Recurrent and metastatic cancer

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One of the most common concerns for women following treatment for breast cancer is uncertainty about the future and fear of a recurrence.

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Cancer recurrence

What is cancer recurrence?

Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumour or to another place in the body.

Lifestyle and breast cancer recurrence

One of the most common concerns for women following treatment for breast cancer is uncertainty about the future and fear of a recurrence. The evidence suggests that there are some lifestyle factors such as physical activity that may reduce the risk of breast cancer coming back after  women have finished their treatment.

Studies of physical activity in women after breast cancer have shown some striking findings. In a recent meta-analysis of observational studies which looked at over 10,000 women after breast cancer diagnosis, even moderate physical activity was shown to reduce risk of recurrence of breast cancer by 24% and reduce risk of death from breast cancer by 34%.

A more recent study of around 3,000 women also confirms that activity such as just 3 hours a week of brisk exercise can reduce risk of breast cancer mortality by 30%.

This could mean that women who feel well enough could undertake some regular exercise such as going for a 30 minute brisk walk several times a week, going for a bike ride or doing some strength training.  It could also mean undertaking some activities such as dancing or taking the dog for a walk may also help you stay healthy.

Individual factors and risk of recurrence

Even with the knowledge about lifestyle factors, it is still not possible to predict if the cancer will return in individual women, and it is not known why breast cancer comes back in some women but not in others with seemingly the same characteristics.

There are factors which may increase the risk of recurrence related to patient characteristics, such as age, tumour characteristics such as the aggressiveness of the tumour, or extent of the spread of cancer at diagnosis.

Research is ongoing to better understand the modifiable factors which influence recurrence of breast cancer.

What makes breast cancer more likely to come back or spread?

Early breast cancer can be treated successfully.

For most women, breast cancer will not come back or spread after treatment.Sometimes breast cancer is found later in the same breast or in other parts of the body. Everyone is different and there is no way of telling for sure whether breast cancer will or will not come back.

Doctors use the information in the pathology report to work out how likely it is that breast cancer will come back or spread to other parts of the body.

Features that can affect the chance of breast cancer coming back or spreading after treatment

These are general statements based on experience with women who have had breast cancer.

INFORMATION IN THE PATHOLOGY REPORT THE BREAST CANCER IS LESS LIKELY TO COME BACK OR SPREAD IF: THE BREAST CANCER IS MORE LIKELY TO COME BACK OR SPREAD IF:
SIZE< Cancer is smaller (< 2 cm) Cancer is larger (>2 cm)
LYMPH NODES IN THE ARMPIT No cancer cells in the lymph nodes Cancer cells in the lymph nodes
HORMONE RECEPTORS Cancer cells have hormone receptors (and the woman has hormonal therapy) Cancer cells do not have hormone receptors
HER2 STATUS Cancer cells are HER2-negative Cancer cells are HER2-positive
GRADE Grade of cancer is low (Grade 1) Grade of cancer is high (Grade 3)
SURGICAL MARGIN Surgical margin is clear Surgical margin is not clear

 

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