Learning About Breast Cancer
When cancer commences it is confined and then at a certain point is can spread - this is when it is called invasive breast cancer. It means it has left an encapsulated area and started to infiltrate into other cells in your body. Surgery, chemo, radiation, hormone therapy are common medical treatments.
However our breast cancer gets diagnosed at different stages of development and can be found in different locations. Some cancer cells may have spun off or escaped prior to treatment being finalised.
Cancer cells can stay in the immediate area of the tumour [called a local or ipsilateral recurrence in the same breast/s]., another cancer in the other breast [contralateral recurence], the overall general body area [called a regional recurrence] or a long way away from the original tumour [called a distant occurrence]. Not all recurrences are from the original treated cancer. Sometimes a completely new breast cancer develops.
It is likely from what you have said that your original breast tumour shed cancer cells prior to its removal. Breast cancer bone mets mean that is where those shed cells lodged. Bone mets can also arise from cancers apart from breast cancer.
For bone mets that came from breast cancer - they happen because within our breast we have blood supply that can take cells into the blood stream to circulate around the body. We also have internal mammary and other lymph nodes that can spread cells via our lymphatic system. That is why surgeons do an underarm [axillary] sentinel node biopsy when we have our surgery - they are testing to see if the cancer has spread to the lymph nodes. There is appox a 5% false negative rate for SNB - that is, cancer cells are there but were not detected via pathology or not enough underarm lymph nodes are removed. So that is another rarer way cancer cells can become mets. Internal chest mammary lymph nodes can also spread breast cancer cells.
The peak time for a BC recurrence to be diagnosed is the third year after diagnosis, You were diagnosed in 2009, so that puts your recurrence in the peak recurrence time.
If you want prognosis statistics you can log on to AdjuvantOnline! - fill in the online form stating you are a Dr [is not true but that does not matter] and voila, you have access to the database. You will need a copy of your histopathology report or at least the answers to the questions posed, you input your personal pathology data including your treatment regimes and recent diagnosis and you the get your prognosis.
I believe strongly in women having access to as much medical information as they want but others have different personalities and want their diagnosis and other information diluted to a lesser or greater extent. Obviously if you say you want to know all the facts about your diagnosis and you chose to access that material away from your treating medico, you must also be prepared for whatever information is revealed.
Some women after thinking it through choose to access this information with a support person present, others like me do it on their own and others prefer to wait till their medical appointment.
I had the unusual experience of my Oncologist twirling his chair around, logging on to AdjuvantOnline!, inputting the exact same stats from the same report and printing out the results - the same results I had printed out myself 2 weeks earlier! Happily I had been able to spend that 2 weeks combing through my results, doing research and coming up with a few highly focussed questions. The time meant I was not in shock during our appointment, I was extremely well prepared and the medical portion of my 20 minute specialist consultation took 7 minutes. The consult was so productive for me because I had my information, my emotions under control, my quick but highly focussed questions & I kept it businesslike. The Oncologist actually told his staff to charge me half the normal fee because it was from his point of view the most efficient consult he'd ever had.
The critical questions are:
1. Tell the specialist truthfully what you personality type and health is. I am a total coward when it comes to physical pain and I have serious allergies, so avoiding pain and allergies are high considerations for me.
2. What if any treatment if any are you recommending for me?
3. What does AdjuvantOnline! state is their algorithms result for each treatment option for someone with my stats on overall survival? ie., you are asking how long each treatment tends to prolong life. This is a critical question because most specialists have plenty of expensive and often painful treatments, but before saying yes or no to the treatment, knowing how long it tends to extend life is important information.
3. Can you have the full list of side effects from every treatment option to take away and consider. You especially want to know about quality of life impacts.
4. Ask if there is any dire problem with taking eg a few days or a week to consider your options and make your decision.
I always avoid the temptation to ask about who has survived the longest or the shortest as these are vast statistical extremes, and naturally people only want to tell me about the most optimistic anecdotes. I find other people's most optimistic anecdotes from friends of friends is not the reliable foundation I want to base my medical treatment decisions on. Adjuvant!Online has hard data fed into it from hundreds of thousands of women with BC over many years so has a sounder evidentiary foundation. Other people whose personalities require hearing only the most wildly optimistic stories will prefer that to my hard data approach.
Best wishes to you!