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Breast Cancer Recurrence Rate After 10 Years

What Are The Signs Of A Breast Mastectomy

Dr. Mamounas on Recurrence Rates in Breast Cancer

A new lump in your breast or irregular area of firmness. Changes to the skin of your breast. Skin inflammation or area of redness. Nipple discharge. Signs and symptoms of local recurrence on the chest wall after a mastectomy may include: One or more painless nodules on or under the skin of your chest wall.

After 10 Years I Went Back To Where I Started

I was first diagnosed with breast cancer in 1999. I had a lumpectomy, followed by radiotherapy.

In 2009, I was told that I had a recurrence, and that the cancer had returned. It wasn’t a complete shock I always had a fear and a feeling that the cancer could come back.

Despite this, it still felt surreal that after 10 years I would be going back to where I had started.

I dealt with it by being as practical as possible. I’d learnt through my previous diagnosis how to process things logically, rather than emotionally. I wanted to know my treatment options, when we would start, what my prognosis was and how we were going to deal with it this time around.

Thinking practically about my recurrence made it so much easier to accept my diagnosis, not just for myself, but for those around me.

What Is Breast Cancer Recurrence

Itâs when your cancer comes back after treatment. It can happen a year after you finish treatment for breast cancer, or 5, 10, even 20 years later. You find another lump, or a shadow appears on your mammogram. Is the cancer back?

Every person who’s had breast cancer knows that recurrence is possible. Sometimes — such as at follow-up visits with the oncologist — it might particularly be on your mind. It helps to know exactly what a recurrence might involve. And if your thoughts about recurrence start to become a worry, it’s a good idea to talk it over with your doctor, therapist, or support group.

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What Types Of Breast Cancer Have The Highest Recurrence Rates

A study published in the Journal of Clinical Oncology found the risk of recurrence for all breast cancers was highest in the first five years from the initial cancer diagnosis at 10.4%. This was highest between the first and second years after the initial diagnosis. During the first five years after the initial diagnosis, patients with oestrogen receptor positive breast cancer had lower rates of recurrence compared with those with ER negative disease. However, beyond five years, patients with ER positive disease had higher rates of recurrence.

Is Stress Bad For Breast Cancer

Effect of anastrozole and tamoxifen as adjuvant treatment for early ...

While were not sure where we are at with cancer initiation, it appears that stress is a bad idea for people who have had breast cancer. Researchers have looked at this from several angles, albeit mostly in cells in a dish or in rodents thus far. 1 . From a biological standpoint it would make sense that stress could stimulate breast cancer

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Receptor Status And Recurrence: Early And Late

In discussing receptor status and recurrence rates it’s important to note that no two tumors are the same, and breast cancerseven those with the same receptor statusare a heterogeneous group of tumors. That said, receptor status plays a significant role in when recurrences may occur.

With estrogen receptor-negative tumors , the risk of recurrence peaks at around two years post-diagnosis, and is relatively uncommon after five years.

Estrogen and/or progesterone receptor-positive tumors, in contrast, are more likely to recur more than five years post-diagnosis than in the first five years in people treated with hormonal therapy. That said, some hormone positive tumors are more likely to recur late than others.

With estrogen receptor-positive breast cancer , more than half of recurrences occur after five years.

Clinical Data And Tumor Characteristics

The surgeon identifying the cases and constructing the database also collected data regarding date of diagnosis, menopausal status, height, weight, parity, laterality, tumor location, and distant metastases through medical records and the Swedish Cancer Registry. Information concerning tumor size, histological type, and ALNI was retrieved from histopathological examinations. Tumor type was classified using a modification of the World Health Organization classification as proposed by Linell et al. . ALNI was divided into positive, negative, or unknown if no axillary dissection had been performed.

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Tumor Size And Lymph Node Status

The risk of recurrence is linked to the size of the original tumor as well as the number of positive lymph nodes, although these factors alone can’t explain all recurrences. In the 2017 study noted earlier, for women who were cancer-free after five years of hormonal therapy, the risk of recurrence was highest for those who had large tumors that had spread to four or more lymph nodes , and lowest with small, node-negative tumors.

