Rak piersi nawrotowy
Etiologia i przyczyny

Nawrót raka piersi definiowany jest jako ponowne pojawienie się choroby nowotworowej po zakończeniu pierwotnego leczenia i remisji klinicznej. Główną przyczyną nawrotu jest przetrwanie mikroskopijnych, uśpionych komórek nowotworowych, które mogą pozostawać w stanie dormancji przez wiele lat, unikając destrukcji przez terapię. Mechanizmy oporności na leki, takie jak adaptacja komórek, zmiany ekspresji genów, przejście nabłonkowo-mezenchymalne (EMT) oraz obecność komórek macierzystych nowotworu (CSCs), odgrywają kluczową rolę w reaktywacji tych komórek i rozwoju nawrotu. Ryzyko nawrotu zależy od wielu czynników, w tym stadium i wielkości guza pierwotnego, statusu węzłów chłonnych, podtypu biologicznego (np. TNBC, HER2+), statusu receptorów hormonalnych, marginesów chirurgicznych, wieku pacjentki, mutacji genetycznych (BRCA1/2), otyłości oraz zastosowanego leczenia (chirurgia, radioterapia, terapia hormonalna). Szczególnie istotne jest, że ryzyko nawrotu u pacjentek z rakiem ER-dodatnim może utrzymywać się nawet do 20 lat po diagnozie.

  1. Etiologia raka piersi nawrotowego
    1. Mechanizm przetrwania komórek nowotworowych
    2. Stan uśpionych komórek nowotworowych
    3. Oporność na leczenie i nawrót
    4. Czynniki ryzyka nawrotu raka piersi
    5. Wzorce nawrotu raka piersi
    6. Mechanizmy molekularne nawrotu
    7. Implikacje kliniczne
  2. Podsumowanie etiologii raka piersi nawrotowego
    1. Kolejne rozdziały

Etiologia raka piersi nawrotowego

Rak piersi nawrotowy (recurrent breast cancer) to ponowne pojawienie się choroby nowotworowej po wcześniejszym leczeniu pierwotnego raka piersi. Nawrót może wystąpić po kilku miesiącach lub nawet po wielu latach od zakończenia pierwotnej terapii, podczas której nie wykryto już żadnych komórek nowotworowych w organizmie pacjentki 12. Zrozumienie przyczyn i mechanizmów odpowiedzialnych za nawrót raka piersi jest kluczowe dla opracowania skutecznych strategii leczenia i zapobiegania nawrotom.

Mechanizm przetrwania komórek nowotworowych

Główną przyczyną nawrotu raka piersi jest przetrwanie niektórych komórek nowotworowych pomimo zastosowanego leczenia. Nawet po zakończonym sukcesem leczeniu, które doprowadziło do całkowitej remisji klinicznej, w organizmie pacjentki mogą pozostać niewidoczne podczas badań, osłabione komórki nowotworowe 1. Te mikroskopijne komórki nowotworowe mogą uniknąć zniszczenia podczas pierwotnego leczenia i pozostać w ukryciu przez dłuższy czas 23.

Komórki nowotworowe mają kilka sposobów na przetrwanie terapii przeciwnowotworowej:

  • Niektóre komórki raka piersi mogą oderwać się od guza pierwotnego przed operacją i przemieścić do okolicznych tkanek, węzłów chłonnych lub do krwiobiegu 12
  • Leczenie może zmniejszyć guzy nowotworowe do punktu, w którym testy nie wykrywają osłabionych komórek nowotworowych, ale komórki te nadal mogą być obecne 1
  • Chirurgiczne usunięcie guza nie zawsze jest w 100% skuteczne 12

Stan uśpionych komórek nowotworowych

Jednym z intrygujących aspektów nawrotu raka piersi jest zjawisko uśpienia (dormancy) komórek nowotworowych. Komórki te mogą pozostawać w stanie uśpienia przez wiele lat, nie powodując żadnych objawów ani wykrywalnych zmian 12. Badania pokazują, że komórki nowotworowe mogą pozostać w stanie spoczynku przez lata, a następnie z niewyjaśnionych przyczyn zostać aktywowane i zacząć się namnażać 3.

