Peter Attia· MD
so breast cancer is really interesting if you have big enough study you know a 1 cimer cancer is less risky than a 1 and a half centimeter Which is less risky than a 2 centimeter Which is less risky than a 2 and a half cimeter and so forth there's another axis that goes by nodal status node negative is less risky than 1 2 3 4 it's all very linear and then finally there's a third dimensional access about the biology of the tumor where um triple negative cancers again ounce for ounce size for size will have a more aggressive Natural History her two positive tumors historically were also a very aggressive tumor now we have some of our most successful outcomes with treatment of her two positive cancers within this large group of er positive her2 negative cancers the risk uh depends on some of these biomarkers like grade so low grade intermediate grade higher grade um how robust the expression of the estrogen receptor is and nowadays we also use so-called genomic tests like the unyp DX recurrence score to understand for that large group of cancers how risky they are and whether they warrant chemotherapy so um I tend to describe it as with many others as sort of a three-dimensional axis of the tumor size the nodal status and then these biological features as well all of which are likely to affect risk of recurrence