What Types of Breast Cancer Have the Highest Recurrence Rates?

Aggressive breast cancers are harder to treat, more likely to spread, and more likely to recur. The two types of breast cancer most likely to recur are inflammatory breast cancer (IBC) and triple-negative breast cancer (TNBC). These cancers are described in more detail below.

• IBC: IBC is a rare and invasive type of breast cancer. About 1% to 5% of all people’s breast cancer is IBC. IBC causes cancer cells to block lymph vessels in your breast tissue. Lymph vessels are the small tubes that drain lymph fluid from your breast. IBC spreads quickly and is usually stage 3 at the time of diagnosis.
• TNBC: About 10% to 15% of all people’s breast cancer is TNBC. Cancer cells that cause TNBC don’t have estrogen receptors (ERs) or progesterone receptors (PRs) and don’t make any, or much, of a breast cancer-associated protein called HER2. TNBC spreads faster than most other types of breast cancer and has few treatment options.

The type of breast cancer you have is a large risk factor for recurrence, but it’s not the only one. There are many other factors that can increase your chances of recurrence. These include:

• Stage at diagnosis: The stage of your cancer at diagnosis influences your risk of recurrence. A high stage increases your risk.
• Lymph node involvement: Cancers that spread to your lymph nodes are more likely to recur.
• Tumor size: Large tumors increase your risk of recurrence.
• Tumor margins: A tumor margin is a border between a tumor and the healthy tissue that surrounds it. After a tumor is removed, a sample of the border area is removed and studied in a lab. If any cancer cells are found in this area, it’s called a “positive tumor margin.” This increases your risk of recurrence.
• ER status: ER-positive breast cancer cells can use estrogen to grow and reproduce. These cancers have a higher risk of recurrence and can sometimes recur decades later.
• HER2 status: HER2 is a protein often found in people who have breast cancer. High amounts of this protein can increase your risk of recurrence.
• BRCA status: People with BRCA1 and BRCA2 gene mutations are at greater risk of recurrence and developing other types of cancers.
• Radiation therapy: Electing not to have radiation therapy after a lumpectomy can increase this risk of recurrence. Not completing or receiving other recommended treatments, such as chemotherapy, immunotherapy, endocrine therapy, or targeted therapy, can also increase your risk of recurrence.
• Endocrine therapy: It’s typically recommended that people who have hormone-positive breast cancer receive endocrine therapy treatment. Not completing or receiving other recommended treatments, such as chemotherapy, immunotherapy, radiation therapy, or targeted therapy, can also increase your risk of recurrence.
• Age: Developing breast cancer while younger than 35 years of age increases your risk of developing breast cancer again.
• Obesity: Having a higher body mass index (BMI) increases your risk of recurrence.
• Sedentary lifestyle: A sedentary lifestyle can increase your risk of recurrence.
• Smoking: Smoking can also increase your risk of recurrence.

If you had a lumpectomy or a partial mastectomy, you’ll typically have a mammogram 6 months to a year after surgery and radiation. During this first year, you’ll likely also have monitoring appointments with your doctor or oncologist.

After your initial postcancer mammogram, yearly mammograms are recommended. If you’ve had a complete mastectomy, you won’t need a mammogram on that side, but you’ll still need to have yearly mammograms on your remaining breast.

Depending on your individual breast cancer risk factors and your breast density, a doctor may also recommend yearly ultrasounds, MRIs, or both.

What percentage of people with breast cancer in remission have a recurrence?

It’s difficult to pinpoint recurrence percentage rates. This is because many individual factors influence these rates, such as the stage of your cancer at the time of treatment, the type of treatment you have, or the particular subtype of your cancer.

It’s best to have a conversation with your doctor about your individual risk of recurrence and how to screen for that possibility.

Does the risk of breast cancer recurrence diminish over time?

For people treated with both a lumpectomy and radiation therapy, their recurrence rate is between 3% and 15%.

Yes. The risk of breast recurrence is highest in the first 2 years after you receive the initial diagnosis. The risk of recurrence decreases steadily as time passes.

What are the signs and symptoms of breast cancer recurrence?

The signs and symptoms of breast cancer recurrence depend on where the breast cancer recurs. A recurrence could be:

• Local: meaning it has reappeared in the same place as your original cancer
• Regional: meaning it has spread to nearby lymph nodes
• Distant: meaning it has spread to a distant part of your body

Is the outlook for an individual worse for breast cancer that returns?

The outlook for a person with recurrent breast cancer depends on multiple factors. For instance:

• whether the recurrence is local, regional, or distant
• the particular subtype of your cancer (ER, PR, or HER2 positive)
• how long it’s been since your initial breast cancer was diagnosed and treated

Your treatment team can look at all the factors specific to your recurrence to give you an idea of your overall outlook.

Aggressive and hard-to-treat breast cancers are the types most likely to recur. This includes IBC and TNBC.

The type isn’t the only breast cancer factor that can influence recurrence. Factors such as your tumor size, stage at diagnosis, tumor margin, and lymph node involvement, along with treatment choices and personal factors such as age and BMI, also play a role.

The chance of breast cancer recurrence is highest in the first 2 years and decreases with each passing year. But regular mammograms are still important for people with breast cancer in remission, no matter how much time has passed.