Table of ContentsView AllTable of ContentsHow Remission Is DeterminedComplete RemissionPartial RemissionTreatmentFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
How Remission Is Determined
Complete Remission
Partial Remission
Treatment
Frequently Asked Questions
Breast cancer treatment may result in complete or partialremission. Complete remission is when physical exams, blood tests, and imaging do not show any signs of cancer in your body. Partial remission occurs when the tumor is still present, but it is substantially reduced.
Healthcare providers use the term remission rather than cure because there remains a possibility thatbreast cancermay return after it’s treated. This is called arecurrence.
This article reviews the different types of remission and the approach to their treatment and management.
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Breast cancer remission is determined in multiple ways including the following:
As valuable as these tests are, they have their limitations.
Complete remission, also known as a complete response, means that cancer appears to be gone after treatment.
Even after complete remission has been declared, there may still be cancer cells below the detection levels of these tests. Some cancer cells may lie dormant indefinitely; others may suddenly multiply months or years later, resulting in a recurrence.
Because of the potential for recurrence, many healthcare providers will refer to complete remission asno evidence of disease, or NED.
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If breast cancer is in partial remission, also known as a partial response, it means that the solid tumor has shrunk. Partial remission is usually declared when there is at least a 50% reduction in the tumor size or the number of cancer cells from the baseline value.
Partial remission is not the usual goal of breast cancer treatment. It is only when a tumor is inoperable or hasmetastasized(spread to other organs) that anoncologistwill aim to control the tumor rather than eradicate it.
In all butstage IV breast cancer, efforts will be made to remove the tumor and useradiationand/orchemotherapyto get rid of all remaining cancer cells.
To qualify as a complete or partial remission, the absence or reduction of cancer must last for at least one month. The absence of symptoms is neither a measure nor an indication of remission.
For those in complete remission, your healthcare providers will continue to monitor you closely so they can quickly identify and treat arecurrenceif needed. You may also require maintenance therapy after the initial treatment.
The goal of maintenance therapy for those in complete remission is to prevent or delay recurrence. For those in partial remission, the goal is to slow the growth or to lengthen a person’s life. In advanced-stage cancer, it may decrease symptoms or increase quality of life.
Maintenance medication may include a lower dose of chemotherapy, targeted therapy, or endocrine (hormone) therapy.
Chemotherapy
One of the most common types of maintenance therapy often involves traditionalchemotherapy drugs. Often, they are given in a lower dose and as a single medication rather than in combination to help decrease side effects.
Targeted Therapy
Targeted therapy includes kinase inhibitors, monoclonal antibodies, or antibody-drug conjugates.
Kinase inhibitorsblock a protein that keeps cancer cells from growing and include:
Monoclonal antibodieshelp boost the immune system. Examples include:
Antibody-drug conjugatescombine monoclonal antibodies and chemotherapy and include medications such as:
Endocrine or Hormone Therapy
Hormone receptor-positive tumors feed off hormones and typically require endocrine therapy that blocks or stops estrogen production. While this is not a complete list, some commonhormone therapymedications include:
Early-Stage Breast Cancer
If you’ve been diagnosed with early-stage breast cancer, you would receive local treatment that’s intended to completely eradicate the disease.
Partial remission is a term that is usually used to describe stage IV metastatic breast cancer treatment response, but, sometimes, partial remission may also apply to earlier stages.
To reduce the risk of recurrence, your healthcare provider may prescribe drugs that suppress either the production of estrogen or the stimulation of estrogen-sensitive cells.
If you have estrogen-sensitive cancer, your practitioner may prescribetamoxifen, which binds to the estrogen receptors on cells. After three to five years, you may be switched to another class of drug known asaromatase inhibitors(AIs).
For post-menopausal women, you may be prescribed an aromatase inhibitor for an additional five years. Your healthcare provider may make this change to avoid the long-term side effects of tamoxifen. Aromatase inhibitors block estrogen production in the liver, pancreas, breasts, brain, and other tissues.
Unlike tamoxifen, aromatase inhibitors are only effective in postmenopausal women or women whose ovaries are suppressed.
If your breast cancer is estrogen-receptor-negative, you may not need any medications.
Metastatic Breast Cancer
If you have stage IV breast cancer, you will be prescribed medications to better control the disease. While treatable, metastatic breast cancer cannot be cured.