Uśpione komórki nowotworowe charakteryzują się:

  • Zdolnością do przetrwania w mikrośrodowisku organizmu bez namnażania się 1
  • Możliwością reaktywacji pod wpływem nieznanych czynników 23
  • Potencjałem do dalszych mutacji i zmiany charakterystyki biologicznej podczas okresu uśpienia 2

Przyczyny ponownej aktywacji uśpionych komórek nowotworowych pozostają w dużej mierze niezbadane i niejasne 12. Rozważa się różne teorie dotyczące czynników aktywujących, w tym stres na poziomie komórkowym, erozję kolagenowej otoczki otaczającej uśpione komórki, czy wpływ mikrośrodowiska składającego się ze zdrowych komórek 3.

Oporność na leczenie i nawrót

Zjawiska oporności na leki i nawrotu nowotworu są ze sobą ściśle powiązane. Aby doszło do nawrotu, komórki nowotworowe muszą przezwyciężyć cytotoksyczne działanie leków stosowanych w terapii 1. Niektóre komórki nowotworowe mogą rozwinąć mechanizmy oporności na stosowane leczenie 2.

Mechanizmy oporności obejmują:

Czynniki ryzyka nawrotu raka piersi

Ryzyko nawrotu raka piersi zależy od wielu czynników związanych zarówno z charakterystyką pierwotnego nowotworu, jak i cechami pacjentki 1. Zrozumienie tych czynników może pomóc w identyfikacji pacjentek o podwyższonym ryzyku nawrotu i wdrożeniu odpowiednich strategii zapobiegawczych.

Czynniki związane z charakterystyką nowotworu

Stadium i wielkość guza pierwotnego: Istnieje związek między stadium raka piersi przy pierwszej diagnozie a ryzykiem nawrotu. Pacjentki z rakiem piersi w stadium III mają większe prawdopodobieństwo rozwoju nawrotowego raka piersi niż pacjentki z rakiem w stadium I lub II 1. Większe guzy są związane z wyższym ryzykiem nawrotu choroby 23.

Status węzłów chłonnych: Obecność przerzutów do węzłów chłonnych pachowych w momencie pierwotnej diagnozy znacząco zwiększa ryzyko nawrotu 12. Przerzuty do węzłów chłonnych pozostają bardzo ważnym czynnikiem prognostycznym 3.

Podtyp biologiczny raka piersi: Różne podtypy raka piersi wykazują odmienne wzorce nawrotu. Nowotwory potrójnie ujemne (TNBC), charakteryzujące się brakiem receptorów ER/PR/HER2, są ogólnie związane z wysokim ryzykiem nawrotu, ze szczególnie wysokim ryzykiem przerzutów odległych do mózgu i narządów miąższowych w porównaniu do guzów receptorowo dodatnich 12.

Status receptorów hormonalnych: Obserwuje się różny wzorzec nawrotów między różnymi podtypami raka piersi, przy czym nowotwory ER-ujemne są związane z wyższym ryzykiem nawrotu w ciągu pierwszych 5 lat po diagnozie w porównaniu do nowotworów ER-dodatnich 1. W przypadku osób z hormonowrażliwym (receptor estrogenowy i/lub progesteronowy dodatni) rakiem piersi, ryzyko nawrotu jest faktycznie wyższe po 5 latach niż w pierwszych 5 latach 2.

Agresywność nowotworu: Agresywne nowotwory, takie jak zapalny rak piersi i potrójnie ujemny rak piersi, są trudniejsze w leczeniu i bardziej prawdopodobne jest ich nawrócenie i rozprzestrzenienie 12.

Marginesy chirurgiczne: Jeśli brzegi usuniętej tkanki (marginesy) są wolne od komórek nowotworowych pod mikroskopem, jest to uważane za margines ujemny. Jednak jeśli komórki nowotworowe są obecne na brzegach (margines dodatni) lub jeśli margines jest bliski, ryzyko nawrotu jest wyższe 12.

Czynniki związane z pacjentką

Wiek: Kobiety, które rozwiną raka piersi przed 35 rokiem życia, są bardziej narażone na ponowny rozwój raka piersi 12. Młodszy wiek w momencie diagnozy jest silnym czynnikiem ryzyka nawrotu 3.

