Breast Cancer Recurrence: What You Should Know
When women quit breast cancer treatment early, they take a big risk.
Importance of Sticking With the Plan
When a woman is first diagnosed with breast cancer, her oncologists analyze the tumor closely -- already calculating her recurrence risk -- to determine the best plan of attack, explains Mark Pegram, MD, a breast cancer specialist with the Sylvester Comprehensive Cancer Center at the University of Miami School of Medicine.
More than ever before, today's breast cancer treatment is individualized -- tailored to the makeup of each patient's cancer cells, Pegram says. "If you have a large tumor that has spread to lymph nodes, the chance of recurrence is much higher than if it's smaller and has not spread. Even if you have a small tumor, it could be the tumor has characteristics that could make it aggressive."
In recent years, gene-based tests have allowed oncologists to also examine the "gene signature" of a tumor, which indicates recurrence risk. The newest such test is MammaPrint, which analyzes breast tumors for 70 cancer-related genes.
"We can pretty precisely predict 10-year probability of recurrence with gene profiles," Pegram tells WebMD. "These tests have revolutionized treatment planning for breast cancer patients."
Specific genes in the cancer cells tell oncologists how the tumor will grow, how likely the cancer is to recur, and generally how the tumor will behave. With this information, oncologists can shape treatment -- whether chemotherapy is necessary or not, and how aggressive it should be, he explains.
In this new era of breast cancer medicine, drugs and treatments can directly target specific types of cancer cells. Some drugs interfere with specific molecules involved in tumor growth. Others slow the growth of breast cancer cells that are fueled by the hormone estrogen. Others target the blood vessels that feed cancer cells.
That's why oncologists emphasize the need to stick with the treatment plan, Vogel explains. "All of this is about avoiding recurrence. The side effects of the drugs are a whole lot better than having breast cancer come back."
Toughing Out the Side Effects
Indeed, the side effects of breast cancer medications can be serious. On the telephone hotline at Living Beyond Breast Cancer (a not-for-profit agency), side effects are a common complaint. "We hear it all the time, women wanting to stop the medications because of side effects," says Caplan, who oversees the hotline.