Fear of Breast Cancer Recurrence
After treatment for early or locally advanced breast cancer ends, many people are afraid they still have cancer or the cancer will come back (breast cancer recurrence).
These fears are normal.
There are healthy ways to cope with the stress caused by these fears.
Some complementary therapies may help ease fears of breast cancer recurrence, including [103-105]:
- Counseling (psychotherapy)
- Cognitive behavioral therapy (a special type of mental health counseling that may include techniques such as relaxation exercises)
- Mindfulness meditation
Sometimes, cognitive behavioral therapy and counseling may be done remotely.
For some people, talking to a counselor or joining a support group can be helpful. Your health care provider may be able to help you find a counselor or support group.
If your fear of recurrence doesn’t get better (or even gets worse) over time, talk with your health care provider. Your provider can help you find ways to reduce your emotional distress.
Learn more about support groups and other types of social support.
Watch our video of Komen grantee Dr. Tarah Ballinger who talks about the fear of breast cancer recurrence and ways to cope with it.
Susan G. Komen® Support Resources |
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How is a local breast cancer recurrence or metastasis found?
Breast cancer that recurs at the original site is called a local recurrence. A local recurrence is usually found on a mammogram, during a physical exam by a health care provider or when you notice a change in or around the breast or underarm.
Breast cancer that returns and spreads to other parts of the body is called a distant recurrence (metastasis). This is metastatic breast cancer and may also be called stage IV or advanced breast cancer.
Metastasis is usually found when new and persistent symptoms are reported to a health care provider and follow-up tests are done.
For people with no signs or symptoms of metastases, using blood or imaging tests (other than mammography) does not increase survival or improve quality of life [3,5]. These tests are not a standard part of follow-up care.
If you have a local recurrence or metastasis, it’s not your fault. You did nothing to cause it.
Learn about follow-up care after breast cancer treatment.
Learn more about breast cancer recurrence.
Risk of breast cancer recurrence
Local recurrence
Most local breast cancer recurrences occur within the first 5 years after diagnosis [107-108].
The risk of local recurrence varies from person to person and depends on the original breast cancer diagnosis and treatment.
Getting regular medical care after treatment is the best thing you can to do make sure a local recurrence is found early, when the chances of survival are highest.
If a local recurrence is found, it’s treated in much the same way as the first breast cancer.
Learn more about the risk of local recurrence.
Learn more about treatment for local recurrence.
Metastasis
When breast cancer metastasizes, it most often spreads to the bones, lungs, liver or brain.
The risk of metastasis varies from person to person and depends on the original breast cancer diagnosis and treatment.
Learn more about the risk of metastasis.
Learn about treatment for metastatic breast cancer.
Risk of a new breast cancer
Women who’ve had breast cancer in the past have a higher risk of getting a new breast cancer than women who’ve never had breast cancer [109-110].
A new breast cancer is called a second primary breast cancer. Unlike a recurrence (a return of the first breast cancer), a second primary tumor is a new cancer unrelated to the first.
- Women treated with lumpectomy (also called breast-conserving surgery) for their first breast cancer can get a second primary cancer in either breast.
- Except in rare cases, women treated with mastectomy for their first breast cancer can only get a new cancer in the contralateral (opposite) breast.
Learn more about risk of a second primary breast cancer.
People at higher risk of a second primary breast cancer (or other second cancer)
Some people may have a higher risk of a second primary breast cancer (or other second cancer) [111]. This includes some people with a family history of breast cancer (or certain other cancers) and those who have a BRCA1, BRCA2 or other inherited gene mutation related to breast cancer [111].
Learn more about family history and risk of breast cancer.
Learn more about BRCA1 and BRCA2 inherited gene mutations and the risk of a second primary breast cancer.
Learn more about BRCA1/2 gene mutations and risk of breast and other cancers.
Learn more about risk-lowering options for women with BRCA1/2 gene mutations.
| For a summary of research studies on BRCA1 and BRCA2 inherited gene mutations and breast cancer, visit the Breast Cancer Research Studies section. |
Risk-reducing surgery does not improve survival for most women diagnosed with breast cancer
Risk-reducing contralateral mastectomy (contralateral prophylactic mastectomy) is the removal of the contralateral (opposite) breast in a person with breast cancer in only one breast.
Removing the contralateral breast does not lower the risk of dying from the original breast cancer [2].
The National Comprehensive Cancer Network (NCCN) recommends risk-reducing contralateral mastectomy only be considered for women who have a very high risk of breast cancer due an inherited gene mutation in one of these genes [111]:
- BRCA1
- BRCA2
- CDH1
- PALB2
- STK11
- TP53
If you have an inherited gene mutation in one of these genes, talk with your health care provider about whether risk-reducing contralateral mastectomy is right for you.
Learn more about risk-reducing mastectomy.
Learn more about inherited gene mutations.
Your risk of breast cancer recurrence
Healthy lifestyle
Some healthy behaviors may be linked to a lower risk of breast cancer recurrence and improved survival. Others are part of a lifestyle linked to a lower risk other cancers and other health conditions.
A healthy lifestyle includes:
- Maintaining a healthy weight
- Eating a healthy diet
- Limiting alcohol intake
- Getting regular physical activity (exercise)
- Not smoking
Learn more about a healthy lifestyle for people who’ve had breast cancer.
Taking hormone therapy as prescribed
If you’re being treated with hormone therapy (tamoxifen or an aromatase inhibitor), it’s important to take these drugs as prescribed.
People who complete the full course of hormone therapy have a lower risk of [112-114]:
- The first breast cancer coming back
- Getting a second primary breast cancer
- Death from breast cancer
Learn more about the importance of following your treatment plan.
Updated 12/28/23