The risk of recurrence of these small, node-negative tumors, however, remains significant at roughly 1% per year until at least 20 years post-diagnosis. Due to the life expectancy of metastatic breast cancer , the risk of death lags somewhat behind recurrence.

Late Recurrence Rate and Lymph Node Status
Years After Diagnosis
31% 52%

Within these ranges, the risk of recurrence was greater in women who had larger tumors than smaller tumors . Tumor grade and Ki-67 had only moderate predictive value, and progesterone receptor status and HER2 status had no predictive value in this study.

It’s noteworthy that women who had one to three positive lymph nodes were twice as likely to have their cancer recur at distant locations between five years and 20 years post-diagnosis than in the first five years, and those who have node-negative tumors were roughly four times more likely to have a late than an early recurrence.

Recurrence Of Breast Cancer After More Than 10 Years Is An Important Factor In Survival

Risk factors for developing triple-negative breast cancer
Date:
ECCO-the European CanCer Organisation
Summary:
Recurrence of breast cancer in the same area as the original tumor remains the strongest, independent prognostic factor for subsequent metastasis and death, even for patients who have been free of disease for ten years, Dutch researchers have shown, in a large study of nearly 8,000 patients. The research provides further information to the debate about how long women who have been treated successfully for breast cancer should be followed up by doctors.

Recurrence of breast cancer in the same area as the original tumour remains the strongest, independent prognostic factor for subsequent metastasis and death, even for patients who have been free of disease for a very long time, according to research presented at the seventh European Breast Cancer Conference .

Dr Sven Mieog, MD, a research fellow at Leiden University Medical Centre told the conference that in women treated with breast conserving treatment for early stage breast cancer, a locoregional recurrence remained the most important prognostic factor after a disease-free interval of five years. Moreover, after a disease-free interval of ten years, locoregional recurrence remained the sole independent prognostic factor.

Dr Mieog said: “These findings suggest that even after a long, event-free interval, locoregional recurrence seems to be associated with distant disease rather than a cause of subsequent distant disease.”

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Now Is The Time To Do Things I Love

Today I feel very lucky to have more time with my family and friends. I take every opportunity I can to go on holidays, to visit relatives and to travel to new places. Now is the time to do things I love, to learn a new skill and to travel the world. I am so thankful to have the chance to do everything I want to do.

From my experience and hearing the stories of others, I know that Breast Cancer Now makes an enormous difference to the lives of people affected by breast cancer. It’s so important that they continue to offer their life-changing services for a long time.

Because of this, I’ve left a legacy in my will for Breast Cancer Now. I hope that it will help give them the resources to help more people in the future, and provide the vital support for families, friends and individuals going through the difficulties of breast cancer.

To request a free guide to gifts in wills, please email , call us on 0333 20 70 300 or download a copy here.

How Long Does It Take For Cancer To Return After Mastectomy

There is a 6% chance of cancer returning within five years if the healthcare providers didnt find cancer in axillary lymph nodes during the original surgery. There is a one in four chance of cancer recurrence if axillary lymph nodes are cancerous. This risk drops to 6% if you get radiation therapy after the mastectomy.

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Which Cancer Has Highest Recurrence Rate

Some cancers are difficult to treat and have high rates of recurrence. Glioblastoma, for example, recurs in nearly all patients, despite treatment. The rate of recurrence among patients with ovarian cancer is also high at 85%.Related Articles.Cancer TypeRecurrence RateGlioblastoma2Nearly 100%18 more rowsNov 30, 2018

Setting And Data Sources

Effects of chemotherapy and hormonal therapy for early breast cancer on ...

We conducted a nationwide cohort study using population-based registries. Denmarks National Health Service provides tax-supported health care to Danish citizens and permanent residents, ensuring equal and free access to all medical care provided by hospitals and general practitioners . Using the civil personal registration number, a unique identification number assigned to all Danish residents at birth or immigration, we linked individual-level data from Danish administrative and population-based registries , namely the Danish Breast Cancer Group database , the Danish National Patient Registry , the Danish Pathology Registry , the Danish Cancer Registry , the Danish Register of Causes of Death , and the Danish Civil Registration System . In addition, we used data on contralateral breast cancer in a database initiated for a previous study .

