Table of ContentsView AllTable of ContentsTypesSymptomsCausesLate RecurrenceTreatmentPrognosisCoping
Table of ContentsView All
View All
Table of Contents
Types
Symptoms
Causes
Late Recurrence
Treatment
Prognosis
Coping
The return of breast cancer after a period of remission, referred to as arecurrence, occurs when cancer returns aftertreatment, despite best efforts to eradicate it. Lingering cancer cells can often remain dormant for years and, for reasons not entirely understood, they may suddenly start to multiply. A recurrence may develop in the same area where cancer first appeared, in the opposite breast, or in another part of the body.
The prospect of recurrence is ultimately something that everyone with breast cancer lives with. Understanding why it happens and who is at risk can help you make the appropriate health decisions, whether you are faced with a recurrence or working to avoid one.
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When diagnosed, a recurrence will be categorized as:
If cancer grows or spreads during your treatment, this would be defined as cancer progression or treatment failure.
To be considered a recurrence, the malignancy must recur at least a year after successful completion of cancer therapy.
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As with the original breast cancer, the signs and symptoms of a recurrence can vary. In some cases, the symptoms may be subtle. In others, there may be overt, as is the case with a lump.
Local or regional recurrence will often present with telltale signs, including:
Local, regional, or distant recurrence may also cause non-specific symptoms, such as:
It is important to report any changes, however subtle, to youroncologistwhen they occur rather than waiting until your next appointment.
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There are many factors that figure into the risk of recurrence. Thebreast cancer type, thestage, the extent of the initial malignancy, and treatment choices can all influence the risk of recurrence. Treatments can include a combination of breast-conservinglumpectomy, total or partialmastectomy.chemotherapy,radiation therapy,hormone therapy,targeted therapy, orimmunotherapy. Age andfamily historyfactor in as well.
It’s not clear whether lifestyle factors (such as diet and weight) play a role in recurrence, although some studies suggest that obesity can worsen outcomes.
Key factors associated with breast cancer recurrence:
The risk of recurrence is generally low if lymph nodes are unaffected and the surgical tumor margins (the tissues surrounding a tumor) are cancer-free. That said, even small stage 1A breast cancers may sometimes recur.
Breast cancers may recur at any time. In fact, estrogen-receptor-positive breast cancers are more likely to recurafter5 years than in the first 5 years.
A 2018 study looking at recurrence after 5-years of hormonal therapy (tamoxifen or an aromatase inhibitor) found that the risk of recurrence remains constant for at least 20 years. In other words, an estrogen receptor-positive breast cancer is just as likely to recur 14 years after treatment as three years after treatment.
Late Recurrence of Breast Cancer
Treatment of a recurrence will depend on whether it is local, regional, or distant.
Local/Regional Recurrence
The type of treatment used for treating a local or regional recurrence can vary based on the type of treatment you initially had:
In any circumstance, chemotherapy and/or hormone therapy may be considered. Targeted therapy withHerceptin (trastuzumab)may be used with or without chemotherapy for women with HER2+ breast cancer to prevent future recurrence.
Distant Recurrence
If you have a distant recurrence, you might be prescribed systemic therapies (and less commonly, surgery and radiation) to control tumor growth. Cancers like these are categorized asstage 4, and that cannot be cured. Your treatment would be focused on extending your life and maintaining your optimal quality of life.
Treatment options for metastatic breast cancer can include chemotherapy, targeted therapies, and immunotherapy (for metastatic triple-negative breast cancer). Some drugs are used primarily for people who have BRCA mutations. There are many clinical trials currently in place looking for better treatments for metastatic breast cancer.
Single vs. Double Mastectomy and Risk of Recurrence
Prevention
Tamoxifen, a drug approved for breast cancer risk reduction, can lower the incidence of invasive, ER-positive breast cancer in high-risk women. Aromatase inhibitors have also been proven to help prevent breast cancer recurrence.
Even if you do everything “right,” breast cancer can still return. Arguably the best strategy is to identify a recurrence early, when treatment is expected to be most effective. This involves keeping your appointments, having routinemammograms, and staying linked to care with a medical team that knows your history.
