Breast cancer recurrence: Which types of breast cancer are most likely to come back?
July 21, 2025
Medically Reviewed | Last reviewed by on July 21, 2025
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.
Key takeaways
- The risk for breast cancer recurrence depends on several factors, including the cancer¡¯s stage, receptor status and treatment.
- Breast cancer can come back in the same breast, nearby lymph nodes or in parts of the body far from the original tumor.
- Your doctor will treat a breast cancer recurrence based on the cancer¡¯s receptor status, location and initial treatment.
Where on the body can breast cancer recur?
Breast cancer recurrence can happen:
- Locally: The cancer comes back in the same breast.
- Regionally: The cancer comes back in lymph nodes surrounding the breast.
- Distant: Breast cancer comes back in other parts of the body far away from the original tumor. This is also called metastatic breast cancer or stage IV breast cancer.
Where breast cancer returns may be associated with the receptor status.
Estrogen receptor-positive breast cancers tend to recur in the bone. But they can also recur in one or several of the following:
- Brain
- Lung
- Liver
- Pleura
- Soft tissue
- Lymph nodes
- Skin
- Chest wall
Triple-negative and HER2 positive breast cancers tend to recur in the brain. About 30% of triple-negative breast cancer cases recur in the brain, and about 50% of HER2 positive breast cancer cases recur in the brain. We also see cases of triple-negative breast cancer that recurs in the bone only, but that is uncommon.
How do you treat breast cancer that has come back?
About 90% to 95% of people with metastatic breast cancer were previously diagnosed with an early-stage breast cancer and received treatment. So, they have what¡¯s called recurrent metastatic breast cancer.
The other 5% to 10% of people are diagnosed with de novo metastatic breast cancer. This means the breast cancer has already spread to distant sites or organs at the time of their initial diagnosis.
Treatment for recurrent breast cancer depends on several factors, including the cancer¡¯s receptor status, the affected organs and how the original cancer was treated. Your doctors will determine how to best treat your recurrence.
Metastatic breast cancer cannot be cured, but it can be treated. At this point, we treat to stabilize the disease and control symptoms. We are constantly looking to see if the disease progresses on the current treatment, so we can offer the next line of treatment. We want to manage metastatic breast cancer and allow you to live as long as possible with minimal symptoms.
Can you screen for breast cancer recurrence?
We¡¯re always encouraging people to get screened for early breast cancer. This helps us find the cancer in its early stages, when it¡¯s easier to treat. This leads to better outcomes for patients.
So, it can be difficult to explain to patients that we do not screen for metastatic breast cancer recurrence.
Clinical trials were conducted in the 1990s with thousands of patients who had received treatment for early-stage breast cancer. Half of these patients were getting scans, blood tests for tumor markers, X-rays and ultrasounds every three to six months. The other half of patients only got annual mammograms and physical exams. After years of follow-up, there was no difference in outcomes. Both arms of the clinical trial did the same. The cost and anxiety from extra screening with potential for false positive results is unnecessary; it¡¯s been proven not to change patient outcomes.
We don¡¯t recommend screening for metastatic breast cancer recurrence. Instead, doctors will do a workup based on any symptoms. Breast cancer that comes back will usually have symptoms.
- A skin nodule will be something you can see or touch.
- Bone metastasis will likely cause bone pain.
- Liver metastasis will change your liver function.
- Lung metastasis may cause a cough.
- Brain metastasis may cause a headache, vision changes or seizures.
If you have a symptom, your doctor will do a thorough exam to find a diagnosis. This will include a physical examination as well as necessary imaging and lab tests.
How does MD Anderson help patients who have a breast cancer recurrence?
Many breast cancer survivors have a fear of breast cancer recurrence, even those who are 20 or 30 years post-treatment. Through MD Anderson¡¯s breast cancer survivorship clinics, we explain to each patient their risk for recurrence and help them manage any feelings they have about that risk.
A breast cancer recurrence can be devastating. We offer psychosocial and psychiatric support to help patients struggling with cancer recurrence. I also reassure my patients that we have great treatments for metastatic breast cancer, and we¡¯re constantly researching to find new and better treatments.
One way to frame metastatic breast cancer is that it¡¯s like having a new diagnosis of a chronic disease, such as diabetes. There are medications for metastatic breast cancer just like there are for diabetes, and you¡¯ll need to take them for the rest of your life to help control the cancer.
MD Anderson also offers resources for metastatic breast cancer patients.
- Advanced Breast Cancer Clinic
- Support groups
- myCancerConnection, MD Anderson¡¯s one-on-one cancer support community
Seeing other people with metastatic breast cancer living fulfilling lives can give patients hope. There are so many people with metastatic breast cancer who are living long, happy lives.
, is a breast medical oncologist and serves as associate medical director of MD Anderson¡¯s breast cancer survivorship clinic.
or call 1-877-632-6789.
There isn¡¯t one variable that uniquely determines whether breast cancer will come back.
Carlos Barcenas, M.D.
Physician