Historia rodzinna i mutacje genetyczne: U pacjentek z rakiem piersi z historią rodzinną raka lub mutacją genu BRCA1 lub BRCA2 wskaźnik nawrotu raka jest wyższy. Ryzyko wykrycia nowych nowotworów, takich jak rak jajnika, może być również wyższe 1. Osoby z mutacjami BRCA mają 10 razy większe prawdopodobieństwo wystąpienia drugiego przeciwległego raka piersi 2.

Otyłość: Wyższy wskaźnik masy ciała (BMI) jest powiązany ze zwiększonym ryzykiem nawrotu raka piersi 12. Duża ilość tkanki tłuszczowej może wpływać na poziom hormonów, w tym estrogenów, które mogą stymulować wzrost niektórych typów raka piersi 3.

Styl życia: Czynniki stylu życia, takie jak palenie, mogą zwiększać ryzyko nawrotu 1. Związek między spożywaniem alkoholu a nawrotem raka piersi jest niejednoznaczny – niektóre badania wykazały związek, a inne nie 2.

Czynniki związane z leczeniem

Wybór leczenia chirurgicznego: Istnieją różne czynniki ryzyka nawrotu u pacjentek z rakiem piersi poddawanych mastektomii w porównaniu do tych wybierających leczenie oszczędzające pierś 1. Lumpektomia z następową radioterapią wiąże się z 3% do 15% ryzykiem miejscowego nawrotu w ciągu 10 lat, natomiast mastektomia wiąże się z 6% ryzykiem nawrotu w ciągu pięciu lat, jeśli rak nie rozprzestrzenił się do węzłów chłonnych 2.

Terapia hormonalna: Nieotrzymanie terapii hormonalnej w przypadku raka piersi z dodatnimi receptorami hormonalnymi może zwiększyć ryzyko nawrotu 1. Hormonoterapia może mieć znaczący wpływ na ryzyko nawrotu 2.

Radioterapia: Pominięcie radioterapii po lumpektomii zwiększa ryzyko miejscowego nawrotu 1. Radioterapia po operacji oszczędzającej pierś zmniejsza ryzyko miejscowego nawrotu 2.

Wzorce nawrotu raka piersi

Ryzyko nawrotu raka piersi jest najwyższe w ciągu pierwszych 2 lat po otrzymaniu początkowej diagnozy, a ryzyko to stopniowo maleje wraz z upływem czasu 1. Jednak w przypadku pacjentek z rakiem piersi z dodatnimi receptorami estrogenowymi, ryzyko nawrotu po 5 latach od diagnozy jest stałe i może utrzymywać się nawet przez 20 lat po diagnozie, nawet w przypadku bardzo małych guzów bez zajęcia węzłów chłonnych 2.

Czas do nawrotu może różnić się w zależności od podtypu biologicznego raka:

  • Nowotwory potrójnie ujemne i HER2-dodatnie mają tendencję do wcześniejszego nawrotu (zwykle w ciągu pierwszych 5 lat) 1
  • Nowotwory ER-dodatnie mogą nawracać nawet po 10, 15 czy 20 i więcej latach 2

Stałe ryzyko nawrotu w przypadku raka piersi z dodatnimi receptorami estrogenowymi oznacza, że ryzyko nawrotu między 15 a 16 rokiem po diagnozie jest takie samo jak ryzyko nawrotu między 5 a 6 rokiem po diagnozie 1.

Mechanizmy molekularne nawrotu

Nawrót raka piersi jest klinicznie ogromnym problemem, który wciąż nie jest dobrze zrozumiany na poziomie molekularnym 1. Badania wskazują na rolę kilku ścieżek molekularnych w procesie nawrotu.

Rola mikroRNA (miRNA): W ostatnich latach zaobserwowano wykładniczy wzrost liczby badań skupiających się na funkcjonalności miRNA w progresji raka piersi 1. miRNA mogą regulować ekspresję genów zaangażowanych w wzrost, inwazję i przerzuty komórek nowotworowych.

Przejście nabłonkowo-mezenchymalne (EMT): Rola TGF-β w EMT raka piersi jest dobrze zrozumiana 1. Proces EMT umożliwia komórkom nowotworowym nabycie cech mezenchymalnych, co sprzyja inwazji i przerzutom.