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Breast Cancer Survival By Age

Five-year survival for female breast cancer shows an unusual pattern with age: survival gradually increases from 85% in women aged 15-39 and peaks at 92% in 60-69 year olds survival falls thereafter, reaching its lowest point of 70% in 80-99 year-olds for patients diagnosed with breast cancer in England during 2009-2013.

Breast Cancer , Five-Year Net Survival by Age, Women, England, 2009-2013

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Recurrence Of Breast Cancer Years After The Initial Tumor

Tamoxifen was approved by the FDA in 1977 to treat advanced breast cancer. In 1998, the Early Breast Cancer Trialists Cooperative Group published results showing that tamoxifen was effective in preventing breast cancer recurrence in patients whose tumors were estrogen receptor -positive or of unknown ER status,1 which led to an expansion of the drugs indication.2 As effective as tamoxifen and other therapies have been, some breast tumors do recur. Despite the considerable scientific data and many successes in treating breast cancer, not much is known about recurrent breast tumors, other than that they can appear in almost any location in the body and at any time after remission is attainedeven decades later.

A Cure or a Disease-Free Period?

The incidence of breast cancer has remained relatively stable since 2004.3 Declining incidence during the 1990s was attributed in part to lower utilization for estrogen replacement therapy for the treatment of menopausal symptoms.4

Despite these encouraging statistics, mortality is still high among patients who are initially diagnosed with advanced-stage breast cancer. For patients who are initially diagnosed with earlystage disease, recurrent breast cancer remains a principal cause of death,7 which may occur years afterward: the old philosophy that patients who do not demonstrate tumor recurrence for 5 years are cured has been replaced by the more precise observation that they remain cancer-free.

The Complexity of Recurrence

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What Are The Signs Of Breast Cancer Recurrence

If you have a local recurrence or new primary breast cancer, you may find symptoms similar to an initial breast cancer. This includes:

  • A new lump in the breast, armpit area or around the collarbone
  • A change in breast size or shape
  • Changes to the nipple, such as sores or crusting, an ulcer or inverted nipple
  • Clear or bloody nipple discharge
  • Changes to the skin including redness, puckering or dimpling
  • Breast tenderness or pain

If your breast cancer has spread to other parts to the body, known as distant recurrence, there are a number of possible symptoms, including:

  • Unexpected weight loss or change in appetite
  • Severe or ongoing headaches

However, symptoms will vary depending on where the secondary cancer presents, and some primary and secondary cancers may not present any obvious symptoms. Sometimes recurrence is identified on a scan or blood test that was done for a reason other than breast cancer.

If you have any health concerns or symptoms that are new or persistent, speak with you GP or treating physician.

How Is Breast Cancer Recurrence Managed Or Treated

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Your treatment depends on the type of cancer recurrence, as well as past treatments. If cancer develops in a reconstructed breast, your surgeon may want to remove the breast implant or skin flap.

Treatments for local and regional breast cancer recurrence may include:

  • Mastectomy: Your surgeon removes the affected breast and sometimes lymph nodes.
  • Chemotherapy:Chemotherapy circulates in blood, killing cancer cells.
  • Hormone therapy:Tamoxifen and other hormone therapies treat cancers that thrive on estrogen .
  • Immunotherapy:Immunotherapy engages your bodys immune system to fight cancer.
  • Radiation therapy: High-energy X-ray beams damage and destroy cancer cells.
  • Targeted therapy: Treatments target specific cancer cell genes or proteins.

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Treatment For Breast Cancer Recurrence

If your care team thinks you might have a cancer recurrence, theyll recommend diagnostic tests, like lab tests, imaging or biopsies, both to be sure the cancer has come back and to get more information to guide your treatment.

