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Prevention

By Mayo Clinic staff

Living with cancer newsletter

Subscribe to our Living with cancer newsletter to stay up to date on cancer topics.

Nothing can guarantee your breast cancer won't return. Most women who are treated for early-stage breast cancer remain free of disease. Many people who experience a cancer recurrence blame themselves for not eating right, missing a doctor visit or something else. It's important to realize that even if you do everything just right, the cancer might return.

The following factors may affect your risk of recurrent breast cancer:

  • Tamoxifen and other hormone therapy. After initial treatment for estrogen receptor positive breast cancer, taking tamoxifen for five years reduces the risk of breast cancer recurrence by 41 percent each year. Other research suggests that some women would benefit even more by switching to an aromatase inhibitor after two to three years on tamoxifen, or by taking an aromatase inhibitor instead of tamoxifen. The decision needs to be made on an individual basis based on your particular cancer.
  • Chemotherapy. For women at high risk of cancer recurrence, chemotherapy has been shown to decrease the chance it will recur, and those who receive chemotherapy live longer.
  • Radiation therapy. Women who've had a breast-sparing operation to treat their breast cancer and those who had a large tumor or inflammatory breast cancer have a lower chance of the cancer recurring if they're treated with radiation therapy.
  • Herceptin. For women whose cancer makes extra HER2 protein, the drug Herceptin can decrease the chance of the cancer recurring.
  • Healthy weight. Weighing more than you should for your age and height increases the risk of recurrent breast cancer.

Research looking at specific aspects of diet — such as fruits and vegetables and fat — and risk of recurrent breast cancer hasn't been conclusive.

Coping and support
References
  1. Oh S et al. Quality of life of breast cancer survivors after a recurrence: A follow-up study. Breast Cancer Res Treat. 2004; 87:45-57.
  2. Hayes DF. Overview of Treatment for Locally Advanced, Recurrent, and Metastatic Breast Cancer. http://uptodateonline.com/index. Accessed Nov. 12, 2008.
  3. American Cancer Society, Living With Uncertainty: The Fear of Cancer Recurrence. http://www.cancer.org/docroot/MLT/content/MLT_4_1x_Living_With_Uncertainty_-_The_Fear_of_Cancer_Recurrence.asp. Accessed May 19, 2009.
  4. Punglia RS et al. Local therapy and survival in breast cancer. N Engl J Med. 2007; 356:2399-2405.
  5. UpToDate, Hirsch A, Management of Locoregional Recurrence of Breast Cancer after Breast-Conserving Therapy, July 31, 2007, accessed November 12, 2007, http://uptodateonline.com/utd/content/topic.do?topicKey=breastcn/23524&view=print.
  6. UpToDate, Hirsch A, Management of Locoregional Recurrence of Breast Cancer after Mastectomy, May 10, 2007, accessed November 12, 2007, http://uptodateonline.com/utd/content/topic.do?topicKey=breastcn/28927&view=print.
  7. Debled M et al. Prognostic factors of early distant recurrence in hormone receptor-positive, postmenopausal breast cancer patients receiving adjuvant tamoxifen therapy: Results of a retrospective analysis. Cancer. 2007; 109:2197-2204. Accessed May 19, 2009.  http://www3.interscience.wiley.com/cgi-bin/fulltext/114214630/PDFSTART
  8. Geiger AM et al. Recurrences and second primary breast cancers in older women with initial early-stage disease. Cancer. 2007; 109:966-974. http://www3.interscience.wiley.com/cgi-bin/fulltext/114082491/PDFSTART Accessed May 19, 2009.
  9. Freedman GM et al. Identifying breast cancer patients most likely to benefit from aromatase inhibitor therapy after adjuvant radiation and tamoxifen. Cancer. 2006; 107:2552-2558.
  10. Hayes DF et al. Follow-up of patients with early breast cancer. N Engl J Med. 2007; 356:2505-2513. http://content.nejm.org/cgi/content/full/356/24/2505. Accessed May 19, 2009.
  11. National Breast Cancer Coalition, Gene-Expression Profile Testing, March 2007, accessed October 30, 2007, http://www.stopbreastcancer.org//index.php?option=com_content&task=view&id=161&Itemid=178.
  12. American Cancer Society, Breast Cancer Recurrence Test Gets FDA Nod, February 7, 2007, accessed May 8, 2008, http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Breast_Cancer_Recurrence_Test_Gets_FDA_Nod.asp.
  13. U.S. Food and Drug Administration, FDA Clears Breast Cancer Specific Molecular Prognostic Test, February 6, 2007, accessed October 5, 2007, http://www.fda.gov/bbs/topics/NEWS/2007/NEW01555.html.
  14. Buchanan CL, Locoregional Recurrence after Mastectomy: Incidence and Outcomes, Journal of the American College of Surgeons, October 2006, 469-474.
  15. Coombes RC, Survival and Safety of Exemestane versus Tamoxifen after 2-3 Years' Tamoxifen (Intergroup Exemestane Study): A Randomised Controlled Trial, The Lancet, February 17, 2007, 559-570.
  16. Thiebaut ACM, Dietary Fat and Breast Cancer: Contributions From a Survival Trial, Journal of the National Cancer Institute, December 20, 2006, 1753-1755.
  17. Pierce JP, Influence of a Diet Very High in Vegetables, Fruit, and Fiber and Low in Fat on Prognosis Following Treatment for Breast Cancer: The Women's Healthy Eating and Living (WHEL) Randomized Trial, JAMA, July 18, 2007, 289-298.

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May 27, 2009

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