Komórki macierzyste nowotworu (CSCs): Istnieje złożony związek między EMT, CSCs, opornością na leki i nawrotem raka piersi 1. CSCs mogą być odporne na konwencjonalne terapie i mogą inicjować nawrót nowotworu.

Zmiany genetyczne i epigenetyczne: Mutacje lub zmiany w genach mogą powodować rozwój normalnych komórek piersi w komórki rakowe 1. Około 90% przypadków raka piersi wynika z nabytych (a nie dziedzicznych) zmian genów 2.

Implikacje kliniczne

Zrozumienie etiologii nawrotu raka piersi ma istotne implikacje kliniczne dla leczenia pacjentek z rakiem piersi.

Indywidualizacja leczenia: Istnienie różnych podtypów raka piersi, które czasami nakładają się na siebie, ale najczęściej są tak odmienne, stanowi wyzwanie dla wyboru odpowiedniej terapii 1. Personalizacja terapii i procedur follow-up dla pacjentek wybierających różne interwencje chirurgiczne jest konieczna 2.

Znaczenie czasu wolnego od nawrotu odległego: Badania przeprowadzone wśród kobiet z HR+ lokoregionalnym, wczesnym rakiem piersi, u których następnie wystąpiła choroba przerzutowa, sugerują, że czas przeżycia wolny od nawrotu odległego dłuższy niż 5 lat jest znacząco związany z około 30% niższym ryzykiem śmierci z powodu raka piersi 1.

Przewidywanie nawrotu: Przewidywanie, które komórki nowotworowe mogą oderwać się i stać się uśpione, może pomóc lekarzom lepiej ocenić możliwość nawrotu raka w przyszłości 1.

Podsumowanie etiologii raka piersi nawrotowego

Nawrót raka piersi jest złożonym zjawiskiem, które może wystąpić nawet po skutecznym leczeniu pierwotnego nowotworu. Główną przyczyną nawrotu jest przetrwanie niektórych komórek nowotworowych po pierwotnym leczeniu, które mogą pozostawać w stanie uśpienia przez lata, a następnie zostać aktywowane i zacząć się namnażać.

Czynniki ryzyka nawrotu obejmują charakterystykę pierwotnego nowotworu (stadium, wielkość, status receptorów, podtyp biologiczny), cechy pacjentki (wiek, predyspozycje genetyczne, styl życia) oraz wybór i skuteczność leczenia. Różne podtypy raka piersi wykazują odmienne wzorce nawrotu, przy czym nowotwory agresywne, takie jak potrójnie ujemny rak piersi i zapalny rak piersi, mają wyższe ryzyko nawrotu.

Mechanizmy molekularne leżące u podstaw nawrotu raka piersi są złożone i obejmują oporność na leki, przejście nabłonkowo-mezenchymalne, rolę komórek macierzystych nowotworu oraz zmiany genetyczne i epigenetyczne. Zrozumienie tych mechanizmów może prowadzić do opracowania skuteczniejszych strategii zapobiegania i leczenia nawrotów raka piersi.

Dalsza identyfikacja czynników prognostycznych i predykcyjnych nawrotu raka piersi, a także biomarkerów odpowiedzi na terapię, pozostaje kluczowym obszarem badań, który może potencjalnie zmienić sposób leczenia pacjentek z rakiem piersi i poprawić ich długoterminowe wyniki 12.

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  1. 16.04.2026
  2. www.leksykon.com.pl

