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Understanding risk of recurrence in early breast cancer

It's true that after you've been treated for early breast cancer, it can come back (recur). The highest risk of recurrence is within the first five years after diagnosis. It's perfectly normal to feel some fear about the possibility of recurrence. But you can fight fear with information. Get involved with your care. Learn as much as you can about recurrence and ways to reduce your risk.

• Defining recurrence
• Risk of recurrence over time

Defining recurrence

Even though surgery has removed your tumor, it is possible that some cancer cells may remain elsewhere in your body. Recurrence is the term used to describe the return of cancer following initial treatment, either at the same site as the original tumor or somewhere else in the body. Breast cancer can recur in the following ways:

• Local recurrence occurs in the breast where the cancer first started, or in the skin and underlying tissues where the breast used to be. This type of recurrence can happen even if you've had a mastectomy.
• Regional recurrence occurs in the lymph nodes near the affected breast. These regional lymph nodes include nodes found under the arm (axillary nodes), in the neck, and in the chest wall.
• Distant recurrence occurs in other parts of the body, such as the lung, liver, bone, or brain.

Risk of recurrence over time

The chart below shows the risk of breast cancer recurrence in each year during the 10-year period after a diagnosis of early breast cancer in patients who received no adjuvant treatment (treatment following surgery with or without radiation).

As indicated by the chart:

• The risk of breast cancer recurrence without adjuvant treatment peaks within the first three years after an initial diagnosis of early breast cancer.
• Some risk of recurrence was seen even 10 years following diagnosis.

More information about the chart above

This chart was obtained by evaluating results from a total of 55 clinical trials involving 37,000 patients. When results from different studies are combined and evaluated in this way, it is called a "meta-analysis."

• Clinical trials included in this meta-analysis all began before 1990 and compared patients who took adjuvant hormonal treatment to patients who took no adjuvant hormonal treatment at all.
• The Early Breast Cancer Trialists' Collaborative Group (EBCTCG) conducted the meta-analysis of these 55 trials.