Fear of Breast Cancer Recurrence
After treatment for early or locally-advanced breast cancer ends, many people are afraid they still have cancer or the cancer will come back (breast cancer recurrence).
These fears are normal.
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.
Susan G. Komen® Support Resources
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 in or around the breast or underarm.
- Metastasis is usually found when signs or symptoms are reported during follow-up office visits with your health care provider.
For people with no signs or symptoms of metastases, using blood or imaging tests (other than mammography) does not increase survival [5,7]. These tests are not a standard part of follow-up care.
Learn about follow-up care after breast cancer treatment.
Learn more about breast cancer recurrence.
Risk of breast cancer recurrence
Most local breast cancer recurrences occur within the first 5 years after diagnosis [97-98].
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.
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 [99-101].
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.
- Except in rare cases, women treated with mastectomy for their first breast cancer can only get a new cancer in the other breast.
Learn more about risk of a second primary breast cancer.
People at higher risk of a second primary breast cancer (or other second cancer)
Some people may have a higher risk of a second primary breast cancer (or other second cancer) . This includes some people with a family history of breast cancer (or certain other cancers) and those who have a BRCA1, BRCA2 or other inherited gene mutation .
Learn more about family history and risk of breast cancer.
Learn more about BRCA1/2 gene mutations and risk of breast and other cancers.
Learn more about risk-lowering options for women with BRCA1/2 gene mutations.
For a summary of research studies on BRCA1 and BRCA2 inherited gene mutations and breast cancer, visit the Breast Cancer Research Studies section.
Preventive surgery does not improve survival for most women diagnosed with breast cancer
Contralateral prophylactic mastectomy is the removal of the opposite (contralateral) healthy breast in a woman with breast cancer in one breast. Sometimes, there may be cosmetic reasons to consider surgery to the contralateral breast.
However, removing the contralateral breast does not lower the risk of dying from the original breast cancer .
The National Comprehensive Cancer Network (NCCN) recommends contralateral prophylactic mastectomy only be considered for women who have a high risk of a new breast cancer. This includes women with an inherited gene mutation in one of these genes :
If you have an inherited gene mutation in one of these genes, talk with your health care providers about whether contralateral prophylactic mastectomy is right for you.
Lowering your risk of getting breast cancer again
Some healthy behaviors may be linked to a lower risk of breast cancer recurrence and improved survival.
Other healthy behaviors have not been shown to impact breast cancer survival, but are part of a lifestyle that may help protect against other cancers and other diseases.
A healthy lifestyle includes:
- Maintaining a healthy weight
- Eating a healthy diet
- Limiting alcohol intake
- Getting regular physical activity (exercise)
- Not smoking
Learn more about a healthy lifestyle for people who’ve had breast cancer.
Taking hormone therapy as prescribed
If you’re 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 [103-105]:
- The first breast cancer coming back
- Getting a second primary breast cancer
- Death from breast cancer
Learn more about the importance of following your treatment plan.
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