top of page
  • Writer's pictureSurviving Breast Cancer

Breast Cancer Recurrence: Second Primary versus Metastasis

Metastatic breast cancer (MBC), also referred to as Stage IV, or advanced stage breast cancer occurs when the cancer cells have spread through the lymphatic system or blood stream to other parts of the body such as the bones, brains, lungs, or liver. De Novo is a term that refers to a metastatic diagnosis at the time of initial diagnosis and staging. A de novo metastatic breast cancer diagnosis accounts for approximately 6-10% of breast cancer diagnoses. Distant Recurrence is a term that is used when the cancer has returned after an initial early stage diagnosis (i.e., Stage 0, II, III) and treatment, and has spread beyond the breast to other parts of the body. Likelihood of recurrence depends on a number of factors including tumor characteristics, genetic predisposition, stage, age at diagnosis, and if there was lymph node involvement to name a few. Typically oncologists will closely monitor patients for the first five years as that tends to be the window in which the likelihood of the cancer returning (recurrence) can occur. According to the Cleveland Clinic, symptoms depend on where the cancer returns. For example, people may experience bone pain if the cancer has metastasized to the bones. Other symptoms may include chronic dry cough, dizziness, extreme fatigue, chest pain, or difficulty swallowing. It is important after treatment to maintain a healthy diet, exercise, and to keep up with your medical follow up appointments. In addition to the whole month of October being recognized broadly as breast cancer awareness month, you may not know that October 13th specifically marks metastatic breast cancer awareness day.

Whereas MBC refers to the original breast cancer spreading to other parts of the body, a second primary cancer (SPC) refers to an additional, separate cancer diagnosis. “A second primary cancer may occur in the same tissue or organ as the first cancer, or in another region of the body. These second cancers may be related to a genetic predisposition, common risk factors, treatments for the original cancer, or simply occur sporadically as cancer often does.” ( For breast cancer survivors, this means a second primary diagnosis could be a new breast cancer diagnosis after original treatment, or a separate cancer in other tissues of the body. The incidence rate of all SPC has been rising, mainly because of improved survival rates of cancer patients after their original diagnosis.

In the articles below, we share research being done on MBC and SPC, as well as support resources for those experiencing either.

#116. Living With Metastatic Breast Cancer & Our MBC Life

While breast cancer may unite us, there are many nuances, even within the metastatic community to bring to light. These women share their unique and powerful stories with us. They are advocates and supporters, and they are here to educate, share in our community and create space for our MBC breast cancer community. Listen Now.

#110. Losing Someone You Love to MBC: Meet The Husbands In this episode, we talk with three men who have lost their wives to metastatic breast cancer -- Jimmy, Andrew, and Christian -- as they take us through their journeys through cancer with their wives and share with us the wonderful memories of these truly impactful women. They reveal the emotions they experienced with the initial diagnosis, the ways they grappled with supporting their wives while maintaining perspective, and share advice for couples who maybe embarking on their own cancer journeys together. Listen Now.

#122. Cancer Recurrence and the Power of Twitter

In this episode we speak with Silke. Diagnosed with stage II breast cancer only to find out it had spread to her bones 6 years later. Silke shares with us the intimate emotions as she navigates the successes of a surgery, a low onco-type score, and not needing radiation. After being on three lines of treatment she is now seeing positive responses from a clinical trial. Listen Now.

Thursday Night Thrivers:

Thursday October 14th, 7 PM EST

In addition to our ongoing weekly Thursday Night Thrivers meetups, beginning October 14th the second Thursday of each month will include a special breakout room for the MBC community to connect. RSVP Here.


Content Across The Web

This research, published in 2018, aimed to examine why some women develop second primary breast cancer after in situ breast cancer. They found that first-degree family history of breast cancer was associated with about a 33% increased risk of developing a second primary breast cancer among women with a previous in situ breast cancer and those with two or more affected first-degree relatives had an even higher risk, about 94% more likely. Those whose relative was diagnosed at less than 50 years old were about 78% more likely to develop a second primary breast cancer. No difference in risks associated with the number or age of affected relatives was observed by menopausal status. If your family history puts you at an increased risk, it is important to know this and share it with your doctor so that they can be proactive about monitoring for a second primary cancer. Read More.

