Breast cancer recurrence rates vary by age, type, treatment, and genetics. Experts advise that those in remission monitor their health and watch for changes in breast tissue or nipples that may indicate recurrence.

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Breast cancer that is successfully treated can sometimes come back years later. This is called cancer recurrence. Most breast cancer stays in remission and does not recur, but staying alert for signs of recurrence is always important. Early diagnosis of recurrence can help increase the likelihood of a successful treatment outcome.

There are a few types of breast cancer recurrence. Breast cancer recurrence types refer to where the cancer comes back. This includes:

  • Local: A local breast cancer recurrence means that the cancer has returned to the breast as your original tumor.
  • Regional: A regional breast cancer recurrence is cancer that comes back near the original tumor, such as in the lymph nodes in your armpit or around your collarbone.
  • Distant: A distant breast cancer recurrence is cancer that comes back in a location such as your lungs, stomach, brain, liver, or another area of the body. This is also called cancer metastasis or stage 4 cancer.

Cancer progression can occur during recurrence. For example, breast cancer may recur and treatment begins, but then the cancer progresses, and the treatment stops working.

Anyone who has received a breast cancer diagnosis can experience a recurrence. However, there are multiple factors that can influence breast cancer recurrence, including:

  • Breast cancer type: Certain types of breast cancer are associated with higher rates of recurrence. This includes inflammatory breast cancer (IBC) and triple-negative breast cancer (TNBC).
  • Initial stage of cancer: The stage of your cancer at diagnosis can affect your risk of recurrence. For instance, cancer that has already spread to the lymph nodes has a higher chance of recurrence. However, radiation treatment can help reduce this risk.
  • Treatment received: Receiving a combination of surgery to remove the tumor and radiation to kill remaining cancer cells is associated with a lowered risk of cancer cells developing.

Certain risk factors are linked to a higher risk of breast cancer recurrence, including:

  • Age: An initial diagnosis before age 35 is linked to a higher chance of breast cancer recurrence.
  • Cancer stage: Being diagnosed at stage III or IV is linked to a higher risk of recurrence.
  • Genetics: Genetic factors, such as mutations on the BRCA 1 and BRCA 2 genes, can increase the risk of recurrence.
  • Lifestyle: There is some evidence to suggest smoking, alcohol, eating a low nutrient diet, and living an inactive lifestyle can increase recurrence risk.
  • Other health conditions: There is a higher risk of recurrence for people with additional health conditions, such as diabetes, stroke, and heart health conditions.

One of the best things you can do to help reduce your risk of recurrence is to stick to any treatments your team prescribes. It’s important to keep all follow-up appointments and follow the advice your oncologist and other care team members provide. It’s also a good idea to take steps such as:

It’s critical to pay attention to your body and your health. It’s important to watch for any changes to your breasts and for symptoms such as:

  • changes to your nipples
  • nipple discharge
  • new lump in the breasts
  • swollen lymph nodes
  • swelling of the breast
  • irritated skin or redness
  • headaches
  • coughing
  • chest pain
  • throat pain
  • fatigue
  • loss of appetite
  • swelling of the skin around your surgical scar or thickening of your scar
  • pain or numbness in one shoulder or arm

It’s important to mention any changes in your breast tissue — or any other symptoms you notice — to your doctor.

Recurrence is often diagnosed through testing. You might undergo some of the same tests you had during your initial diagnosis. This could include:

Treatment varies depending on the recurrent cancer’s location and earlier treatments. For instance, if you have a local recurrence of breast cancer that was previously treated with a lumpectomy, the next step might be a mastectomy. Your doctor might also recommend additional treatments that were not part of your initial treatment, such as:

  • targeted therapies
  • immunotherapy
  • hormone therapy
  • chemotherapy

These treatments can be especially beneficial for people with regional or distant breast cancer recurrence. Their exact use depends on the type of breast cancer you have and on factors such as your genetics and your previous response to treatment.

Breast cancer can recur after initial treatment. Factors such as age, type of breast cancer, genetics, and lifestyle, can all influence the risk of breast cancer recurrence, but any breast cancer can recur.

It’s important to keep an eye out for signs of breast cancer recurrence, such as changes to your breast tissue and nipples. Reporting these changes and any other possible symptoms to your doctor right away is a key part of managing your health.