The people whose discussions fill the Breastcancer.org forums are savvy folks. They are highly informed about the details of breast cancer—they read the research and discuss it like pros. So, when they came across an essay in The New York Times that presented some frightening statistics, they questioned it.
The piece, “Finding Little Comfort in the Statistics of Survival,”was written by Ellen D. Feld, M.D., an internist and teacher at Drexel University. Feld was diagnosed with a 2.2-centimeter tumor with no affected lymph nodes, making hers a stage IIA cancer. Her chances of survival, she writes, referring to an unnamed book, are at 70 percent for five years and 50 percent at ten years.
The writers on the BCO discussion boards, though, wanted to know where Feld got those numbers, as they are odds with their own research. Clarify and verify, they said.
“I notice the author doesn't quote a source for the numbers,” wrote Michelleo13.
“There is something we don't understand about those statistics,” wrote Mitymuffin.
This discussion thread was for women with triple-negative breast cancer and many of the writers also noted that Feld’s numbers don’t necessarily match the stats for TNBC. And nowhere in the article does she say what type of breast cancer she had—an omission that makes significant difference, as the statistics can vary a great deal from cancer to cancer, and TNBC women have much better long-term survival rates once they hit three years past diagnosis.
I appreciate Feld’s position of constantly worrying. We do that. In fact, I have written about it myself.
But why make others worry more? This is the unintentional result of Feld’s piece, which is otherwise well written. Wouldn’t it be better to advance the dialogue of hope rather than of terror?
So, let’s clarify and verify survival rates for TNBC.
In a study at the M.D. Anderson Cancer Center and published in the Journal of the National Cancer Institute (2008) of 2,838 women treated between 1985 and 2001:
• 93 percent of women with hormone-negative breast cancer had no recurrences within 5 years
• 89 percent had no recurrences after 10 years.
• They did not break other figures down by hormone receptor status, so these figures apply for all breast cancers: Within five years, those with stage I cancer had a 7 percent risk of recurrence; stage II faced an 11 percent risk; and stage III faced a 13 percent risk. Nowhere is there a 50 percent risk.
And in research on 1,601 patients with breast cancer diagnosed between 1987 and 1997 and published in Clinical Cancer Research (2007) at Women’s College Hospital in Toronto:
• The death rate for those ten years after diagnosis was zero. Nothing. Nada. No deaths.
• Most deaths were within one to three years of diagnosis.
I do not know where Feld’s numbers come from, but using these numbers as our guide, we can say estimate that, if her stage IIa tumor were triple-negative, she would face an 11 percent risk of recurrence within five years, a 0-11 percent risk within 10 years.
Remember that these are averages and are a bit like weather reports. When the forecaster says we face a 10 percent chance of rain on any given day, that means that, because of the specific weather conditions, there is a 1 in 10 chance it will rain. It seldom rains on those days. And we all can remember instances when the forecast told us a huge storm was coming and we ended up with sunny skies.
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