Understanding Breast Cancer Recurrence: Risks, Treatments, and More

Breast cancer can be such a hard topic to discuss for many people, including those who have been diagnosed. But talking about and understanding breast cancer recurrence can be even harder to do. But we’re here to discuss it and hopefully assuage fears you may have around the possibility.

What is recurrent breast cancer?

Simply put, breast cancer recurrence occurs when the disease returns (or recurs) after treatment. While this doesn’t always happen, it is possible to have recurrent breast cancer months or even years after your treatment. It’s important to remember that if you have breast cancer in one breast that goes away after treatment but develop it in your other untreated breast, the tumor is considered new cancer, not recurrent breast cancer. This is often referred to as second cancer.

Is it common?

No, breast cancer recurrence isn’t common. There are many factors that play a part in recurrent breast cancer, and a little less than 30% of breast cancer patients show evidence of breast cancer recurrence, with most of these cases being within the first five years following treatment. According to the American Cancer Society, triple negative breast cancer (also known as TNBC) and inflammatory breast cancer (IBC) are the two breast cancers most likely to come back.

When does it typically occur?

Although it’s not common to recur, when it does happen, the most common cases are within the first five years after treatment. While recurrence chances will never drop to zero, your risk lowers each year you don’t have a recurrence. There is a 3% to 15% chance of breast cancer recurrence within 10 years of treatment. If you decide to undergo genetic testing, your provider could recommend treatments that can reduce your specific risk.

What is the prognosis?

Before we dive into that, it’s important to note that most rates are just estimates based on the survival rates of large groups of people who have recurrent breast cancer. On top that, survival rates have changed significantly, and are improving year over year.

With that being said, your survival chances of five years after diagnosis with recurrent breast cancer is:

• 99% for localized breast cancer,
• 86% for regional breast cancer, and
• 27% for metastatic breast cancer

Again, these numbers are just an estimate, but they can give you a fairly clear picture on why it’s important to keep up with your follow-up care, even if you feel better after treatment and recovery.

What are the types of breast cancer recurrence?

There are a few different types of breast cancer recurrence. These include local, regional, and distant.

Local recurrence happens when the cancer cancer returns in the same breast or area as the original tumor. Regional recurrence describes when cancer comes back near the original tumor, or in your axillary (armpit) lymph nodes or collarbone area. Last but not least, distant breast cancer recurrence (the rarest recurrence) occurs when the breast cancer spreads away from your original tumor, to your lungs, bones, or other parts of your body. This is typically referred to as metastatic breast cancer (Stage 4 breast cancer).

What are the symptoms?

If at any point after treatment you start to feel like something is wrong, it’s best to reach out to your provider as soon as possible. While the following list of symptoms can be a great starting point, it is not an exhaustive list, and you know your body best. Remember, the risk for recurrent breast cancer goes down significantly five years after treatment, and further decreases the longer you go after treatment but it’s never zero.

Local breast cancer recurrence can include symptoms like;

• Nipple changes (like discharge)
• Breast lumps or bumps on your chest
• Firm breast tissue that wasn’t firm before
• Swollen skin

Regional breast cancer recurrence can include symptoms like;

• Chronic chest pain
• Pain in your arm or shoulder
• Swelling or numbness in an arm or shoulder
• Fatigue
• Swollen axillary lymph nodes
• Jaundice

Distant (also known as Stage 4) breast cancer recurrence can include symptoms like;

• Pain where the cancer has spread, including bone pain
• A chronic dry cough
• Consistent and extreme fatigue
• Seizures
• Loss of appetite
• Nausea (that doesn’t go away)
• Sudden weight loss
• Migraines
• Numbness
• Blood in your urine or stools

Again, it’s important to talk to your provider if you experience any symptom that you feel isn’t normal or related to having something as simple as a cold. Even if a symptom isn’t listed here, if it’s consistent and you feel something is wrong it’s always best to be safe

Are there any complications with breast cancer recurrence?

Treatment for breast cancer recurrence can be more challenging to treat for a few different reasons. First, treatments that worked in the past may not work this time. If the cancer has spread to multiple places on your body (metastatic breast cancer), this can also make treatment more difficult.

It’s also important to talk about other potential complications outside of treatments, including mentioning the potential psychological impact and side effects that you may experience if you have recurrent breast cancer. First, pain can be a significant issue for many patients, especially if the cancer has spread to certain parts of your body, like your bones. You may also have more or different side effects than the last time, including severe fatigue, skin irritation, or even surgical complications.

The last piece is your mental health. The emotional stress of cancer recurrence can be significant and can impact your quality of life. It’s essential to find support and aid during this time. You do not have to go through this alone, especially if it’s for the second time. Family, friends, your care team, and support groups can be there for you as you navigate recurrent breast cancer. 

How to Reduce Your Risk

Is it possible to reduce your risk of having breast cancer for a second time? While science can’t pinpoint exactly what you should and should not do, there are ways to lower your risk overall. But before diving into that, please remember that recurrent breast cancer isn’t a reflection on you personally. There is nothing you could or couldn’t do to deserve having breast cancer for a second time. It is not a personal failure, and even the most diligent people may experience it, which isn’t fair, but not a personal fault.

Steps to Reduce Your Risk

First, there are a few groups of women who are at a higher risk of recurrence, including women and people assigned female at birth who developed breast cancer before the age of 35. Another group that has a higher risk is anyone who was originally diagnosed with Stage III breast cancer or who were diagnosed with more aggressive breast cancers like inflammatory breast cancer and triple-negative breast cancer. Since these are harder to treat, they’re also more likely to come back and spread.

There has been some research that shows that certain treatments may reduce the risk that certain breast cancers come back. For example, hormone therapy options, like tamoxifen, could reduce the risk of recurrence for people diagnosed with early-stage estrogen-receptive breast cancer (ER+). Of course, these treatments should be discussed with your team to see if they are a good option for you.

Next up, it’s still important to perform breast self-examinations and keep up with your regular follow-up screenings to help your provider identify recurrent breast cancer before it spreads or while metastatic breast cancer tumors are relatively small and easier to treat.

Some things that you can do within your own journey include eating a balanced diet with plenty of fiber, vitamins, and minerals. You should also try to stay active, performing low-impact exercises like walking, swimming, and yoga. These can help boost your mood, reduce fatigue, and even help you be more in tune with your body, which is helpful if you feel like something is off.

What to Do If You’re Diagnosed

Even if you do everything “right”, you may still be diagnosed with breast cancer for a second time. While this isn’t the news that anyone would want to hear, it’s important to stay calm and focus on the next step in what you need to do.

First, if you’ve tested positive for breast cancer again, there are a few questions that you can ask your provider. These include;

What are the treatment options?

Treatment of recurrent breast cancer depends on where it has recurred and treatments you’ve had before.

If you have local recurrence and haven’t had a mastectomy, that is usually the first treatment option. You may also undergo chemotherapy and radiation again (or for the first time), as well as hormone therapy and/or targeted therapy depending on your specific cancer.

If you have a regional recurrence, your likely next step is to have surgery to remove your affected lymph nodes. Then, you may again have to go through radiation, chemotherapy, hormone therapy, and/or targeted therapy.

If you’ve been diagnosed with metastatic or distant recurrence, your treatments may mostly consist of drug therapy, including chemotherapy, hormone therapy, radiation, or a combination of therapies.

*The information provided on this website is for informational and educational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Reliance on any information provided by this website is solely at your own risk. The owners, contributors, authors, and publishers of this website are not liable for any losses, injuries, or damages arising from the use of the information on this website.*