Cancer Research Lab

Remember – ‘5 year survival’ and ‘10 year survival’ are terms doctors use. This doesn’t mean you will only live 5 or 10 years. 10 year survival relates to the proportion of people in research studies who were still alive 10 years after diagnosis. Doctors follow what happens to people for 10 years or more after treatment in breast cancer research studies. This is because there is only a small chance that a cancer will come back more than 10 years after treatment. They do not like to say these people are cured because there is that small chance. So they use the term ‘10 year survival’ instead.

Statistics can be very difficult to get. We’ve tried to show them so that they are easy to follow. But unfortunately, some are 5 year survival figures and some are 10 year survival figures. We’ve said which is which, so please do check which you are looking at.

The overall outlook

As with many other types of cancer, the outcome of breast cancer depends on how advanced it is when it is diagnosed. In other words, the stage of your cancer. Overall, in England and Wales, 79 out of every 100 people diagnosed with breast cancer live for at least 5 years after diagnosis. About 72 out of every 100 people live for at least 10 years. The figures for Scotland are very similar.

It takes time to gather statistics and put them together. Doctors monitor women with breast cancer for many years. So the cancer statistics you see always relate to people diagnosed and treated some time ago. The outlook for breast cancer continues to improve. So bear in mind that figures for women treated more recently may be better.

Researchers have recently predicted survival rates so that we have more up to date figures. The first of these predictions were released in October 2005. They predict that 64 out of every 100 women diagnosed recently with breast cancer (64%) will live for at least 20 years. There is more about these predicted survival rates in our breast cancer question and answer section.

If breast cancer is going to come back, it is most likely to do so within the first 2 years. With some other types of cancer, you are likely to be cured if your cancer has not come back within 5 years. Unfortunately, breast cancer can come back 10 or 20 years after you were first diagnosed. But, this is not common and it is still true that the more time that passes since your diagnosis, the less likely it is that your cancer will come back.

The number of women dying from breast cancer has gone down by 20% in the past 10 years in the UK. This is probably for a number of reasons. In particular, the UK breast screening programme is picking up breast cancer earlier and treatments continue to improve. Overall, for women whose breast cancers were picked up during screening, 93 out of every 100 (93%) lived for at least 5 years after their diagnosis. And 88 out of every 100 (88%) lived for at least 10 years after their diagnosis.

The grade of your cancer

We know that the outlook for your cancer depends on how early it is diagnosed – its stage. But it also depends on something called the ‘grade’ of your cancer. The grade means the appearance of the cancer cells under a microscope. When your breast cancer is biopsied or removed, the tissue is sent to the lab where a pathologist looks at the cells and decides what grade they are. The more like normal breast cells they look, the lower the grade. And the more abnormal they look, the higher the grade. For breast cancer, there are 3 grades, called grade 1 (low grade), grade 2 (intermediate grade) and grade 3 (high grade). This is important because high grade cancers may be faster growing and more likely to spread. So doctors use grade to help decide on the best treatment for you. There is more about breast cancer grade in our question and answer section.

Outlook by stage and grade

Doctors work out the likely prognosis of breast cancer using something called the ‘Nottingham Prognostic Index’ (NPI). The index uses stage and grade. There are also online tools to help doctors make decisions on ther risks and benefits of treatments after surgery (adjuvant treatment).

DCIS
The prognostic index doesn’t include DCIS. There is very little risk of the cancer cells spreading in DCIS. They are trapped inside the ducts of the breast. So if you are diagnosed with DCIS and treated, you will almost certainly be cured.

Small, early breast cancers
The earlier a breast cancer is diagnosed, the smaller it is likely to be and the lower the chance that it will have spread. For breast cancers that are less than 2cm across, with no cancer in the lymph nodes and either low or intermediate grade (grade 1 or 2), between 85 and 89 out of every 100 women (85 – 89%) will live for at least 10 years after diagnosis.

For early breast cancers less than 2cm across, with no cancer in the lymph nodes, but where the cancer cells are high grade (grade 3), between 70 and 78 out of every 100 women (70 – 78%) will live for at least 10 years after diagnosis.

Breast cancers that are larger or have spread to lymph nodes nearby
It gets more complicated here. Between 70 and 78 out of every 100 women (70 – 78%) in the following situations live for at least 10 years after diagnosis

A cancer smaller than 2cm, low grade, with cancer in 4 or more lymph nodes
A cancer smaller than 2cm, intermediate grade, with cancer in 1, 2 or 3 lymph nodes
Cancer between 2 and 7cm, low grade, with cancer in 1, 2, or 3 lymph nodes
Cancer between 2 and 7cm, intermediate grade, with no cancer in the lymph nodes
Between 50 and 64 women out of every 100 (50 – 64%) in these situations live for at least 10 years after diagnosis

A cancer smaller than 2cm, intermediate grade, with cancer in 4 or more lymph nodes
A cancer smaller than 2cm, high grade, with cancer in 1, 2 or 3 lymph nodes
Cancer between 2 and 7cm, low grade, with cancer in 4 or more lymph nodes
Cancer between 2 and 7cm, intermediate grade, with cancer in 1, 2 or 3 lymph nodes
Between 20 and 42 women out of every 100 (20 – 42%) in these situations live for at least 10 years after diagnosis

Cancer between 2 and 7cm, intermediate grade, with cancer in 4 or more lymph nodes
Cancer between 2 and 7cm, high grade, with cancer in 1, 2 or 3 nodes
Any size cancer in the breast, high grade, with cancer in 4 or more lymph nodes
Breast cancer that has spread
In about 1 in 20 women (5%), the cancer has already spread to another part of their body when they are first diagnosed. Sadly, the outlook once a cancer has spread to another body organ is not so good. It is not curable at this point, but may be controlled for some time with the right treatment. About 1 in 5 of these women (20%) live for at least five years after their diagnosis. But only about 1 in 25 women (4%) will live for more than 10 years.

How reliable are these statistics?
No statistics can tell you what will happen to you. Your cancer is unique. The same type of cancer can grow at different rates in different people.

The statistics available are not detailed enough to tell you about the different treatments people may have had. And how that treatment worked for them. There are many individual factors that will determine your treatment and prognosis. For breast cancer, there seem to be more and more tests that specialists can take into account both to decide your treatment and to estimate how it will turn out.

Clinical trials for breast cancer treatments
People treated at centres where clinical trials are taking place tend to do better. This is almost certainly because that is where the most expertise is concentrated. Research is more likely to take place in specialist centres. For people in the trials, it may be partly to do with having a closer eye kept on them by their doctors than they might if not in a trial – for example, they may have more scans and blood tests. But it might also be something to do with morale. You may feel more positive if you are taking part in a trial because it is more obvious to you that something is being done to help you. There is more about understanding clinical trials in CancerHelp UK. You can search our clinical trials database for trials for breast cancer. Pick ‘breast’ from the drop down menu of cancer types.

Source: Cancer Research UK