Materiały źródłowe

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    https://my.clevelandclinic.org/health/diseases/8328-breast-cancer-recurrence
    Breast cancer recurrence happens when treatment doesnt kill all the cancer cells in your breast. Breast cancer treatments are effective, but breast cancer cells can be tricky: […] Treatment can shrink breast cancer tumors to the point that tests dont detect weakened cancer cells. But the cells are still there, and over time, they can return stronger, start to grow and create tumors. […] Surgery to remove a tumor isnt always 100% effective. Before surgery, cancer cells may move from your breast to nearby lymph nodes, tissue or into your bloodstream. […] Your risk of cancer recurrence depends on several factors: […] Females who develop breast cancer before age 35 are more likely to get breast cancer again. […] Theres a connection between the cancer stage at first diagnosis and the risk breast cancer will recur. For example, people with Stage III breast cancer are more likely to develop recurrent breast cancer than people with Stage I or Stage II breast cancer. […] Aggressive cancers like inflammatory breast cancer and triple-negative breast cancer are harder to treat. Theyre more likely to come back and spread.
  • #1 Mayo Clinic Health Library – Recurrent breast cancer | Swiss Medical Network
    https://www.swissmedical.net/en/healtcare-library/con-20377118
    Recurrent breast cancer occurs when cells that were part of your original breast cancer break away from the original tumor and hide nearby in the breast or in another part of your body. Later, these cells begin growing again. […] The chemotherapy, radiation, hormone therapy or other treatment you may have received after your first breast cancer diagnosis was intended to kill any cancer cells that may have remained after surgery. But sometimes these treatments aren’t able to kill all of the cancer cells. […] Sometimes cancer cells may be dormant for years without causing harm. Then something happens that activates the cells, so they grow and spread to other parts of the body. It’s not clear why this occurs.
  • #1 Late Recurrence of Breast Cancer
    https://www.verywellhealth.com/late-recurrence-of-breast-cancer-4766608
    The reasons why cancer cells can lie dormant for extended periods of time have eluded researchers to date and are very difficult to study. […] It’s thought that in most cases, breast cancer cells metastasize (in small numbers or micrometastases) before cancer is detected, and roughly 30% of people with early-stage breast cancer have been found to have cancer cells in their bone marrow. […] For people who have estrogen receptor-positive breast cancers (and some triple-negative tumors), reducing the risk of late recurrence is critical in order to reduce deaths from the disease. […] While chemotherapy primarily reduces early recurrences, hormonal therapy can reduce the risk of late recurrence. […] There have been some studies (but not all) that suggest regular aspirin use is associated with a lower risk of recurrence.
  • #1 Pathways to Breast Cancer Recurrence
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3603357/
    This is another indication of a complex relationship between EMT, CSCs, drug resistance, and the breast cancer recurrence. […] The causes for such breast cancer recurrence remain completely unknown, except for many putative molecular markers that are under active investigation for their possible role in determining the recurrence. […] The phenomena of drug resistance and tumor recurrence are intricately related because, in order to recur, cancer cells need to overcome the cytotoxic effects of drugs that are used to control the growth of these cancers in clinics. […] The last few years have seen an exponential increase in the number of investigations focused on the functionality of miRNAs in breast cancer progression. […] The cause(s) of breast cancer recurrence and the possible strategies to prevent it remain elusive.
  • #1 Recurrent Breast Cancer: Signs, Symptoms, and Treatment Options
    https://www.compassoncology.com/blog/recurrent-breast-cancer-signs-symptoms-and-treatment-options
    Breast cancer recurrence is a second appearance of breast cancer, whether in the breast or another area of the body. […] While there may not be an exact reason that breast cancer recurrence happens, there are some things that could lead to it. Common reasons include: Incomplete removal or destruction of cancer cells during initial treatment. […] Biological characteristics of the cancer, such as aggressive tumor behavior or genetic mutations. […] Resistance to treatments, where some cancer cells adapt and survive therapies. […] The likelihood of recurrence depends on whether its fast-growing as well as the stage at the time breast cancer was initially diagnosed. […] Several factors can increase the likelihood of breast cancer returning. This includes the type of breast cancer found at the initial diagnosis, the stage at the initial diagnosis, and the size of the tumor that was initially found.
  • #1 Recognizing and Managing Recurrent Breast Cancer: Signs and Treatment Options
