The Who, What, Where, When and Sometimes, Why.

Survival and Risk of Breast Cancer Recurrence After Treatment

Everyone who’s had breast cancer is at risk of recurrence (return of breast cancer). However, most people diagnosed with breast cancer will never have a recurrence.

Talk with your health care provider about your risk of recurrence and things you can do that may lower your risk.

Learn about medical care after breast cancer treatment ends, including breast cancer screening.

Risk of breast cancer recurrence

The risk of breast cancer recurrence varies greatly from person to person and depends on many things including the:

  • Biology of the tumor, including biomarkers (such as hormone receptor status, HER2 status)
  • Tumor profiling score, for hormone receptor-positive tumors
  • Stage at the time of the original diagnosis
  • Treatments used for the original cancer

If you have a breast cancer recurrence, it’s not your fault. You did nothing to cause it.

Learn about treatment for local breast cancer recurrence.

Learn about treatment for distant breast cancer recurrence (also called metastatic or advanced breast cancer).

Treatment type and breast cancer survival

One major decision you may face with early breast cancer is whether to have a lumpectomy (also called breast-conserving surgery) plus radiation therapy or a mastectomy. They are equally effective in treating early breast cancer.

If both surgeries are options, overall survival is the same for a lumpectomy plus radiation therapy and a mastectomy [1-2]. This means both treatments lower the risk of dying (from breast cancer or other cause) by the same amount.

Learn more about deciding between a mastectomy and a lumpectomy.

For a summary of research studies on lumpectomy plus radiation therapy and mastectomy in the treatment of early breast cancer, visit the Breast Cancer Research Studies section

Risk of breast cancer recurrence

The choice between a lumpectomy plus radiation therapy and a mastectomy doesn’t affect survival. However, it may affect your risk of breast cancer recurrence within the breast.

Local recurrence

Local recurrence is the return of cancer to the breast, chest wall or nearby lymph nodes after treatment.

Most local recurrence occurs within the first 5 years after diagnosis [169-170].

If you have a local recurrence, you’ll need more treatment.

Learn about treatment for local breast cancer recurrence.

Distant recurrence (metastasis)

Distant recurrence occurs when cancer spreads beyond the breast and nearby lymph nodes to other organs such as the bones, liver, lungs or brain. This is metastatic, stage IV or advanced breast cancer.

The risk of distant recurrence is the same for people who have a lumpectomy plus radiation therapy and those who have a mastectomy [171].

Learn about treatment for distant recurrence (metastatic or advanced breast cancer).

Lumpectomy plus radiation therapy and local breast cancer recurrence

For women with early breast cancer who have a lumpectomy plus radiation therapy, the risk of local recurrence depends on tumor characteristics, including biomarkers (such as hormone receptor status and HER2 status).

It also depends on whether or not the tumor margins and the axillary lymph nodes (the lymph nodes in the underarm area) contain cancer cells. The chance of local recurrence is higher when [171-173]:

  • Tumor margins contain cancer
  • Lymph nodes contain cancer

Chemotherapy, hormone therapy, HER2-targeted therapy and/or other drug therapies can lower the risk of breast cancer recurrence for people treated with a lumpectomy plus radiation therapy [10].

Mastectomy and local breast cancer recurrence

With a mastectomy, the best predictor of local breast cancer recurrence is whether the axillary lymph nodes (the lymph nodes in the underarm area) contain cancer.

The risk of local recurrence is usually higher when there are more axillary lymph nodes with cancer than when there are few or no nodes with cancer [169,173].

Learn more about breast cancer recurrence.

Updated 04/11/24

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