A 2020 study out of China used data on second primary diagnoses among long-term breast cancer survivors to create a clinically predictive model of patients’ likelihood to develop an SPC. The researchers found that cumulative incidence of SPC increased over time. Radiotherapy was associated with increased risk of any SPC, while chemotherapy was significantly associated with decreased risk of any SPC. These findings can help identify patients at increased risk of SPC. Read More.

METAvivor is an organization dedicated specifically to supporting the MBC community. For Metastatic Breast Cancer Awareness Day on October 13th, they’ve created the #LightUpMBC campaign to promote the necessity of devoting more funds to MBC research. Currently only 5% of all breast cancer research funding goes toward MBC research. To help spread this message, on October 13th, 200 landmarks worldwide will be lit in pink, teal, and green, the colors of the metastatic breast cancer ribbon. Visit their site and find if any landmarks in your area will be participating this year. Read More.

Symptoms of MBC can vary depending on where it has spread to, but can include bone pain, bones that fracture or break more easily, nausea, worsening headaches, visual disturbances, jaundice, and unexplained weight loss. While some symptoms of MBC are similar to side effects of some medications you may be on, if these are new symptoms, it’s important to let your doctor know.

Most treatment for MBC is systemic, meaning the treatment targets the whole body. Treatments can include a combination of chemotherapy, hormonal therapy, immunotherapy, and targeted therapy. Your exact treatment plan will depend on what parts of the body the cancer has spread to, past breast cancer treatments, symptoms, and tumor biology (how the cells look and behave). Read More.

Recent Posts

See All


Meditation Mondays:

Chakra Chanting with Gloria

Mondays at 10:00 a.m. ET 


Thursday Night Thrivers:

All Stages Support Group

Thursdays at 7:00 p.m. ET



Thursday Night Thrivers:

Metastatic Breast Cancer Support Group

First and third Thursdays

of the month at 7:00 p.m. ET



Thursday Night Thrivers:

Inflammatory Breast Cancer Support Group

Second Thursday

of the month at 7:00 p.m. ET


The Caregiver Huddle

Third Tuesday

of the month at 7:00 p.m. ET


Tuesday Night Thrivers

Después de un Diagnóstico:

Grupo de Apoyo en Español

2do y Cuarto Martes de cada mes 

7:00 p.m. ET


Encourage and Empower

For Newly Diagnosed

September 10, 11:00 a.m. ET


Breast Cancer Book Club

The first Sunday of the month



June 14,  11:30 a.m. ET


Restorative Yoga:

Unearthing Opportunities

June 17 ,  5:30 p.m. ET


The Sun's Embrace: A Summer Solstice Meditation

June 21,  11:00 a.m. ET


Qi Gong

June 25,  11:30 a.m. ET


Art Therapy

July 1, 6:00 p.m. ET


Forest Bathing

July 2,  6:00 p.m. ET


Yoga Fitness with Chair Assist

July 9, 11:30 a.m. ET


Yoga Stretching for DIEP flap

July 9,  6:00 p.m. ET


Reflect & Recharge

Expressive Writing

July 22,  6:00 p.m. ET


Más eventos en español


Upcoming Events


Surviving Breast Cancer provides breast cancer support, events, and webinars at no cost to you! Whether you are looking to gain more knowledge on a particular topic or meet up with other breast cancer survivors, we have something for everyone. 


Our standing appointment on Thursdays is for all stages. We also host specific breakout groups once a month for specific stages and subtypes such as Metastatic breast cancer, and Inflammatory Breast Cancer, etc. 


The Book Club meets the first Sunday of every month at 11 am ET. You are welcome to join each month or pick and choose your month based on your availability and the book we are reading. 


Through art, writing, and other creative modalities, we hold the power to manage our stress, make sense of our now, and relax into moments of stillness. 


Free, monthly, online classes in restorative yoga, yoga for breast cancer, and Zumba. 


Después de un Diagnóstico

bottom of page