    https://aocancer.com/blog/recognizing-and-managing-recurrent-breast-cancer-signs-and-treatment-options
    Cancer in nearby lymph nodes at the time of the original diagnosis increases the likelihood of recurrence. […] If the edges of the removed tissue (margins) are free of cancer cells under a microscope, it is considered a negative margin. However, if cancer cells are present at the edges (positive margin) or if the margin is close, the risk of recurrence is higher. […] Not receiving endocrine therapy for hormone receptor-positive breast cancer can increase the risk of recurrence.
  • #1 Pathways to Breast Cancer Recurrence
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3603357/
    Breast cancer recurrence is clinically a huge problem and one that is largely not well understood. […] A number of researchers have tried to predict some sort of pattern for breast cancer recurrence. […] A differential pattern of recurrence between different breast cancer subtypes has been suggested, and it appears that ER-negative breast cancers are associated with higher risk of recurrence during the initial 5 years after diagnosis, compared to ER-positive breast cancers. […] The TNBCs, marked by absence of ER/PR/HER2, are generally associated with high risk of recurrence with particularly high risk of distant recurrences in brain and visceral metastases, compared to receptor positive tumors. […] The existence of such subtypes, which are at time overlapping but most of the time so distinct, presents a challenge to the choice of appropriate therapy.
  • #1 Breast Cancer Recurrence: Types, Symptoms and Risk
    https://www.cancercenter.com/cancer-types/breast-cancer/types/rare-breast-cancer-types/recurrent-breast-cancer
    Even after initial treatment is complete and tests show no sign of disease, there is a chance breast cancer may return. When that happens, its called recurrent breast cancer. In most cases, recurrent cancers appear within the first three years after treatment. But in some cases, breast cancer recurrence may develop many years later, either locally or in distant organs in the body. […] For breast cancer patients with a family history of cancer, or a BRCA1 or BRCA2 gene mutation, the cancer recurrence rate is higher. The risk of finding new cancers, such as ovarian cancer, may also be higher. Cancer recurrence risk is based on many factors, including the cancer type and how it was treated. […] Theres still so much that is unknown about cancer recurrence, but researchers have found some patterns in recent years that point to clues about why it happens. These factors might be linked to a higher risk of breast cancer recurrence:
  • #1 Recognizing and Managing Recurrent Breast Cancer: Signs and Treatment Options
    https://aocancer.com/blog/recognizing-and-managing-recurrent-breast-cancer-signs-and-treatment-options
    Recurrent breast cancer is caused by cancer cells that were not completely destroyed during the initial treatment process. […] While there is no way to determine for sure if breast cancer will come back, there are some possible risk factors to keep in mind, including: […] Larger tumors are associated with a higher risk of the cancer returning. […] Individuals under the age of 35 at the time of their original diagnosis have a higher risk of recurrent breast cancer. […] Skipping radiation therapy increases the risk of local recurrence. […] Individuals with triple-negative breast cancer (which lacks receptors for estrogen, progesterone, and HER2) are at a higher risk of recurrence. […] This type of breast cancer carries a higher risk of local recurrence. […] A higher body mass index (BMI) is linked to an increased risk of breast cancer recurrence.
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    The number of recurrent events greatly affected the risk of death: for the medium risk profile, the probability of death (P1) between 5 and 10 years after cancer diagnosis was 6% for no recurrence in the first 5 years after diagnosis, 19% for one recurrence, 36% for two recurrences and 53% for three previous recurrences. […] Smoking exposure after breast cancer diagnosis was associated with an increased risk of relapse but not with the risk of death. […] The tumor characteristics (high grade, high tumor size, nodal involvement) were also associated with a higher risk of those two failure times. […] The proposed approach (with joint model) is really appropriate to both study their link and to predict the prognosis of patients suffering from a primary breast cancer and with possible relapses.
  • #1 Pathways to Breast Cancer Recurrence
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3603357/
    Axillary lymph node metastases remain a very important prognostic variable, and identification of molecular markers for development of lymph node metastases can potentially help intervene early reducing the chances of breast cancer recurrence. […] The choice for surgical intervention largely depends on the cancer stage. […] It seems that there are distinct risk factors of recurrence in breast cancer patients undergoing mastectomy versus those choosing breast conserving therapy. […] The distinct clinical and histopathological determinants result in differential response to radiotherapy and point to the need for more robust personalized therapies and follow-up procedures for patients opting for different surgical interventions. […] The role of TGF- in EMT of breast cancer is well understood.
