Why Do Some Breast Cancers Come Back? Expert Shares Causes And Preventive Measures

A breast cancer diagnosis can be a challenging journey, and for many survivors, the battle doesn't end with successful treatment. Recurrent breast cancer, when the disease makes a comeback after a period of remission, can be a daunting reality. In this blog post, we'll explore the concept of recurrent breast cancer, its types, and strategies to confront it with strength and resilience.

According to a study conducted by researchers from the National University of Ireland, Galway, even though deaths have decreased due to improved screening and treatment options, 25–30% of breast cancer patients witness a recurrence of breast cancer and eventually die from this comeback. To understand this phenomenon, the team of OnlyMyHealth spoke to Dr Rahul Wagh, Consultant- Onco Surgeon, Manipal Hospitals, Baner, Pune.

Understanding Breast Cancer Recurrence

Breast cancer recurrence occurs when cancer cells that were once thought to be eradicated during treatment reappear in the same breast, nearby lymph nodes, or other parts of the body. Recurrence can happen months or years after initial treatment, posing new challenges for patients and their healthcare teams.

Before we delve into the types of cancer that have a higher chance of recurrence, Dr Wagh explained the various types of breast cancers. “Breast cancers are generally divided on the basis of the receptors which are present in tumour cells. Tumour cells are those mutated cells that divide uncontrollably and can start spreading through a particular organ or the whole body, which is defined as cancer,” he shared.

Also Read: Triple-Negative Breast Cancer: Causes, Symptoms, And Treatment

He added, “There are three such receptors- the Estrogen receptor, the Progesterone receptor and the HER-2, which is the Human Epidermal Growth Factor Receptor 2. Depending on which type of receptor is present, breast cancers are further divided into four subtypes- three of which possess the above-mentioned receptors respectively, and the fourth is the triple-negative breast cancer (TNBC) in which neither of these three receptors is present.”

Listing the types of breast cancer that have the highest chance of recurring, Dr Wagh shared:

• Triple-Negative Breast Cancer: This cancer type is extremely aggressive. Although it originates in the breast, it can soon spread to various areas of the body beyond the breast. In stages one to three, TNBC has a recurrence rate of almost 40% post-treatment.
• Locally Advanced Breast Cancer: Breast cancer that has progressed within the breasts but has not spread outside of the mammary gland is called locally advanced breast cancer. This cancer has a recurrence rate of 27%.
• Early Onset Breast Cancer: This cancer occurs before a woman goes through menopause, and is seen in a third of the women diagnosed with breast cancer worldwide. Early-onset breast cancer is often advanced, aggressive, and harder to treat than breast cancer which begins at an older age. It has a recurrence rate of 3% to 15% within 10 years of remission.

Risk Factors For Breast Cancer Comeback

Underlining the importance of early screening and timely detection, Dr Wagh shared, “The type of breast cancer is one factor for recurrence. However, what matters most is the stage at which your breast cancer is diagnosed. If you are diagnosed when your breast cancer is still in its early stages, then your chances of recurrence are lower, maybe even less than 10-20%. But, if you are diagnosed with late-stage breast cancer, then the chances of survival and recurrence depend on the receptor type and available treatment options like targeted therapies.”

Also Read: Breast Cancer Surgery: 10 Things You Should Know Post Treatment

Explaining other risk factors that increase the rate of recurrence and mortality due to breast cancer, Dr Wagh listed:

• Gaining weight during or post-treatment can increase the risk of recurrence.
• Unchecked exposure to carcinogenic or immunity-suppressing habits also adds to the risk of breast cancer making a comeback. 
• Keeping a close watch on the spread of tumours is essential to prevent recurrence, or to effectively manage them before they lead to a full-blown comeback of breast cancer. 
• Irregular follow-up or a failure to properly follow cancer treatment also increases the chances of breast cancer recurrence. 

Dealing With A Breast Cancer Comeback

Receiving the news that your cancer is back is disheartening for survivors who gave it their all to be free of cancer. Breast cancer recurrence might be emotionally challenging, but it's essential to remember that there is still hope that you can fight breast cancer all over again. Here's how you can navigate this journey:

• Open Communication: Maintain open and honest communication with your healthcare team. Discuss your treatment options, side effects, and goals for care.
• Treatment Options: Depending on the type and location of recurrence, treatment options may include surgery, radiation therapy, chemotherapy, targeted therapy, hormone therapy, or immunotherapy.
• Support Network: Lean on your support network, including family, friends, and support groups. Emotional support can make a significant difference in coping with the challenges of recurrent breast cancer.
• Lifestyle Choices: Maintain a healthy lifestyle with a balanced diet and regular exercise. These factors can positively impact your overall well-being and treatment outcomes.
• Emotional Well-Being: Consider seeking counselling or therapy to address the emotional toll that recurrent breast cancer can have on your mental health.
• Clinical Trials: In some cases, participating in clinical trials can offer access to cutting-edge treatments and therapies. Do consult with your healthcare provider before participating as these clinical trials study experimental drugs that are not yet approved.

Recurrent breast cancer is a formidable adversary, but with the right information, support, and determination, many individuals face it head-on and continue to lead fulfilling lives. However, early detection and advances in treatment have improved the outlook for those dealing with a recurrence, yet the key to fighting cancer recurrence lies in routine checkups as early detection is the first line of defence against breast cancer recurrence. Remember, you are not alone on this journey, and there is hope even in the face of a breast cancer comeback. Stay strong, stay informed, and keep fighting. If you or someone you know is dealing with recurrent breast cancer, consult with healthcare professionals for personalised guidance and support tailored to your specific situation.