With that being said, recent advances in chemotherapy andimmunotherapyhave allowed people with stage IV cancer to live longer without symptoms of the disease. This includes experimental adoptive cell therapy (ACT) in which your body’s own cancer-fighting cells are harvested and cultured for use as immunotherapy.
How Immunotherapy Works in Cancer
Summary
When breast cancer is treated, it may result in complete or partial remission. Complete remission occurs when physical exams, blood tests, and imaging do not show any signs of cancer. Partial remission is when the tumor is still present but reduced.
A Word From Verywell
After any breast cancer diagnosis, you will need to see an oncologist on an ongoing basis to monitor your condition. This typically involves a healthcare provider’s visit every few months for the first five years, after which you may only need yearly appointments. You will also need an annualmammogramand possibly a breast MRI unless you’ve had abilateral mastectomy.
Although there is no way to definitively prevent breast cancer recurrence, there are preventive medications that reduce the risk of a recurrence for some types of breast cancer. By remaining linked to medical care, you will increase the chances that a recurrence will be caught early when it is most treatable.
Why Does Cancer Come Back?
Frequently Asked QuestionsMaintenance therapy can continue for weeks, months, or years. The length is based on the type of cancer, the medication, efficacy (how well it works), and side effects.According to the American Cancer Society, there is no time limit. It depends on multiple factors including how you tolerate treatment and the type of cancer you have. If the treatment stops working or causes severe side effects, your healthcare provider may change your medications.While hair loss does not occur with all maintenance therapy, it is a possibility with certain medications. Some medications may cause your hair to change colors or become curly. Others can make your hair dry, thin, or brittle. This is very specific to the medication and how your body reacts to it.Estrogen-receptor negative (triple-negative or HER2 - positive) breast cancer has a higher risk of early recurrence. This means within the first five years of diagnosis.Estrogen-receptor-positive tumors have a higher chance of later recurrence (after five years).Other risk factors of recurrence include larger tumors, lymph node involvement, younger age, more aggressive (higher grade) tumors, and type of initial treatment.Learn MoreLate Recurrence vs. Early Relapse of Breast Cancer
Maintenance therapy can continue for weeks, months, or years. The length is based on the type of cancer, the medication, efficacy (how well it works), and side effects.
According to the American Cancer Society, there is no time limit. It depends on multiple factors including how you tolerate treatment and the type of cancer you have. If the treatment stops working or causes severe side effects, your healthcare provider may change your medications.
While hair loss does not occur with all maintenance therapy, it is a possibility with certain medications. Some medications may cause your hair to change colors or become curly. Others can make your hair dry, thin, or brittle. This is very specific to the medication and how your body reacts to it.
Estrogen-receptor negative (triple-negative or HER2 - positive) breast cancer has a higher risk of early recurrence. This means within the first five years of diagnosis.Estrogen-receptor-positive tumors have a higher chance of later recurrence (after five years).Other risk factors of recurrence include larger tumors, lymph node involvement, younger age, more aggressive (higher grade) tumors, and type of initial treatment.Learn MoreLate Recurrence vs. Early Relapse of Breast Cancer
Estrogen-receptor negative (triple-negative or HER2 - positive) breast cancer has a higher risk of early recurrence. This means within the first five years of diagnosis.Estrogen-receptor-positive tumors have a higher chance of later recurrence (after five years).Other risk factors of recurrence include larger tumors, lymph node involvement, younger age, more aggressive (higher grade) tumors, and type of initial treatment.
Learn MoreLate Recurrence vs. Early Relapse of Breast Cancer
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Cancer Institute.Understanding cancer prognosis.Ciruelos E, Pérez-García JM, Gavilá J, Rodríguez A, de la Haba-Rodriguez J.Maintenance therapy in HER2-Negative metastatic breast cancer: a new approach for an old concept.Clin Drug Investig. 2019;39(7):595-606. doi:10.1007/s40261-019-00790-9American Cancer Society.Managing cancer as a chronic illness.American Cancer Society.Treatment of stage IV (metastatic) breast cancer.American Cancer Society.Targeted drug therapy for breast cancer.Breastcancer.org.Treatments for hormone receptor-positive breast cancer.American Cancer Society.Treatment of breast cancer stages I-III.Cancer Research UK.Hair loss, hair thinning and cancer drugs.American Cancer Society.Targeted therapy side effects.Pan H, Gray R, Braybrooke J, et al.20-year risks of breast-cancer recurrence after stopping endocrine therapy at 5 years.N Engl J Med. 2017;377:1836-1846. doi:10.1056/NEJMoa1701830.Rueda O, Sammut S, Seoane J, et al.Dynamics of breast-cancer relapse reveal late-recurring ER-positive genomic subgroups.Nature.2019;567:399-404. doi:10.1038/s41586-019-1007-8.