  • #1 Breast Cancer Recurrence: Types, Rates, and More
    https://www.healthline.com/health/breast-cancer/what-type-breast-cancer-has-the-highest-recurrence-rate
    Many factors can increase your chances of recurrence, including the type of cancer you have, its stage and size at diagnosis, as well as ER, HER2, and BRCA status. […] Other factors such as age, obesity, having a sedentary lifestyle, and smoking can also increase your risk. […] The risk of breast recurrence is highest in the first 2 years after you receive the initial diagnosis. The risk of recurrence decreases steadily as time passes. […] The outlook for a person with recurrent breast cancer depends on multiple factors. […] Aggressive and hard-to-treat breast cancers are the types most likely to recur. This includes IBC and TNBC. […] The type isnt the only breast cancer factor that can influence recurrence. Factors such as your tumor size, stage at diagnosis, tumor margin, and lymph node involvement, along with treatment choices and personal factors such as age and BMI, also play a role.
  • #1 Stage 2 Breast Cancer: Symptoms, Recurrence, Treatment
    https://www.emedicinehealth.com/does_stage_2_breast_cancer_come_back/article_em.htm
    Stage 2 breast cancer generally has a good prognosis and can be cured with treatments. […] On average, 7 to 11 percent of women with early breast cancer may experience a local recurrence in the first five years following treatment. […] Even if there is no evidence of disease, there is a chance breast cancer may come back (called recurrent breast cancer). Most of the time, recurrent breast cancer will occur within the first three years after treatment, though sometimes the cancer may come back years later, either locally or in distant organs in the body. […] On average, 7 to 11 percent of women with early breast cancer may experience a local recurrence in the first five years following treatment. Patients who have a family history of breast cancer or the BRCA mutation have a higher incidence of recurrence. […] The specific cause of breast cancer is unknown, but it is a result of damage to a cells DNA.
  • #1 Late Recurrence of Breast Cancer
    https://www.verywellhealth.com/late-recurrence-of-breast-cancer-4766608
    Hormonal therapy can have a significant effect on the risk of recurrence. […] Factors such as initial tumor size, number of nodes involved, and receptor status play into the risk of late recurrence, but tumor biology appears to have the greatest effect. […] The risk of recurrence is linked to the size of the original tumor as well as the number of positive lymph nodes, although these factors alone can’t explain all recurrences. […] The constant rate of recurrence means that the risk that an estrogen receptor-positive breast cancer will recur between 15 years and 16 years post-diagnosis is the same as the risk that it will recur between five years and six years after diagnosis. […] The impact of late distant recurrence cannot be stressed enough. Once breast cancer is metastatic, it is no longer curable.
  • #1 Breast Cancer Symptoms, Signs, Types, Risk Factors and Prevention PACE Hospitals – Best Hospitals in Hitech City, Hyderabad, India | Near Madhapur, Kukatpally, KPHB, Kondapur, Gachibowli, Jubilee Hills, Banjara HillsPACE Hospitals Contact
    https://www.pacehospital.com/breast-cancer-symptoms-causes-risk-factors-and-prevention
    Mutations or changes in genes can cause normal breast cells to develop into cancer. However, there is only a 10% familial link between breast cancer and known abnormal genes (inherited). […] Women with a strong family history of breast cancer may have inherited a mutation in a gene that is not yet detectable by genetic testing. Around 90% of breast cancers result from acquired (rather than inherited) gene changes.
  • #1
    https://link.springer.com/article/10.1007/s10552-022-01561-2
    Women with hormone receptor (HR)-positive early-stage breast cancer (BC) have five-year survival rates of 90% but remain at serious risk for developing distant metastases beyond five years from diagnosis. […] However, the risk of distant recurrence persists for decades, with up to 23% and 38% of patients with HR+ disease experiencing distant recurrence by five and 25 years after diagnosis, respectively. […] This study evaluated the association between DRFI and the risk of BC-specific mortality among women with recurrent metastatic HR+ BC. […] Women with DRFI of 5 years had a five-year BC-specific survival rate of 31% compared to 52% in women with DRFI of 5 years. […] This population-based study of women with HR+ locoregional, early BC who subsequently experienced metastatic disease suggests that distant recurrence-free survival time greater than 5 years is significantly associated with ~30% lower risk of BC-specific mortality. […] These findings may inform discussions between patients and clinicians surrounding both treatment approaches in early-stage BC and prognosis following metastatic recurrence.
