Relapse after breast cancer is bad news, but rather rare

Breast cancer survival rates are improving, thanks to increased knowledge and improved therapies. In addition, just under half of all breast cancers are detected early, thanks to vigilance (take the Mammoquiz!, know the alarm signs!) and early detection. Treatment is tough, but when you're cancer-free five years after diagnosis, in all likelihood you've conquered the tumor. You are then in remission: you feel better and, on examination, no trace of the cancer can be found. If the cancer returns after a period of remission, it is called relapse. Most breast cancer patients never relapse, but a minority, including the lamented VRT news anchor, unfortunately do.

Risk factors

The chance of relapse depends on several factors: how large was the original breast cancer? How aggressive were the cancer cells? Perhaps there were already affected lymph nodes or metastases? Both hormone and hormone-sensitive cancers can relapse. In a hormone-sensitive cancer, such as triple-negative breast cancer, the risk of relapse is greatest in the first few years after diagnosis. If the breast cancer was hormone-sensitive, as most are, then relapse is still possible years, even several decades, later. No matter how small the risk, you are actually never comfortable. Breast cancer cells may have detached from the original tumor and nestled somewhere in the body, in the bone marrow for example, where they sometimes "sleep" for years, until, for unknown reasons, they wake up and begin to grow again, forming a metastasis. In this case, a metastasis in the bone is not called a bone cancer, but a metastatic breast cancer, because the cancer cells originated from breast cells. Relapse can also occur in the liver, or in the treated breast, in the scar tissue, for example. It does not matter whether you underwent breast-conserving surgery or mastectomy. The chance of relapse is the same. By the way, it can also be a new breast cancer, unrelated to the first one. Doctors can make that distinction by looking at a piece of the lump under the microscope.

Approach

When faced with relapse, the new cancerous tumor may have the same characteristics as the original breast cancer, but this is by no means always the case. Sometimes there are differences, so treatment is also different. It is even possible for a relapse of a hormone-sensitive breast cancer to be hormone-sensitive. Therefore, another biopsy is needed and a new customized treatment plan, with surgery, radiation, chemotherapy and whatever else is needed. Relapse after breast cancer is not necessarily more aggressive: certainly if the new tumor appears in the breast, it can often be treated well again. The earlier the relapse is detected, the better. Therefore, stay alert and follow up as your doctor suggests. If the relapse is located elsewhere in the body, it is a metastasis that is usually more difficult to treat. Relapse is bad news, but it is not a death sentence. You always have a chance to go back into remission and live for years to come. And remember: most women do not relapse after breast cancer.