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

Fear of Recurrence

After treatment for early or locally-advanced breast cancer ends, many people are afraid they still have cancer or that their cancer will come back (breast cancer recurrence).

These fears are normal.

There are healthy ways to cope with the stress caused by these fears. For example, mindfulness meditation may help ease fears of recurrence [107].

For some people, talking to a counselor or joining a support group can be helpful. Your health care provider may be able to help you find a counselor or support group.

Learn more about support groups and other types of social support.

 

Susan G. Komen® Support Resources

  • If you or a loved one needs more information about breast health or breast cancer, call the Komen Breast Care Helpline at 1-877 GO KOMEN (1-877-465-6636). All calls are answered by a trained specialist or oncology social worker in English and Spanish, Monday through Friday from 9:00 a.m. to 10:00 p.m. ET (6:00 a.m. to 7:00 p.m. PT). You can also email the helpline at helpline@komen.org.
  • Komen Affiliates offer breast health education as well as fund breast cancer programs through local community organizations. Your local Affiliate may also help you find breast cancer resources in your area. Find your local Affiliate.
  • Our Co-Survivor section has detailed information and resources for family and friends. 
  • Our fact sheets, booklets and other education materials offer additional information.

 

 

How is a local breast cancer recurrence or metastasis found?

Breast cancer can recur at or near the original site (called local recurrence). It can also return and spread to other parts of the body (called metastasis or distant recurrence).

  • Local recurrence is usually found on a mammogram, during a physical exam by a health care provider or when you notice a change.
  • Metastasis is usually found when symptoms are reported during follow-up office visits with your provider.

For people with no symptoms of metastases, blood and imaging tests (other than mammography) are not a standard part of follow-up care.

Using blood or imaging tests to check for early metastases in people with no symptoms of metastases does not increase survival or improve quality of life [9].

Learn about follow-up care after breast cancer treatment.

Learn more about breast cancer recurrence.

Risk of breast cancer recurrence

Local recurrence

Most local recurrences occur within the first 5 years after diagnosis [108-109].

The risk of local recurrence varies from person to person and depends on the original breast cancer diagnosis and treatment.

Getting regular medical care after treatment is the best thing you can to do ensure a local recurrence is found early, when the chances of survival are highest.

If you have a local recurrence, you will need more treatment.

Learn more about the risk of local recurrence.

Learn more about treatment for local recurrence.

Metastasis

When breast cancer metastasizes, it most often spreads to the bones, lungs, liver or brain.

The risk of metastasis varies from person to person and depends on the original breast cancer diagnosis and treatment.

Learn more about the risk of metastasis.

Learn about treatment for metastatic breast cancer.

Risk of a new breast cancer

Breast cancer survivors have an increased risk of getting a new breast cancer compared to people who have never had breast cancer [110-113].

A new breast cancer is called a second primary breast cancer. Unlike a recurrence, which is a return of the first breast cancer, a second primary tumor is a new cancer unrelated to the first.

  • Women treated with lumpectomy (also called breast conserving surgery) for their first breast cancer can get a second primary cancer in either breast.
  • Women treated with mastectomy for their first breast cancer can only get a new cancer in the other breast (except in rare cases, from any remaining breast tissue).

Learn more about risk of a second primary breast cancer.

Preventive surgery does not improve survival for most survivors

Although breast cancer survivors are at risk of a new breast cancer, preventive mastectomy of the healthy breast (contralateral prophylactic mastectomy) is not recommended for most survivors [3]. For most survivors, this surgery does not improve survival [3,114].

Only some breast cancer survivors with a very high risk of a new breast cancer should consider prophylactic mastectomy. This includes women with a mutation in one of these genes [3]:

  • BRCA1
  • BRCA2
  • PTEN
  • TP53

These women should talk with their health care providers about whether contralateral prophylactic mastectomy is right for them.

Risk of second cancers in people with family history or BRCA1/2 gene mutations

Compared to other survivors, the risk of a second primary breast cancer is higher for those with a strong family history and those who carry a BRCA1 or BRCA2 gene mutation [115-121].

For women with a BRCA1/2 gene mutation, the chance of a contralateral breast cancer 10 years after diagnosis of the first cancer is about 10-30 percent compared to about 5-10 percent for women diagnosed with breast cancer without a BRCA1/2 mutation [115-121].

The lifetime risk of a second primary contralateral breast cancer is about 40-70 percent for women with a BRCA1/2 mutation [118,121].

Women who have a BRCA1/2 mutation also have an increased risk of ovarian cancer [122].

Breast cancer survivors with a BRCA1/2 mutation should talk with their health care providers about whether contralateral prophylactic mastectomy and/or prophylactic oophorectomy (removal of the ovaries) is right for them [3].

Learn more about risk-lowering options for women with BRCA1/2 mutations.

Learn more about BRCA1/2 gene mutations and risk of breast and other cancers.

Learn more about family history and risk of breast cancer.

For a summary of research studies on BRCA1 and BRCA2 gene mutations and breast cancer, visit the Breast Cancer Research Studies section.

Lowering your risk of getting breast cancer again

Healthy lifestyle

Some healthy behaviors may lower the risk of breast cancer recurrence and improve survival.

Other healthy behaviors have not yet been shown to impact breast cancer survival, but are part of a lifestyle that may help protect against other cancers and diseases.

A healthy lifestyle includes:

Learn more about a healthy lifestyle for breast cancer survivors.

Taking hormone therapy as prescribed

If you are being treated with hormone therapy (tamoxifen or aromatase inhibitors), it’s important to take these drugs as prescribed. People who complete the full course of hormone therapy have a lower risk of [123-126]:

  • The first cancer coming back
  • Getting a second primary breast cancer
  • Death from breast cancer

Learn more about the importance of following your treatment plan.