally not so accurate, such as 1-2 months /4-6 months/less than half a year and so on. But when the doctor said this time, his heart was helpless and depressed.
Nevertheless, we still encounter some unexpected surprises from time to time. We thought we could live for three months at most, but we lived far beyond this time limit. Therefore, there must be hope for patients with advanced breast cancer and their families. First of all, there are various treatments for breast cancer, just like there are eighteen martial arts. Finally, all kinds of moves are used in different places, and sometimes they will work. Secondly, the effective rate of breast cancer research is far ahead in all kinds of solid cancers, and all kinds of advanced treatment concepts and methods can be used, especially if economic adjustment allows. In addition, we call the distant metastasis of breast cancer as advanced breast cancer, but the survival time varies greatly with different sites of metastasis, and 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, and it is common for several years. According to the type of breast cancer, if you are sensitive to drugs, you can also get better curative effect.
The survival time of advanced breast cancer we are talking about is the average time, that is to say, in the past period of time, how long did several breast cancer patients with organ metastasis survive on average under the existing technical level? This is a retrospective statistical result, so this time index has no influence on the individual, because no one predicts whether the patient's survival time is above or below this average. As far as the same person is concerned, the effective rate of a drug program is 20%, and the effective rate of a drug program is 30%. If the price difference is huge, which one should I choose? If I choose the expensive one, can I guarantee that it will fall within the 30% effective range? So this probability, including the prediction of survival time, doesn't mean anything to individuals. So doctors are not fortune-tellers, let alone in charge of life and death books, and they can't figure out how long anyone can live.
Therefore, for patients with advanced cancer, it is unnecessary for patients and their families to ask this question. For patients themselves, it is more important not to know how long they can live, but to be proactive when they are awake, feel the sunshine every day, breathe every breath of fresh air, and figure out their plans, because the choice of treatment plan is in their own hands, whether to let go or let go, or choose a comfortable short time. It is still very difficult to strive for the maximum length of life, listen to your heart, accept the arrangement of your family, let yourself get a full rest, or try to complete the unfinished wish or career, and so on. For family members, don't secretly ask doctors how long their cancer family members can live, and often show concern behind the patients. What is important is how to choose between staying with family and being busy with work and life, whether to spend all the money to save the family at all costs, or whether to find out how the patient wants to walk the rest of the way, whether to face the situation of spending money like water or even borrowing money, whether the family's situation is getting worse and worse, and whether to face the constant pain calmly. These questions seem simple, and the answers are only yes or no, but who can answer these questions at once? As a doctor, it is difficult for me to answer them. This is not a simple medical problem, but a social, ethical, moral, belief, life, values and painful problem. Perhaps, for some people, it is an unsolved problem, which has nothing to do with right or wrong.
It's a bit heavy to say so much. Tell a story. I have a young breast cancer patient, less than 30 years old. The child was still in kindergarten when lung metastasis was found after operation. She asked me if I could live to see my children go to primary school. I'm relieved when my child goes to primary school. When the child was in primary school, she asked me if I could live to see the child's tenth birthday. She is so young that she really wants to accompany her until she is ten years old. . . . . .
So the question of the title is meaningless. It is important to have hope, feel the love of relatives, and make a unique farewell to the world, a farewell that everyone has to face.
The survival time of patients with advanced breast cancer is related to the pathological type, molecular classification, lymph node status, metastatic site and focus of the primary tumor. In addition, age factors, patients' compliance and tolerance to treatment should also be considered. Some months, some years, and some can almost reach normal life after treatment. Statistics show that the overall median survival time of patients with advanced breast cancer is 2 ~ 3 years, and the situation of different molecular subtypes is different.
Among the new cases of breast cancer every year, 3% 10% of women had distant metastasis when they were diagnosed. 30% and 40% of early patients can develop advanced breast cancer, and the 5-year survival rate is about 20%. The treatment of advanced breast cancer is a complicated process, and many factors such as the tumor itself, the patient's physical condition, existing treatment methods and so on should be considered comprehensively. In short, the treatment principle of advanced breast cancer is to control the development of the disease, improve the quality of life, prolong the survival time, and let patients get long-term quality survival.
According to different molecular typing, the treatment of advanced breast cancer is also different. For patients with hormone receptor (ER/PR) positive (luminol type), endocrine therapy or chemotherapy can be considered. Generally speaking, endocrine therapy should be the first choice for patients with slow progress, tumor metastasis to bone or soft tissue, or small visceral metastasis, mild symptoms and high ER/PR positive ratio, otherwise chemotherapy should be the first choice. For HER-2 positive patients, anti-HER-2 therapy should be the first choice, usually anti-HER-2 targeted therapy combined with chemotherapy. For a few patients with very slow progress and low tumor load, anti-HER-2 targeted therapy combined with endocrine therapy can also be considered. Patients with triple negative breast cancer need chemotherapy. For patients with visceral metastasis who need to control the disease quickly, the disease progresses rapidly and the symptoms are obvious, we should consider giving two drugs combined chemotherapy; On the contrary, for patients with relatively slow disease, bone or soft tissue metastasis and inconspicuous symptoms, single drug chemotherapy should be considered.
