Column worries cancer survivor

Dear Dr. Roach: You put my life into disarray as I read your column on the risk of recurrence with respect to breast cancer! I promptly grabbed my retired pathologist husband, and he was floored also. He accessed respected medical sites online, and we cannot find any stating that “women with estrogen receptor positive, progesterone receptor positive and HER2 negative tumors are more likely to experience recurrence.” What research are you looking at?

I was told by my breast surgeon, oncologist and radiologist that I am in the best possible position with breast cancer. If this is an actual error, you’ll have a whole nation of readers and breast cancer survivors in an anxious state! Please tell me that this was a misprint. — T.W. It is not a misprint.

The issue is that risk factors for late recurrences are different from overall prognostic findings. Because fortunately late recurrences are relatively rare, they don’t have a major effect on overall prognosis, which is where I think you and your husband may be looking. Specifically, triple-negative tumors (ER negative, PR negative, HER-2 negative) have a worse overall prognosis, but survivors have a low risk of recurrence.

I am putting some of the original research onto my page at facebook.com/keithroachmd1.

I must note that there are more sophisticated genetic markers that can help predict recurrence. My column lacks space to go into those, but your oncologist can speak to you about them.

I am sorry your life is in disarray. I don’t mean to increase your anxiety. Perhaps it would help if I noted that according to one of the studies I am posting, recurrence rate in the 20 years after diagnosis is only 1.4% per year for ER+ women with no lymph nodes positive for cancer.