Clinical trials are currently in place looking at therapies such as daily low dose aspirin and melatonin to reduce recurrence risk,but it’s not known if these treatments will be effective.
How to Reduce Your Risk of Breast Cancer Recurrence
Theprognosisafter a recurrence depends on whether the recurrent is local, regional, or distant. Generally speaking, more advanced malignancy is associated with shorter anticipated survival.
A 2019 study inPLoS Onereported that women with triple-negative breast cancer (an especially aggressive form of the disease) have a higher risk of recurrence and death if regional lymph nodes are involved.
None of this should suggest that breast cancer recurrence will inherently shorten your life span. Some women are successfully treated for recurrence and go on to live long, healthy lives.
A 2016 study from MD Anderson reported that, among 881 women with triple-negative breast cancer who were disease-free after five years, only 16 deaths occurred in the subsequent five years. Of these, most occurred within a year due to an advanced malignancy. This indicates a low probability of recurrence after five years disease-free.
If you have been diagnosed with breast cancer recurrence, the emotional impact can be just as profound as the physical impact. In fact, some people say that this news is even more distressing than receiving their first diagnosis. It is normal to feel sad, anxious, and even angry about what the recurrence means for your immediate health and your future.
More than ever, it is important to reach out to your support network of friends, family, and health professionals. You should also seek asupport group of breast cancer survivorswho understand firsthand what you are going through.
Even if you are not faced with breast cancer recurrence, it is not unusual to feel on edge at times, wondering if a certain pain or redness is a sign that the cancer is returning. It’s important not to swallow these feelings, and, at the same time, not to allow them to control your life.
If you are unable to cope, seek professional help from a qualified therapist or psychiatrist. Going through the experience of breast cancer is traumatic, and it can manifest with anxiety and depression for months and years after treatment. By reaching out and asking for help, you can work through these emotions and be better equipped to face whatever challenges lie ahead.
12 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.American Cancer Society.What Is cancer recurrence?Cleveland Clinic.Breast cancer recurrence.Breastcancer.org.Recurrent breast cancer.Kenne sarenmalm E, Ohlén J, Jonsson T, Gaston-johansson F.Coping with recurrent breast cancer: predictors of distressing symptoms and health-related quality of life.J Pain Symptom Manage. 2007;34(1):24-39. doi:10.1016/j.jpainsymman.2006.10.017Ecker BL, Lee JY, Sterner CJ, et al.Impact of obesity on breast cancer recurrence and minimal residual disease.Breast Cancer Res. 2019;21(1):41. doi:10.1186/s13058-018-1087-7Vaz-Luis I, Ottesen RA, Hughes ME, et al.Impact of hormone receptor status on patterns of recurrence and clinical outcomes among patients with human epidermal growth factor-2-positive breast cancer in the National Comprehensive Cancer Network: a prospective cohort study.Breast Cancer Res. 2012;14(5):R129. doi:10.1186/bcr3324Rudra S, Yu DS, Yu ES, Switchenko JM, Mister D, Torres MA.Locoregional and distant recurrence patterns in young versus elderly women treated for breast cancer.Int J Breast Cancer. 