Addressing Breast Cancer Recurrence in High-Risk Patients

Breast cancer recurrence is the return of cancer after treatment, and it is a concern for many breast cancer survivors. High-risk patients, who have a higher chance of recurrence, require more proactive management strategies to address this concern.

What makes someone high risk for breast cancer recurrence?

While it is not always black or white, here are some of the general factors that may increase one’s risk for breast cancer recurrence:

Advanced stage at diagnosis: The stage of breast cancer at diagnosis is one of the most important factors that determine the risk of recurrence. Patients with advanced-stage cancer, such as stage III or IV, have a higher risk of recurrence.
Younger age at diagnosis: Women who are diagnosed with breast cancer at a younger age, especially before menopause, have a higher risk of recurrence.
Hormone receptor status: Breast cancers that are estrogen receptor (ER) and/or progesterone receptor (PR) negative have a higher risk of recurrence.
HER2 status: HER2-positive breast cancers have a higher risk of recurrence.
Lymph node involvement: Breast cancers that have spread to the lymph nodes have a higher risk of recurrence.
Tumor size: Larger tumors have a higher risk of recurrence.
Disease remaining after treatment: If there are traces of cancer remaining in your body after surgery and/or other treatment like chemotherapy (called “molecular residual disease”), there is an increased risk of the cancer coming back.
Previous history of breast cancer: Patients who have had breast cancer in the past have a higher risk of recurrence.

It is important to note that while these factors increase the risk of recurrence, they do not necessarily mean that a patient will experience a recurrence. It is essential to discuss with your healthcare provider about your specific risk factors and create an individualized plan for surveillance and management.

What proactive steps can you take now?

Below are some proactive ways to address breast cancer recurrence if you are a high-risk patient:

Adjuvant therapy: Adjuvant therapy includes chemotherapy, hormonal therapy, and targeted therapy, which are given after surgery to destroy any remaining cancer cells. High-risk patients are typically recommended to receive adjuvant therapy to lower the risk of recurrence.
Lifestyle changes: Patients can lower their risk of recurrence by adopting a healthy lifestyle, which includes regular exercise, a balanced diet, maintaining a healthy weight, and avoiding alcohol and smoking.
Regular follow-up care: Patients should have regular follow-up care with their healthcare provider to monitor for signs of recurrence. Follow-up care may include regular physical exams, mammograms, blood and other imaging tests as needed. There are also new tests that look for traces of cancer in the blood called circulating tumor DNA (ctDNA) that can provide an early alert that your breast cancer may be coming back. Talk to your doctor about whether this testing may be helpful for you.
Genetic counseling and testing: High-risk patients may benefit from genetic counseling and testing to determine if they have an inherited genetic mutation that increases their risk of breast cancer. If they do, they can take steps to reduce their risk, such as prophylactic surgery or increased surveillance.
Clinical trials: High-risk patients may be eligible to participate in clinical trials for new treatments or interventions that may reduce their risk of recurrence.

In summary, addressing breast cancer recurrence in high-risk patients involves a combination of adjuvant therapy, lifestyle changes, regular follow-up care, genetic counseling and testing. You are your own best advocate! Don’t be afraid to ask questions and speak with your healthcare provider about your breast cancer and if you are at a higher risk of breast cancer recurrence. Being proactive is key!

Learn more:

Breast Cancer Recurrence: Second Primary versus Metastasis

Reducing the Risk of Breast Cancer Recurrence

Adolescents and Young Adults (AYA) with Breast Cancer

Genetic Testing for Cancer: What You Need to Know

Exercise and Breast Cancer