Risk factorsBy Mayo Clinic Staff
For breast cancer survivors, factors that increase the risk of a recurrence include:
June 05, 2014
- Lymph node involvement. Finding cancer in nearby lymph nodes at the time of your original diagnosis increases your risk of the cancer coming back. Women with many affected lymph nodes have a higher risk.
- Larger tumor size. Women with larger tumors have a greater risk of recurrent breast cancer.
Positive or close tumor margins. During breast cancer surgery, the surgeon tries to remove the cancer along with a small amount of the normal tissue that surrounds it. A pathologist examines the edges of the tissue to look for cancer cells.
If the borders are free of cancer when examined under a microscope, that's considered a negative margin. If any part of the border has cancer cells (positive margin), or the margin between the tumor and normal tissue is close, the risk of breast cancer recurrence is increased.
- Lack of radiation treatment following lumpectomy. Most women who choose lumpectomy (wide local excision) for breast cancer undergo breast radiation therapy to reduce the risk of recurrence. Women who don't undergo the radiation therapy have an increased risk of local breast cancer recurrence.
- Younger age. Younger women, particularly those under age 35 at the time of their original breast cancer diagnosis, face a higher risk of recurrent breast cancer.
- Inflammatory breast cancer. Women with inflammatory breast cancer have a higher risk of local recurrence.
- Cancer cells with certain characteristics. If your breast cancer wasn't responsive to hormone therapy or treatments directed at the HER2 gene (triple negative breast cancer), you may have an increased risk of breast cancer recurrence.
- Niederhuber JE, et al., eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2014. http://www.clinicalkey.com. Accessed March 12, 2014.
- Breast cancer. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed March 12, 2014.
- When cancer returns. National Cancer Institute. http://www.cancer.gov/cancertopics/coping/when-cancer-returns. Accessed March 12, 2014.
- Distress management. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed March 12, 2014.
- Hurria A, et al. Patterns of relapse and long-term complications of therapy in breast cancer survivors. http://www.uptodate.com/home. Accessed March 13, 2014.
- Rock CL, et al. Nutrition and physical activity guidelines for cancer survivors. CA: A Cancer Journal for Clinicians. 2012;62:242.
- Pruthi S (expert opinion). Mayo Clinic, Rochester, Minn. March 17, 2014.
- Moynihan TJ (expert opinion). Mayo Clinic, Rochester, Minn. March 25, 2014.