There are different types of advanced breast cancer, and the prognosis of patients with multiple systemic metastases is really bad. Why is it easy to relapse and metastasis? It shows that the clinical stage of the tumor itself is relatively late and the tumor is relatively aggressive, so this treatment is more troublesome. For a few patients with metastasis, there is still the possibility of cure. I have a patient with bone metastasis and lung metastasis. After endocrine therapy, bone metastasis basically recovered, and lung metastasis was the focus. After surgery and radiotherapy, the effect is very good. In recent years, surgical radiotherapy and other local treatments have been used to replace advanced breast cancer, especially in a few metastatic patients. In fact, the effect is very good, and some patients can get long-term disease-free survival after standardized treatment. Therefore, you must never give up treatment.
How long does it take for patients with advanced breast cancer or other types of advanced cancer to survive? This depends on the patient's own situation in many aspects. In short, it can be considered from the following three aspects:
First, the patient's own comprehensive health status, if the patient's own comprehensive health status is good, the survival time will be long, while the patient's own comprehensive health status is poor, the survival time will be short, especially the patient's own psychological state, their own psychological state is good, the survival time will be long; Patients' mental state is poor, even they just want to leave this world as soon as possible every day, and their survival time is short, although in our country, the party and the state are trying to safeguard the interests of the broad masses of the people. The social medical insurance coverage has been continuously expanded, including medical insurance for serious illness, but some families and individuals are still poor due to illness. Therefore, some patients voluntarily give up their efforts to improve themselves because they don't want to drag down their families and their loved ones! This is also the saddest!
Secondly, the place where patients receive medical treatment and the hospital environment, as well as the cancer treatment technology and methods adopted, are all factors to be considered. Under the premise that patients still maintain a strong desire to survive, the treatment methods and drugs adopted by doctors play a decisive role. A few medical institutions and medical research institutions in China have good medical treatment methods for various cancers, including advanced cancers, which can effectively delay the survival of patients.
Third, the medical treasure house of the motherland is extensive and profound. The classic of Chinese medicine says, "What is medicine? Cold clothes are medicine, and hungry food is medicine. If you have stomach qi, you will be born, and if you don't have stomach qi, you will die! " The diet that patients choose every day is also an important factor to live with cancer and prolong the survival time of patients with various advanced cancers. Choosing foods, drinks and health products that are recognized by traditional Chinese medicine and produced by regular enterprises and have anti-cancer effects may have unexpected effects on prolonging the survival period of patients and even improving their condition!
@ Dr. Liu Yongyinuo. WD405
The survival time of advanced breast cancer varies greatly, which is closely related to pathological grade, hormone receptor status, HER-2 status, Ki-67, patients' physical condition and treatment attitude. Some people have studied the relationship between CTC and the prognosis of circulating tumor cells in the blood, which is more accurate. At present, it is only checked in some top hospitals. After reasonable treatment, the survival time of patients with bone metastasis without visceral metastasis is longer, while the survival time of patients with visceral metastasis or bone metastasis is much worse. There are also some unscientific treatment methods, such as patients looking for "imperial doctors" for treatment, which is almost impossible.
You can't give up advanced breast cancer easily, so you should make an individualized evaluation. Is it the first treatment or postoperative recurrence? Organ metastasis or bone metastasis? Or do they all exist? Hormone receptor status, HER-2 status, body ECOG score, organ function, complications, etc. Only by objective and correct evaluation can we have a suitable treatment plan.
In addition to chemotherapy and targeted therapy, there is a special treatment for advanced breast cancer, endocrine therapy! For hormone receptor positive patients, if there is no serious and life-threatening organ metastasis, endocrine therapy should be chosen first, and the condition should be evaluated every 2-3 months 1 time, and the treatment will continue smoothly without progress.
If HER-2 positive patients are in good health, targeted chemotherapy can be used, and if the economy permits, dual-target drugs can also be combined, such as trastuzumab combined with pettuzumab. Triple-negative breast cancer is the worst, with fast metastasis and easy metastasis to brain and organs. At present, the main method is chemotherapy. It is reported that the research on targeted therapy of triple negative breast cancer has achieved initial results.
Patients with advanced breast cancer and their families, whether they say it or not, basically understand that this disease cannot be cured by current treatment methods, so everyone hopes that the tumor will be controlled, and it is best not to develop. If the indicators change slightly, patients will be agitated immediately. It is necessary to choose an effective treatment scheme with little toxic and side effects, reduce the discomfort caused by treatment, and pay attention to the quality of life.
Breast cancer is a relatively malignant tumor. How long you can live in the late stage of breast cancer depends on many factors, such as the patient's constitution (physical quality), treatment methods, sensitive compliance of patients with treatment, nutritional status of patients with advanced stage, psychological problems and so on.
Relatively speaking, the physical condition is better. For systemic treatment and local treatment of advanced tumors, economic conditions permit the increase of targeted therapy and endocrine therapy. During the treatment, patients are more sensitive to drugs and actively cooperate with doctors. Even for advanced breast cancer, the survival time is still very long.
However, for patients with poor health, no treatment or no cooperation with treatment, and high psychological pressure, breast cancer progresses rapidly and its life cycle is often short.