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Cancer Institute.Understanding cancer prognosis.Ciruelos E, Pérez-García JM, Gavilá J, Rodríguez A, de la Haba-Rodriguez J.Maintenance therapy in HER2-Negative metastatic breast cancer: a new approach for an old concept.Clin Drug Investig. 2019;39(7):595-606. doi:10.1007/s40261-019-00790-9American Cancer Society.Managing cancer as a chronic illness.American Cancer Society.Treatment of stage IV (metastatic) breast cancer.American Cancer Society.Targeted drug therapy for breast cancer.Breastcancer.org.Treatments for hormone receptor-positive breast cancer.American Cancer Society.Treatment of breast cancer stages I-III.Cancer Research UK.Hair loss, hair thinning and cancer drugs.American Cancer Society.Targeted therapy side effects.Pan H, Gray R, Braybrooke J, et al.20-year risks of breast-cancer recurrence after stopping endocrine therapy at 5 years.N Engl J Med. 2017;377:1836-1846. doi:10.1056/NEJMoa1701830.Rueda O, Sammut S, Seoane J, et al.Dynamics of breast-cancer relapse reveal late-recurring ER-positive genomic subgroups.Nature.2019;567:399-404. doi:10.1038/s41586-019-1007-8.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Cancer Institute.Understanding cancer prognosis.Ciruelos E, Pérez-García JM, Gavilá J, Rodríguez A, de la Haba-Rodriguez J.Maintenance therapy in HER2-Negative metastatic breast cancer: a new approach for an old concept.Clin Drug Investig. 2019;39(7):595-606. doi:10.1007/s40261-019-00790-9American Cancer Society.Managing cancer as a chronic illness.American Cancer Society.Treatment of stage IV (metastatic) breast cancer.American Cancer Society.Targeted drug therapy for breast cancer.Breastcancer.org.Treatments for hormone receptor-positive breast cancer.American Cancer Society.Treatment of breast cancer stages I-III.Cancer Research UK.Hair loss, hair thinning and cancer drugs.American Cancer Society.Targeted therapy side effects.Pan H, Gray R, Braybrooke J, et al.20-year risks of breast-cancer recurrence after stopping endocrine therapy at 5 years.N Engl J Med. 2017;377:1836-1846. doi:10.1056/NEJMoa1701830.Rueda O, Sammut S, Seoane J, et al.Dynamics of breast-cancer relapse reveal late-recurring ER-positive genomic subgroups.Nature.2019;567:399-404. doi:10.1038/s41586-019-1007-8.
National Cancer Institute.Understanding cancer prognosis.
Ciruelos E, Pérez-García JM, Gavilá J, Rodríguez A, de la Haba-Rodriguez J.Maintenance therapy in HER2-Negative metastatic breast cancer: a new approach for an old concept.Clin Drug Investig. 2019;39(7):595-606. doi:10.1007/s40261-019-00790-9
American Cancer Society.Managing cancer as a chronic illness.
American Cancer Society.Treatment of stage IV (metastatic) breast cancer.
American Cancer Society.Targeted drug therapy for breast cancer.
Breastcancer.org.Treatments for hormone receptor-positive breast cancer.
American Cancer Society.Treatment of breast cancer stages I-III.
Cancer Research UK.Hair loss, hair thinning and cancer drugs.
American Cancer Society.Targeted therapy side effects.
Pan H, Gray R, Braybrooke J, et al.20-year risks of breast-cancer recurrence after stopping endocrine therapy at 5 years.N Engl J Med. 2017;377:1836-1846. doi:10.1056/NEJMoa1701830.
Rueda O, Sammut S, Seoane J, et al.Dynamics of breast-cancer relapse reveal late-recurring ER-positive genomic subgroups.Nature.2019;567:399-404. doi:10.1038/s41586-019-1007-8.
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