The Who, What, Where, When and Sometimes, Why.

Factors that Affect Prognosis and Treatment

If a biopsy finds breast cancer, it’s important to understand the factors related to your diagnosis. These factors help you and your health care provider make treatment decisions that are right for you.

Tests are done on the tumor (and any lymph nodes removed during surgery). The results of these tests help determine your prognosis and guide your treatment.

Some tests can be done on the small amount of tissue removed during a needle biopsy. Others need a larger amount from tissue removed during surgery.

Metastatic breast cancer

The most important factor related to survival is the presence or absence of metastasis. Metastasis is the spread of cancer beyond the breast and nearby lymph nodes to other organs in the body (most often the bones, lungs, liver or brain).

Learn more about metastatic breast cancer.

Early and locally advanced breast cancer

Factors that affect prognosis and treatment for early and locally advanced breast cancer are considered in combination (rather than alone). They include:

Figure 4.3 describes these factors.  

Figure 4.3:
Factors that Affect Prognosis and Treatment

Which factors best determine prognosis and predict response to treatment is under study. 

A factor only becomes a part of standard practice after a great deal of research has shown it’s accurate and reliable.

Breast cancer staging

Breast cancer stage is the most important factor for prognosis.

Ductal carcinoma in situ (DCIS) is considered stage 0 (or non-invasive) breast cancer and has the best chance for survival.

There are 4 main stages of invasive breast cancer (stages I-IV). The lower the breast cancer stage, the better the prognosis tends to be.

Breast cancer stage is determined by:

Oncotype DX® score is part of breast cancer staging for some estrogen receptor-positive, lymph node-negative tumors.

If you were diagnosed before 2018, your breast cancer was staged using only lymph node status, tumor size and the presence or absence of metastases.

Learn more about staging.