2015;2015:213123. doi:10.1155/2015/213123Pan 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/NEJMoa1701830Lazzeroni M, Serrano D, Dunn BK, et al.Oral low dose and topical tamoxifen for breast cancer prevention: modern approaches for an old drug.Breast Cancer Res.2012;14(5):214. doi:10.1186/bcr3233Bojková B, Kubatka P, Qaradakhi T, Zulli A, Kajo K.Melatonin may increase anticancer potential of pleiotropic drugs.Int J Mol Sci. 2018;19(12):3910. doi:10.3390/ijms19123910Mousavi SA, Kasaeian A, Pourkasmaee M, et al.Assessing the prognostic factors, survival, and recurrence incidence of triple negative breast cancer patients, a single center study in Iran.PLoS ONE. 2019;14(1):e0208701. doi:10.1371/journal.pone.0208701Reddy S, Sinha A, Hsu L. et al.Recurrence and survival outcomes of triple-negative breast cancer survivors disease-free at 5-years and relationship to low hormone receptor positivity (1-9% versus <1%).J Clin Oncol.2016;34(Suppl 15):1077. doi:10.1200/JCO.2016.34.15_suppl.1077Additional ReadingBraunstein L, Taghian A, Niemierko A, et al.Breast-cancer subtype, age, and lymph node status as predictors of local recurrence following breast-conserving therapy.Breast Cancer Res Treat.2017;161(1):173-9. doi:10.1007/s10549-016-4031-5
12 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.American Cancer Society.What Is cancer recurrence?Cleveland Clinic.Breast cancer recurrence.Breastcancer.org.Recurrent breast cancer.Kenne sarenmalm E, Ohlén J, Jonsson T, Gaston-johansson F.Coping with recurrent breast cancer: predictors of distressing symptoms and health-related quality of life.J Pain Symptom Manage. 2007;34(1):24-39. doi:10.1016/j.jpainsymman.2006.10.017Ecker BL, Lee JY, Sterner CJ, et al.Impact of obesity on breast cancer recurrence and minimal residual disease.Breast Cancer Res. 2019;21(1):41. doi:10.1186/s13058-018-1087-7Vaz-Luis I, Ottesen RA, Hughes ME, et al.Impact of hormone receptor status on patterns of recurrence and clinical outcomes among patients with human epidermal growth factor-2-positive breast cancer in the National Comprehensive Cancer Network: a prospective cohort study.Breast Cancer Res. 2012;14(5):R129. doi:10.1186/bcr3324Rudra S, Yu DS, Yu ES, Switchenko JM, Mister D, Torres MA.Locoregional and distant recurrence patterns in young versus elderly women treated for breast cancer.Int J Breast Cancer. 2015;2015:213123. doi:10.1155/2015/213123Pan 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/NEJMoa1701830Lazzeroni M, Serrano D, Dunn BK, et al.Oral low dose and topical tamoxifen for breast cancer prevention: modern approaches for an old drug.Breast Cancer Res.2012;14(5):214. doi:10.1186/bcr3233Bojková B, Kubatka P, Qaradakhi T, Zulli A, Kajo K.Melatonin may increase anticancer potential of pleiotropic drugs.Int J Mol Sci. 2018;19(12):3910. doi:10.3390/ijms19123910Mousavi SA, Kasaeian A, Pourkasmaee M, et al.Assessing the prognostic factors, survival, and recurrence incidence of triple negative breast cancer patients, a single center study in Iran.PLoS ONE. 2019;14(1):e0208701. doi:10.1371/journal.pone.0208701Reddy S, Sinha A, Hsu L. et al.Recurrence and survival outcomes of triple-negative breast cancer survivors disease-free at 5-years and relationship to low hormone receptor positivity (1-9% versus <1%).J Clin Oncol.2016;34(Suppl 15):1077. doi:10.1200/JCO.2016.34.15_suppl.1077Additional ReadingBraunstein L, Taghian A, Niemierko A, et al.Breast-cancer subtype, age, and lymph node status as predictors of local recurrence following breast-conserving therapy.Breast Cancer Res Treat.2017;161(1):173-9. doi:10.1007/s10549-016-4031-5
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.