Treatment options depend on where the cancer has recurred and what breast cancer treatment youve had before:

  • Local recurrence is likely to be treated surgically first with a mastectomy if you didnt have one already or a surgical removal of the tumor if you did. After surgery, breast cancer chemotherapy and radiation are commonly used, as well as hormone therapy or targeted therapy if your kind of cancer will respond to one or both of them.
  • Regional recurrence is also typically treated first with surgery to remove affected lymph nodes. After the surgery, youll likely have radiation and possibly chemotherapy, hormone therapy and/or targeted therapy, too.
  • Distant recurrence is mainly treated with drug therapychemotherapy, hormone therapy, targeted therapy for breast cancer or a combination of these. Breast cancer surgery and/or radiation might be used, too, but only in cases where the aim is relieving symptoms.

Expert cancer care

Treatment Type And Breast Cancer Survival

One major decision you may face with early breast cancer is whether to have lumpectomy plus radiation therapy or mastectomy. They are equally effective in treating early breast cancer.

Overall survival is the same for lumpectomy plus radiation therapy and mastectomy. This means both treatments lower the risk of dying by the same amount.

For a summary of research studies on lumpectomy plus radiation therapy and mastectomy in the treatment of early breast cancer, visit the Breast Cancer Research Studies section.

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How Does Breast Cancer Spread

Breast cancer can spread through the lymphatic system, the bloodstream, or uncommonly, by local invasionwhich is when cancer cells actually invade nearby tissues, such as the chest wall or ribs.

When breast cancers spread and enter the lymphatic system, they usually first arrive at nearby lymph nodes and may still be early-stage. The spread of breast cancer to lymph nodes does not necessarily mean that its metastatic, even though pathology reports often somewhat confusingly state breast cancer metastatic to lymph nodes.

A growing cancer may shed a cell or a clump of cells, and It can use your blood or lymph system as a network of highways for traveling. So, if a loose cancer cell makes it via the lymphatic system to your lymph nodes, its also possible that it may spread via the bloodstream to other parts of your body.

When cancer recurs in a lymph node near the breast, it is considered a regional recurrence and not a distant recurrence.

When breast cancer spreads to lymph nodes it has essentially declared its intent to metastasize. Breast cancer reaching the lymph nodes is in effect a declaration that its working to spread further.

In women with negative nodes, its trickier. What we want is a way to identify the 20 to 30 percent who have microscopic cells elsewhere and not over-treat the other 70 percent. At present we dont have a perfect way to do this.

Can Breast Cancer Recur

Figure 4 from Time distribution of the recurrence risk for breast ...

Most people diagnosed with breast cancer will never have a breast cancer recurrence. However, everyone who has had breast cancer is at risk of recurrence. The risk of breast cancer recurrence varies greatly from person to person. Talk with your health care provider about your risk of recurrence and things you can do that may lower your risk.

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What Are The Signs Of Distant Breast Cancer Recurrence

If your breast cancer has spread to other parts to the body, known as distant recurrence, there are a number of possible symptoms, including:

  • Unexpected weight loss or change in appetite
  • Severe or ongoing headaches

However, symptoms will vary depending on where the secondary cancer presents. Sometimes recurrence is identified on a scan or blood test that was done for a reason other than breast cancer.

Studies have shown that doctors are sometimes reluctant to mention the symptoms of metastatic disease. In medical school it was suggested that we shouldnt tell people who had been treated for cancer what to look for if they were worried about recurrences because theyd start imagining that they had every symptom we told them about, but that doesnt reassure people at all it just means theyll be afraid of everything instead of a few specific things. When youve had cancer, youre acutely aware of your body, and any symptom thats newor that you never noticed beforecan take on terrifying significance as you worry that your cancer may be back. Inevitably this will mean a lot of fear over symptoms that turn out to be harmless.

As I explain to my patients, there are good reasons these days to remain optimistic, even after cancer comes back. Newer, better treatments are becoming available all the time. And for women who were treated a long time ago, the options for treatment may have changed and improved significantly since the first time they were treated

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