Risk of recurrence

A recurrence of breast cancer can occur months or years after treatment for the original cancer has finished. Recurrence is categorised by the area in which the cancer recurs:

• Loco-regional recurrence: The breast cancer reappears in the same or similar area as the primary cancer (e.g the remaining breast tissue, chest wall or lymph nodes in the chest and axilla)
• Distant recurrence: The breast cancer has travelled to other parts of the body, most commonly the bones, liver and lungs.

Recurrences undergo testing to determine their pathology, as this may have changed from the original diagnosis.

Loco-regional recurrences are also known as locally advanced cancer, and can be treated successfully. A distant recurrence means the cancer has metastasised, and this is incurable.

Patients presenting with a symptom of breast cancer recurrence should be referred back to oncology services for assessment. Patients with suspected recurrence should not be referred to the breast clinic.

In New Zealand, 92% of patients whose breast cancer was detected by mammogram will survive 10 years or more. For patients who found their breast cancer via a palpable lump, 10-year survival is 75%.

The following factors further raise the risk of recurrence:

• Lymph node involvement
• Larger tumour size
• Higher grade of cancer
• Positive or close margins in tumour excision
• Lack of radiation therapy following breast conserving surgery
• Lack of endocrine therapy for hormone receptor-positive breast cancer
• Triple negative or inflammatory breast cancer
• Younger age (particularly patients aged under 35 years at the time of diagnosis)
• Obesity.

The patient’s medical team will be able to discuss their individual risk of recurrence in detail.