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

Survival and Risk of Recurrence After Treatment

Everyone who’s had breast cancer is at risk of recurrence (return of breast cancer). However, most people diagnosed with breast cancer will never have a breast cancer recurrence.

Talk with your health care provider about your risk of breast cancer recurrence and things you can do that may lower your risk.

Risk of breast cancer recurrence

Risk of breast cancer recurrence varies greatly from person to person and depends on:

  • The biology of the tumor (characteristics of the cancer cells)
  • The stage at the time of the original diagnosis
  • The treatments for the original cancer

If you are diagnosed with a recurrence, it’s not your fault. You did nothing to cause it.

Treatment type and breast cancer survival

One major decision you may face with early breast cancer is whether to have lumpectomy (also called breast conserving surgery) plus radiation therapy or mastectomy. They are equally effective in treating early breast cancer.

Overall survival is the same for lumpectomy plus radiation therapy versus mastectomy. This means both treatments lower the risk of dying (from breast cancer or other cause) by the same amount.   

For a summary of research studies on lumpectomy plus radiation therapy versus mastectomy in the treatment of early breast cancer, visit the Breast Cancer Research Studies section

Risk of breast cancer recurrence

The choice between lumpectomy plus radiation therapy versus mastectomy doesn’t affect survival. However, it may affect your risk of breast cancer recurrence within the breast.

Local recurrence

Local recurrence is the return of cancer to the breast, chest wall or nearby lymph nodes after treatment.

Most local recurrence occurs within the first 5 years after diagnosis [133-134].

If you have a recurrence, you’ll need more treatment.

Learn about treatment for local recurrence.

Distant recurrence (metastasis)

Distant recurrence (metastasis) occurs when cancer spreads beyond the breast and nearby lymph nodes to other organs such as the bones, liver, lungs or brain.

The risk of distant recurrence is the same for people who have lumpectomy plus radiation therapy and those who have mastectomy [135].

Learn about treatment for distant recurrence (metastatic or advanced breast cancer).

Lumpectomy plus radiation therapy and local recurrence

For women who have lumpectomy plus radiation therapy, the chance of local recurrence in 10 years is about 3-15 percent [136-137].

The risk of local recurrence depends on tumor characteristics such as hormone receptor status and HER2 status.

It also depends on whether or not the tumor margins and the lymph nodes in the underarm area contain cancer cells. The chance of local recurrence is lower when [2,135]:

  • Tumor margins do not contain cancer
  • Lymph nodes do not contain cancer

Chemotherapy, hormone therapy and/or HER2-targeted therapy can lower the risk of breast cancer recurrence for people treated with lumpectomy plus radiation therapy [135].

Mastectomy and local recurrence

With mastectomy, the best predictor of local recurrence is whether the lymph nodes in the underarm area (axillary lymph nodes) contain cancer.

The more axillary lymph nodes with cancer, the higher the risk of recurrence tends to be [133].

  • When the axillary nodes don’t contain cancer, the chance of local recurrence in 5 years is about 6 percent [133].
  • When the axillary nodes contain cancer, the chance of local recurrence in 5 years is about 23 percent following mastectomy without radiation therapy [133]. Radiation therapy can reduce this risk to about 6 percent [133].

Learn more about breast cancer recurrence.

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