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Breast cancer recurrence happens when breast cancer comes back after you receive treatment. I often get asked which breast cancer types have the highest rates of disease recurrence.

The answer isn¡¯t so simple. Read on to learn what factors may contribute to breast cancer recurrence and get answers to other common questions I hear about breast cancer recurrence.

Which types of breast cancer are more likely to recur?

All types of breast cancer can recur.

There isn¡¯t one variable that uniquely determines whether breast cancer will come back in a particular patient. Recurrence depends on several factors, including the cancer¡¯s stage, receptor status, the tumor¡¯s response to treatment and compliance with the recommended treatment.

Cancer stage

One of the best predictors of breast cancer recurrence is the cancer¡¯s stage at the time of diagnosis.

In general, the higher the cancer¡¯s stage, the higher the risk for recurrence. So, if you are diagnosed with breast cancer at stage III, there¡¯s a higher chance that the breast cancer will come back compared to being diagnosed with breast cancer at stage I.

However, this doesn¡¯t mean that all stage III breast cancers will eventually recur. And some stage I breast cancers may recur.

Receptor status

The breast cancer¡¯s receptor status subtype may also contribute to recurrence. There are three receptors that we measure in breast cancer: estrogen, progesterone and HER2. Receptor status refers to how these three receptors express in the breast cancer cell: positive or negative. The combination of these three receptors determines the receptor status of each breast cancer and guides doctors on how to treat the disease.

Triple-negative breast cancer (all three receptors are negative) is an aggressive subtype of breast cancer, meaning that the cancer tends to grow rapidly and usually requires chemotherapy.

Inflammatory breast cancer is an aggressive type of cancer that is often triple-negative or HER2 positive. It has a high rate of recurrence.

Treatment

While aggressive breast cancers have a higher risk for recurrence, that¡¯s not always the case.

How you treat the breast cancer initially ¨C including chemotherapy, radiation therapy, the type of surgery and other therapies ¨C as well as how the tumor responds to these treatments can affect your risk for recurrence.?

For example, triple-negative breast cancer usually responds well to systemic therapy. So, patients who get chemotherapy with immunotherapy and then have breast surgery and experience a pathological complete response have a lower risk for recurrence than someone who has an estrogen receptor-positive breast cancer that did not respond to therapy.

However, if someone has triple-negative breast cancer and the tumor does not respond after chemotherapy and surgery ¨C or grows larger during chemo, that cancer has a very high risk for recurrence.

How long after treatment does breast cancer come back???

Again, it depends.

We researched the recurrence risk for triple-negative breast cancer after five years from completion of treatment and found that the risk was very low, around 2% to 3%. This is for all stages of triple-negative breast cancer. If you are disease-free at year five, you have a very low risk for recurrence.

HER2 positive breast cancer is like triple-negative breast cancer in that if it does recur, it¡¯s usually in the first five years after treatment.

About 50% of estrogen receptor-positive breast cancer recurrences happen in the first five years. The other 50% of recurrences are after five years. Most recurrences happen in the first 10 years, but it could be further out than that. We¡¯ve had patients who had a recurrence 25 years after treatment, but those cases tend to be rare.?

Cancer runs very strongly on one side of my family. Several members have had either breast cancer or ovarian cancer. Two tested positive for the BRCA1 genetic mutation. So, I knew the odds were pretty high that I carried it, too.?

After finding out about the mutation, I put off getting genetic testing for about two years. I didn¡¯t want to know yet.

But I became the first person of my generation in my family to take the plunge. The testing confirmed my fears: I had the BRCA1 mutation. That substantially increased my risk of developing both breast and ovarian cancers. I started getting high-risk breast cancer screenings every six months.?

So, I was shocked when I was diagnosed with triple-negative breast cancer at age 34.

My triple-negative breast cancer diagnosis

I¡¯d been told that I had until I was about 40 to start making decisions about whether to have my breasts or ovaries removed to reduce my risk. I was glad, because I wanted to wait until I was finished having children to do so.

But when I had my last check-up about two months after I weaned my son, the scan showed a peanut-sized lump in my right breast. Additional testing revealed it was stage II triple-negative breast cancer.

Why I chose MD Anderson

My relatives didn¡¯t get sick until they were in their 50s. And I¡¯d done everything I was supposed to do, including being proactive on screening. But I still got cancer. I was pretty surprised and frightened. Breast cancer sucks, period. But triple-negative breast cancer makes it feel extra scary, because it¡¯s even harder to treat and has higher rates of recurrence.

I knew from relatives that where you go first for cancer treatment is pretty important. But what clinched my decision to go to MD Anderson was the online research my husband conducted. He quickly discovered that chemotherapy only has about a 50% chance of working against triple-negative breast cancer. We wanted better odds than that.

My triple-negative breast cancer treatment

My husband found a clinical trial at MD Anderson run by breast medical oncologist . He reached out to her for more information. Dr. Litton was not able to take me on as a patient, but she referred me to a colleague who was almost entirely focused on triple-negative breast cancer.

I joined a clinical trial under that doctor and received a PARP inhibitor for six months as a part of her study. For a while, the PARP inhibitor kicked my cancer¡¯s butt. Unfortunately, it also caused me a lot of blood issues, so the doctors had to reduce my dosage.?

I didn¡¯t have a complete response to the PARP inhibitor. So, after the clinical trial, I had a double mastectomy, an oophorectomy and a chemotherapy combination called ACT. That acronym stands for doxorubicin hydrochloride (Adriamycin) and cyclophosphamide, followed by paclitaxel (Taxol).?