American Cancer Society.What Is cancer recurrence?Cleveland Clinic.Breast cancer recurrence.Breastcancer.org.Recurrent breast cancer.Kenne sarenmalm E, Ohlén J, Jonsson T, Gaston-johansson F.Coping with recurrent breast cancer: predictors of distressing symptoms and health-related quality of life.J Pain Symptom Manage. 2007;34(1):24-39. doi:10.1016/j.jpainsymman.2006.10.017Ecker BL, Lee JY, Sterner CJ, et al.Impact of obesity on breast cancer recurrence and minimal residual disease.Breast Cancer Res. 2019;21(1):41. doi:10.1186/s13058-018-1087-7Vaz-Luis I, Ottesen RA, Hughes ME, et al.Impact of hormone receptor status on patterns of recurrence and clinical outcomes among patients with human epidermal growth factor-2-positive breast cancer in the National Comprehensive Cancer Network: a prospective cohort study.Breast Cancer Res. 2012;14(5):R129. doi:10.1186/bcr3324Rudra S, Yu DS, Yu ES, Switchenko JM, Mister D, Torres MA.Locoregional and distant recurrence patterns in young versus elderly women treated for breast cancer.Int J Breast Cancer. 2015;2015:213123. doi:10.1155/2015/213123Pan 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/NEJMoa1701830Lazzeroni M, Serrano D, Dunn BK, et al.Oral low dose and topical tamoxifen for breast cancer prevention: modern approaches for an old drug.Breast Cancer Res.2012;14(5):214. doi:10.1186/bcr3233Bojková B, Kubatka P, Qaradakhi T, Zulli A, Kajo K.Melatonin may increase anticancer potential of pleiotropic drugs.Int J Mol Sci. 2018;19(12):3910. doi:10.3390/ijms19123910Mousavi SA, Kasaeian A, Pourkasmaee M, et al.Assessing the prognostic factors, survival, and recurrence incidence of triple negative breast cancer patients, a single center study in Iran.PLoS ONE. 2019;14(1):e0208701. doi:10.1371/journal.pone.0208701Reddy S, Sinha A, Hsu L. et al.Recurrence and survival outcomes of triple-negative breast cancer survivors disease-free at 5-years and relationship to low hormone receptor positivity (1-9% versus <1%).J Clin Oncol.2016;34(Suppl 15):1077. doi:10.1200/JCO.2016.34.15_suppl.1077
American Cancer Society.What Is cancer recurrence?
Cleveland Clinic.Breast cancer recurrence.
Breastcancer.org.Recurrent breast cancer.
Kenne sarenmalm E, Ohlén J, Jonsson T, Gaston-johansson F.Coping with recurrent breast cancer: predictors of distressing symptoms and health-related quality of life.J Pain Symptom Manage. 2007;34(1):24-39. doi:10.1016/j.jpainsymman.2006.10.017
Ecker BL, Lee JY, Sterner CJ, et al.Impact of obesity on breast cancer recurrence and minimal residual disease.Breast Cancer Res. 2019;21(1):41. doi:10.1186/s13058-018-1087-7
Vaz-Luis I, Ottesen RA, Hughes ME, et al.Impact of hormone receptor status on patterns of recurrence and clinical outcomes among patients with human epidermal growth factor-2-positive breast cancer in the National Comprehensive Cancer Network: a prospective cohort study.Breast Cancer Res. 2012;14(5):R129. doi:10.1186/bcr3324
Rudra S, Yu DS, Yu ES, Switchenko JM, Mister D, Torres MA.Locoregional and distant recurrence patterns in young versus elderly women treated for breast cancer.Int J Breast Cancer. 2015;2015:213123. doi:10.1155/2015/213123
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
Lazzeroni M, Serrano D, Dunn BK, et al.Oral low dose and topical tamoxifen for breast cancer prevention: modern approaches for an old drug.Breast Cancer Res.2012;14(5):214. doi:10.1186/bcr3233
Bojková B, Kubatka P, Qaradakhi T, Zulli A, Kajo K.Melatonin may increase anticancer potential of pleiotropic drugs.Int J Mol Sci. 2018;19(12):3910. doi:10.3390/ijms19123910
Mousavi SA, Kasaeian A, Pourkasmaee M, et al.Assessing the prognostic factors, survival, and recurrence incidence of triple negative breast cancer patients, a single center study in Iran.PLoS ONE. 2019;14(1):e0208701. doi:10.1371/journal.pone.0208701
Reddy S, Sinha A, Hsu L. et al.Recurrence and survival outcomes of triple-negative breast cancer survivors disease-free at 5-years and relationship to low hormone receptor positivity (1-9% versus <1%).J Clin Oncol.2016;34(Suppl 15):1077. doi:10.1200/JCO.2016.34.15_suppl.1077
Braunstein L, Taghian A, Niemierko A, et al.Breast-cancer subtype, age, and lymph node status as predictors of local recurrence following breast-conserving therapy.Breast Cancer Res Treat.2017;161(1):173-9. doi:10.1007/s10549-016-4031-5
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