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Breast Cancer

continued from page 6
List of Contents
Overview
Risk factors
Staging of Breastcancer
Prognostic Factors

Prognostic factors
So, how do you know if the chosen treatment is the right one? Your doctor will try to determine your prognosis - the likely outcome after treatment. Prognostic indicators are characteristics that may help predict whether the disease will recur.

The prognostic indicators most commonly used are:

Lymph node involvement. Lymph nodes in the underarm or chest are a common site where breast cancer spreads. Doctors usually remove at least 10 of the underarm lymph nodes to determine whether they contain cancerous cells. If cancer is found, the woman is said to be 'node positive.' If the lymph nodes are free of cancer, the patient is said to be 'node negative.' Women who have positive nodes are more likely than those with negative nodes to have a recurrence of breast cancer.
Tumour size - in general, patients with small tumours have a better prognosis than patients with large tumours.
Histologic grade. This term refers to how much the tumour cells resemble normal cells when viewed under the microscope. The grading scale usually ranges from one to three. Grade one tumours are composed of cells that closely resemble normal ones; grade three tumours contain very abnormal-looking and rapidly growing cancerous cells.
Hormone receptors. Cells in the breast contain receptors for the female hormones oestrogen and progesterone. These receptors allow the breast tissue to grow or change in response to changing hormone levels. Research has shown that about two-thirds of all breast cancers contain significant levels of oestrogen receptors. These tumours are said to be oestrogen receptor positive (ER+). About two-thirds of ER+ tumours also test positive for receptors to progesterone (PR+). Tumours that are hormone receptor positive are more likely to respond to hormone therapy, and they also tend to grow less aggressively, resulting in a better prognosis for patients with ER+ tumours.
Proliferative capacity of a tumour. This characteristic refers to the rate at which cancer cells in a tumour divide to form more cells. Cancer cells that have a high proliferative capacity divide more often and are more aggressive (fast growing) than those in tumours with a low proliferative capacity.
Oncogene expression and amplification. An oncogene is a gene that causes or promotes unrestrained growth of a cell. The activation of an oncogene can convert a normal cell into a tumour cell. Research has shown that patients whose tumour cells contain certain oncogenes may be more likely to have a recurrence. Tests for oncogenes are experimental.

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