Late Breast Cancer Recurrences

Generally speaking, a recurrence more than five years after the diagnosis of cancer is consider a "late recurrence". As an aside, the famous five year mark is really not a very helpful way to think about all of this. Yes, there are some cancers (e.g. leukemia) that, after five healthy years, you can begin to believe that you really are going to stay well. However, most other cancers don't bring that kind of reassurance after five years. Of course, most of the really lethal ones don't have too many people who are alive and well at that point, but that is hardly a reassuring consideration.

With breast cancer, there are far too many late recurrences. And by late, I am talking about seven or twelve or even (uncommon) twenty years later. No one knows all the reasons this can happen. The obvious ones are that most women with ER positive breast cancers are treated with hormonal/anti-estrogen therapies (Tamoxifen and/ or an AI) for at least five, and increasingly, ten years. That theory would be that those medication keep the cancer quiet for the duration. Once stopped, sometimes the cancer starts to move. Please don't get too scared here: most women do stay well at this point.

Hardly a week passes that I don't meet with a woman who is many years post her breast cancer diagnosis and treatment and has just, to her shock and horror, learned of a recurrence. By the time a decade or more has passed, most of us are not living in the same state of anxious anticipation, and the cancer has pretty much become part of our history.

This is an article from Cancer Net about these breast cancer late recurrences. It is not exactly reassuring, but it will increase your knowledge and understanding of the problem.

Understanding the Risk of Late Recurrence of Breast Cancer

I can't explain the reason, but I am unable to copy and paste the beginning of this article. Here is the link:

http://www.cancer.net/blog/2017-05/understanding-risk-late-recurrence-breast-cancer

From surgery and reconstruction to radiation therapy, chemotherapy, adjuvant hormone therapy, and follow-up doctor visits, the road back to health after a breast cancer diagnosis can be long and difficult to navigate. Patients anxiously await the day when they’ll hear that seemingly magical word: “remission.”

While remission can signal the end of a long road, it does not necessarily mean that the journey is over. Once there has been a diagnosis of breast cancer, the risk of a recurrence is never zero.

Beyond the first 5 years

The risk of breast cancer recurrence is highest during the first 2 years after the initial diagnosis. As time passes, the risk of recurrence steadily decreases. Many survivors celebrate their 5-year cancer-free date because it is well known that the vast majority of patients who have not had a recurrence by that time have a relatively low risk of recurrence at all.

A “late recurrence” of breast cancer is one that recurs after the 5-year milestone. Since the likelihood of recurrence is so low at this point, we must ask ourselves:

• Who experiences a late recurrence?

• What factors contribute to their risk?