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 recurrence.
Talk with your health care provider about your risk of 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, including biomarkers (such as hormone receptor status and HER2 status))
- 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 and 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 and 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 and mastectomy doesn’t affect survival. However, it may affect your risk of breast cancer recurrence within the breast.
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 [152-153].
If you have a local 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 .
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 [155-156].
It also depends on whether or not the tumor margins and the lymph nodes in the underarm area (axillary lymph nodes) contain cancer cells. The chance of local recurrence is lower when [2,154]:
- 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 .
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 risk of recurrence is usually higher when there are more axillary lymph nodes with cancer than when there are few or no nodes with cancer .
- When the axillary nodes don’t contain cancer, the chance of local recurrence in 5 years is about 6 percent .
- When the axillary nodes contain cancer, the chance of local recurrence in 5 years is about 23 percent following mastectomy without radiation therapy . Radiation therapy can reduce this risk to about 6 percent .
Learn more about breast cancer recurrence.