Reoccurrence & Breast Cancer: Am I At Risk?

19 Aug 2021

The road to good health following breast cancer is not always easy and is often difficult to navigate.

Despite the all clear, the reality is that the chance of reoccurrence for many women remains high, especially within the first five years, meaning you’re always on the lookout for the slightest twitch, twinge or lump in their breasts that could signal something isn’t right.

While remission can indicate that the end of a long road is over, the reality is risk of reoccurrence for any woman who has had a breast cancer diagnosis is never going to be zero.

Beyond the first five years
The risk of breast cancer reoccurrence is at its highest within the first two years after an initial diagnosis. As time passes, the risk of reoccurrence steadily decreases, so it’s common for many patients to celebrate their five-year cancer free date, as those who have not had a reoccurrence in this time, therefore, have a relatively low risk of reoccurrence at all.

A ‘late’ reoccurrence of breast cancer, however, is one that occurs after the five-year milestone. Since the likelihood at this point is so low, it’s important to ask:

  1. Who experiences a late reoccurrence?
  2. What factors contribute to this risk?
  3. Why do patients who seem to have been ‘cured’ have to face cancer again?

Medical researchers have identified that there are many factors that can contribute to a late-stage reoccurrence, and generally relate to age, the stage of diagnosis, hormone receptor status, genetic information and lymph node involvement. Overall, while the risk of reoccurrence after five years does remain incredibly low, breast cancer survivors with an increased risk are those who:

Survivors with the following receptor statuses

    • Estrogen receptor-positive (ER+) tumour
    • Progesterone receptor-positive (PR+) tumour
    • HER2-negative (HER2–) tumour

 Premenopausal survivors who had

    • Tumour larger than 2 centimetres (cm)
    • High number of involved lymph nodes

Postmenopausal survivors who are younger than 60 and had

    • Tumour larger than 2 cm
    • High number of involved lymph nodes

Postmenopausal women who are older than 60 and had

    • High number of involved lymph nodes
    • Low levels of estrogen expression from the tumour
    • Received adjuvant hormone therapy, such as tamoxifen or aromatase inhibitors, for only a short time, because of the side effects or other reasons.

Breast cancer reoccurrences fall into two categories including local or regional.

Local is where the cancer is near the original location of the cancer, whilst regional is when the cancer has spread to other areas such as organs and bones. This is otherwise known as metastasis.

Local reoccurrences are often discovered during follow-up mammograms and annual check-ins, whilst distant metastases tend to be diagnosed during follow up exams, scans and blood tests, or when the patient tells the doctor about new symptoms.

When a late reoccurrence of breast cancer is found, your healthcare team will evaluate and categorise all of the details for you to help you plan your treatment pathway.

While breast cancer reoccurrences tend to be the same type and have the same hormone receptor status, for some women, it can change. This critical information will help to determine your treatment plan and give you the best chance for a successful outcome.

Life After Breast Cancer

Following a breast cancer diagnosis, it’s important to be kind to yourself, as you get slowly back to ‘normal’. The journey itself can be long and challenging, so it’s important to be patient and above all, kind to yourself, in order to ensure the transition is made as easy as possible.

To help support a reduced risk of reoccurrence, there are some steps you can take to help your overall health and thereby improve your cancer survivorship:

    • Take care of yourself emotionally: Seek support, speak to friends, be kind to yourself.
    • Eat a balanced diet: Good nutrition, as we all know, supports overall health.
    • Maintain a balanced weight: Research suggests that a healthy weight through a healthy diet and exercise lowers your risk of developing diabetes, blood pressure, and other cancers and chronic disease.
    • Stick with your follow-up care and screenings: While your routine oncology appointment may seem redundant, it’s important to continue with your regular screenings such as pap tests, blood tests etc to manage any potential risk, and catch things early should something occur.
    • Take your prescribed medications: If you are given a full course of hormone therapy, such as Tamoxifen, despite the side effects – which you can read about here – these medications are designed specifically to help reduce the risk of reoccurrence and are therefore incredibly important to keep up with.

Remember, as the patient, you are the single most important member of your team. So, put yourself at the top of your to-do list and be empowered to manage your overall health and wellbeing!