Breast cancer is an abnormal growth of tissue in the breast that affects about 1 in 13 women in Singapore. Despite advancements in medical technology, curability varies based on a multitude of factors. Only one thing is clear: the earlier the cancer is detected, the higher the chances of a successful treatment. In this article, we will explore is breast cancer curable? What affects the survival rates, and the ongoing treatments to improve prognosis.
Is breast cancer curable?
When one says ‘the cancer is cured’, it means that the cancer is no longer in the body and is not expected to come back. However, one can never be sure whether the cancer will reappear and doctors cannot predict the future of one’s health.
Hence, doctors usually use the term ‘treatable’ or ‘in remission’, which means that cancer is currently absent in the body.
Depending on the type and severity of the cancer, the earlier the cancer is detected, the higher the chances of treating it.
What Is the Prognosis of Breast Cancer?
Prognosis is a term that predicts the expected development of a disease, including the person’s life expectancy. It is usually described as a 5-year or 10-year survival rate, which indicates the percentage of individuals with a diagnosed cancer to live past 5 and 10 years respectively.
According to the 2021 National Cancer Registry Report, breast cancer patients have an average of 82.5% age-standardised 5-year survival rate – the 3rd highest out of the top 10 cancers among women in Singapore.
Do note that the prognosis does not indicate that you only have a fixed number of years left to live. For example, a 5-year survival rate of 90% means that 90% of the population diagnosed with breast cancer survive past 5 years. This is relative to a large population and does not represent your chances for cure or remission. Each experience is unique based on general health, type of cancer, how one’s body responds to the treatment, and the advancements in treatment.
Knowing the survival statistics may be daunting to some but relief for others. It is up to you to decide how much information you wish to know. Do talk to your doctor about how you want to receive any information, as well as any concerns or feelings you may have about the diagnosis.
What Affects Breast Cancer Survival Rate?
Generally, survival rates are higher with earlier diagnosis and treatment. Nonetheless, various factors affect the survival rate of breast cancer:
Staging of cancer
In general, early-stage cancer has a higher survival rate than advanced-stage. The staging of cancer is determined by the tumour size, and whether it has spread to the lymph nodes and other parts of the body:
Stage 0/Stage 1: ductal or lobular carcinoma in situ, this stage of tumour is less than 20mm in diameter, is localised to the milk ducts or glands but has not spread to the surrounding breast tissues. At this stage, the cancer is highly treatable, with a near 100% 5-year survival rate.
Stage 2/3: Tumour is regional, meaning it has grown in size and spread to the axillary lymph nodes (near the underarms) or chest walls. The more common forms of breast cancer at this stage are:
- Invasive ductal carcinoma (IDC): Cancer originated in the milk ducts and has spread to surrounding tissues.
- Invasive lobular carcinoma (ILC): Cancer originated in the milk glands (also known as lobules) and has spread to surrounding tissues.
The cancer is still highly treatable with a combination of chemotherapy, radiotherapy, surgery etc.
Stage 4: The cancer is categorised as distant, meaning it has spread beyond the breasts to other parts of the body such as the skin, chest wall, lungs, brain, heart, etc. At this point, the cancer is advanced though treatment is still possible to reduce the symptoms and prolong lifespan.
Type of cancer
The type of cancer will determine the range of treatments that are suitable for you. Hormone receptor-positive breast cancer (cancer cells are sensitive to estrogen and/or progesterone) or HER2 receptor positive cancer (cancer cells have receptors that bind to HER2 growth factor) have more treatment options such as targeted therapy, which uses drugs to target specific proteins or receptors that would allow cancer cells to grow.
On the other hand, less sensitive breast cancer such as Triple-Negative breast cancer, which lacks estrogen, progesterone, or HER2 receptors, will have a smaller pool of treatments available. This can reduce the survival rate.
Some types of cancer are more aggressive than others. For example, inflammatory breast cancer, although rare, is usually diagnosed at a more advanced stage. Aggressive or late-stage cancers may require a multimodal approach, meaning a more extensive combination of treatment.
The location of the tumour would affect the efficacy of certain treatments. Ductal or lobular carcinoma in situ (DCIS) is easier to remove via surgery than more invasive forms of cancer (IDC and ILC) as the tumour is more localised.
Hence, the treatment plan for each diagnosis is constantly evaluated and can change based on how the cancer responds to the current treatment.
General factors
Your general health and fitness will affect how your body responds to the breast cancer, as well as the treatment. While the risk of developing breast cancer increases with age, young women tend to experience breast cancer at a more advanced stage. Hence, it is important to perform self-examination regularly and schedule a breast screening, especially if you have a family history of getting breast cancer.
What Are The Breast Cancer Treatments Available?
Breakthroughs in diagnostic and treatment technologies have increased the rates of survival. According to the Singapore National Registry of Diseases, the five-year Age-Standardised Relative Survival rate (ASRS) for cancer in females has improved from 49.9% in 1973-1977 to 82.5% in 2017-2021.
Early detection increases the chances of treating breast cancer. As per Singapore Cancer Society guidelines, it is recommended for women aged 40 to 49 to go for a mammogram screening once per year, and once every 2 years for women aged 50 and above. Self-examination every month, preferably one week after your menstruation, would help identify any abnormalities such as lumps, nipple discharge, red and dimpled skin etc.
From generalised treatment to more targeted therapy, there is a range of treatments that suit the specific type of breast cancer. A multidisciplinary team will look at your condition to create a targeted treatment plan. It typically comprises a combination of treatments including:
Hormonal therapy
This is effective for hormone-positive breast cancer. The treatment, usually involving drugs such as tamoxifen, blocks estrogen and progesterone production or activity normally required for cancer growth.
Chemotherapy
It involves a combination of drugs to destroy cancer cells. It could be used to shrink large tumours until they become operable, or after surgery to reduce the risk of recurrence.
Radiotherapy
It uses high-energy rays to kill off cancer cells. It can be given directly to the tumour area (partial breast irradiation) or the entire breast (whole breast irradiation). Radiotherapy can be given before or after surgery or as a standalone treatment.
Surgery
Surgery is performed to remove the tumour, as well as a small margin of healthy tissues surrounding the tumour to ensure that the entire tumour is removed. Surgery is usually performed for early-stage cancer whereby the tumour is smaller and localised, as it is easier to remove. Other forms of therapy may be used after surgery to kill off microscopic cancer cells.
Immunotherapy
It involves using one’s immune cells to target cancer cells but not the healthy cells. While this is still in its infancy, it has the potential to provide a more precise treatment for breast cancer with lesser side effects.
Safeguard Your Health Today
How treatable breast cancer is depends on the type of cancer, the staging, and how early it is detected. Alas, every experience is different based on one’s general health and fitness.
Cancer treatment is moving towards precision medicine – one that can target the cancer cells more directly and precisely. With more research on creating new therapies as well as ways to improve on existing ones, treatment for breast cancer is certainly moving in an optimistic direction.
Nonetheless, prevention is better than cure – early detection is key to improving the treatability of breast cancer. At the Centre for Screening and Surgery, we can perform breast screenings to detect both benign breast lumps and breast cancers. We also specialise in minimally invasive procedures for cancer treatment. If you are looking for a breast screening or treatment options, call us to book an appointment today!
