It also explains why late recurrence happens and how to reduce your risk.
Lisa Fought Breast Cancer for 8 Years.
People are often shocked to learn that their breast cancer has come back after, say, 15 years.
Istockphoto.com/Stock Photo©Chinnapong
Hormonal therapycan have a significant effect on the risk of recurrence.
Estimating this risk may help determine who should receive extended hormonal therapy (beyond five years).
Research is actively looking for ways to assess gene expression and copy number to predict risk.
People with these tumors remain at risk for the remainder of their lives.
A small number of people with triple-negative breast cancer also experienced late recurrences.
Many breast cancer survivors underestimate their risk of late recurrence.
Early recurrence is usually defined as cancer that comes back within the first five years after diagnosis.
Late recurrence can occur anywhere from five to 10 or more years after diagnosis.
Distant metastases are associated with a poorer survival rate than local or regional cancer.
It is distant recurrences that are discussed here.
These include:
Some factors do not appear to affect the risk of recurrence.
That said, receptor status plays a significant role in when recurrences may occur.
That said, some hormone-positive tumors are more likely to recur late than others.
With estrogen receptor-positive breast cancer (hormone-sensitive tumors), more than half of recurrences occur after five years.
The lowest risk was seen in people with small, node-negative tumors.
Those who have node-negative tumors were roughly four times more likely to have a late than an early recurrence.
Cancers with lower tumor grade were also more likely to recur after five years.
Impact of Late Recurrence
The impact of late distant recurrence cannot be stressed enough.
Once breast cancer is metastatic, it is no longer curable.
Altogether, these four subtypes accounted for roughly 26% of breast cancers that were estrogen receptor-positive and HER2-negative.
Why Late Recurrence?
While dormant, these cells are, in fact, the greatest threat to people diagnosed with early-stage disease.
The tumor microenvironment also likely plays a role no matter the mechanism.
Unfortunately, both tamoxifen and aromatase inhibitors have side effects that can reduce a person’s quality of life.
Also, the risks and benefits of extending treatment beyond five years must be weighed carefully for each individual.
However, there areside effects to taking aspirinas well.
Longer-term research has, unfortunately, dispelled this belief.
Some degree of fear can be a good thing.
Yet, too much fear can be paralyzing.
If you’re struggling with this fear, seeking professional help can be wise.
And in fact, there have even been studies linking psychological support with survival.
The characteristics of cancer may change as well.
HER2 status can also change.
Prognosis of Late vs.
Early Cancer Recurrence
Late recurrence is associated with a better prognosis than early recurrence in estrogen receptor-positive breast cancer.
In this study, the lungs were the most common site of late distant recurrence.
Summary
Learning that late recurrences are common with hormone receptor-positive breast cancer can be disconcerting.
In some ways, hormone receptor-positive tumors are more treatable but may be less curable.
For this reason, it’s important to talk to your oncologist about your particular cancer.
National Cancer Institute.Cancer stat facts: female breast cancer subtypes.
2022;14(3):e22804.
2019;37(16):1365-1369. doi:10.1200/JCO.18.01933