It¡¯s been almost five years now since I finished breast cancer treatment. Assuming I don¡¯t have a recurrence, I will officially show no evidence of disease by summer 2025.

My life today

The clinical trial I joined didn¡¯t work out quite as well for me as I¡¯d hoped. But I made a lot of friends on it. And some of them had a perfect response to it, with no blood issues. I was really happy for them.

I have an 8-month-old baby now, and my son is 7. So, I¡¯m finding ways to cultivate more balance in my life and focusing on the things that matter most: family, friends and community. I¡¯ve learned that waking up every day is not guaranteed. So, I live my life full of gratitude. I am grateful to all the nurses, doctors, surgeons, and staff at MD Anderson who supported me ¡ª and do so every day, for thousands of other patients.

Dr. Litton told me that MD Anderson is working on new PARP inhibitors that may cause fewer side effects. That made me feel really good, too. Clearly, I wasn¡¯t the only person who struggled with the one I was on. But if what I went through was helpful for somebody else, then I¡¯m glad I did it.

Right now, my only lingering issues are osteoporosis and dry mouth. Those are no big deal, though, considering I¡¯m still here. I¡¯m just happy to be alive.?

If the cancer ever comes back, the new medication Dr. Litton mentioned could be an option for me. It might not save my life, but it could prolong it. And that would be OK.

or call 1-877-632-6789.

By late 2021, Jennifer Connaly and her husband, Trey, completed five rounds of IVF in the hopes of becoming pregnant with a second child. The process had been unsuccessful, but when she felt a lump in her left breast, she thought it could be a side effect of the medication she had been taking. At an exam with her gynecologist, she asked for a mammogram just to be sure. Jennifer was only 36 years old at the time.

When the mammogram showed a suspicious spot, she underwent a biopsy and ultrasound. Jennifer remembers receiving the call that she had stage II triple-negative breast cancer.?

¡°I was in shock,¡± Jennifer recalls. ¡°No one in my immediate family had dealt with cancer.¡±?

Jennifer, her husband and her parents gathered and prayed together while they processed the news. She also shared the diagnosis immediately with her 10-year-old son and her niece. One of Jennifer¡¯s family members was an MD Anderson employee and suggested she come to MD Anderson before making any treatment decisions.?

¡°I didn¡¯t know what to expect,¡± recalls Jennifer. ¡°After my first appointment at MD Anderson, I felt much more confident.¡±

Navigating breast cancer treatment, complications and work?

When Jennifer met with Abenaa Brewster, M.D., she?explained that the cancer was aggressive and the treatment would need to be, too. The plan was to start 24 weeks of chemotherapy with concurrent immunotherapy treatments every three weeks.

Unfortunately, Jennifer had a severe reaction to the immunotherapy. She was hospitalized with hemolysis, which is a breakdown of red blood cells. Despite the complications, scans revealed that the treatment was working. The tumor was shrinking.

Jennifer had started a new job near Pasadena, Texas at the time of her diagnosis, so she scheduled her chemotherapy treatments at MD Anderson League City on a Thursday, went to work on Friday, and used the weekend to recover from any side effects she was feeling.?

¡°Chemotherapy was actually the easiest part of treatment for me,¡± she says. ¡°It¡¯s important to stay on top of medications, especially if you¡¯re dealing with nausea. I had some fatigue, but it was manageable.¡±

In May 2022, Jennifer underwent a lumpectomy to remove the remaining tumor.?

But her complications weren¡¯t over. She had an acute liver injury and developed diabetes as a result of the steroid treatment for the liver injury, which required receiving insulin injections. Jennifer was treated by hepatologist , and was eventually able to discontinue taking insulin.

The final step in Jennifer¡¯s treatment plan was radiation therapy. But due to previous complications and medications, she was experiencing poor wound healing after surgery. She wasn¡¯t able to start radiation until her wounds were completely healed, which took about four months.

She underwent 30 rounds of daily radiation under the care of Jennifer says the treatment ¡°went rather well¡± and was able to continue working.

¡°The staff was amazing. They told me what to expect, played music for me and made me feel so comfortable,¡± says Jennifer. ¡°I knew at that point that my cancer was gone, and we were just killing any remaining cells, so that helped ease my mind.¡±

When she finished radiation treatment at the end of November 2022, Jennifer rang the bell at MD Anderson League City to mark the end of her treatment.

Gratitude for family, friends and MD Anderson¡¯s expertise

Jennifer now returns to MD Anderson for follow-up visits every four months. She appreciates being able to ask her care team questions through MyChart between appointments.?

¡°I still have my moments where I get a little scared, but I have to keep my faith,¡± says Jennifer. ¡°Now, I know what to expect if my cancer ever came back. MD Anderson really cares about their patients, and I know they¡¯re on top of it.¡±

She also tells the women in her life to get their mammograms and advocate for themselves.?

¡°Don¡¯t be scared to advocate for your health,¡± says advises. ¡°I saw two doctors who brushed me off before I found one who listened to me and got me a mammogram.¡±

Jennifer says the strength of her husband, family, God and friends helped her get through the ups and downs of treatment.

¡°Cancer not only affects the patient; it affects the entire family,¡± says Jennifer. ¡°My journey was far from easy, but I knew I was in the right place at MD Anderson.¡±

or by calling 1-877-632-6789.?