  • #1 Secondary breast cancer: Why does cancer recur?
    https://www.medicalnewstoday.com/articles/in-conversation-what-makes-breast-cancer-come-back
    Predicting which cancer cells may be able to detach and become dormant may help doctors better address the possibility of cancer recurrence in the future. […] I think its important that women know that their breast cancer can come back in the future. […] A lot of us shy away from having those discussions and women dont realize that [breast cancer] can come back 20 or 30 years down the line. […] Following these lifestyle interventions following a breast cancer diagnosis may also help reduce the side effects of some therapies, such as the fatigue associated with chemotherapy, and they may also help lower the risk of recurrence, according to the American Cancer Society.
  • #1 Factors associated with breast cancer recurrences or mortality and dynamic prediction of death using history of cancer recurrences: the French E3N cohort | BMC Cancer | Full Text
    https://bmccancer.biomedcentral.com/articles/10.1186/s12885-018-4076-4
    In addition to tumor characteristics and lifestyle factors, cancer relapses are often related to the risk of death but have not been jointly studied. […] We investigate the prognostic factors of recurrent events and death after a diagnosis of breast cancer and predict individual deaths including a history of recurrences. […] Cases with high grade, large tumor size, axillary nodal involvement, and negative estrogen and progesterone receptors had a higher risk of recurrence or death. Furthermore, smoking increased the risk of relapse. […] The risk of death was strongly dependent on the history of recurrence even after adjusting for the covariates (frailty variance and power significantly different from zero). […] Our study showed the importance of considering baseline lifestyle characteristics and history of relapses to dynamically predict the risk of death in breast cancer cases.
  • #2 Breast Cancer Recurrence: Types, Symptoms and Risk
    https://www.cancercenter.com/cancer-types/breast-cancer/types/rare-breast-cancer-types/recurrent-breast-cancer
    Even after initial treatment is complete and tests show no sign of disease, there is a chance breast cancer may return. When that happens, its called recurrent breast cancer. In most cases, recurrent cancers appear within the first three years after treatment. But in some cases, breast cancer recurrence may develop many years later, either locally or in distant organs in the body. […] For breast cancer patients with a family history of cancer, or a BRCA1 or BRCA2 gene mutation, the cancer recurrence rate is higher. The risk of finding new cancers, such as ovarian cancer, may also be higher. Cancer recurrence risk is based on many factors, including the cancer type and how it was treated. […] Theres still so much that is unknown about cancer recurrence, but researchers have found some patterns in recent years that point to clues about why it happens. These factors might be linked to a higher risk of breast cancer recurrence:
  • #2 Recurrent Breast Cancer | Cancer Care & Oncology | Bon Secours
    https://www.bonsecours.com/health-care-services/cancer-care-oncology/conditions/recurrent-breast-cancer
    Recurrent breast cancer is caused by cancer cells that somehow evaded and survived initial cancer treatment that was believed to have destroyed all cancer cells. […] Breast cancer is caused by mutations (changes) to the DNA of the cells of the breast.
  • #2 Metastatic Breast Cancer: Symptoms, Treatment & Prognosis
    https://my.clevelandclinic.org/health/diseases/21497-metastatic-breast-cancer
    Most metastatic breast cancer is recurrent cancer, meaning its cancer that came back after treatment and is affecting tissue and organs located far from the original breast cancer tumor. […] Breast cancer typically comes back when treatment doesnt destroy all cancer cells. Treatments can reduce tumors so much that tests dont detect their presence. Even surgery to remove a cancerous tumor isnt always 100% effective. Cancer cells can move into nearby tissue, lymph nodes or the bloodstream before the surgery. […] These weakened cancer cells can remain in your body after treatment. Over time, the cells get stronger. They start to grow and multiply again. These cells may travel through your bloodstream and lymphatic system, using your lymph nodes and blood vessels to carry cancer to other areas of your body.
  • #2 Is Recurrent Breast Cancer Worse | Dr. Jay Anam
    https://drjayanam.com/blogs/recurrent-breast-cancer-worse/
    Breast cancer that returns after therapy is known as recurrent breast cancer. Even though the initial therapy aims to eliminate all cancer cells, some may survive through the treatment. These cancer cells grow undetected, leading to recurrent breast cancer. […] When your original breast cancer cells break away from the tumour and hide nearby in the breast, they can later develop to form recurrent breast cancer. These cells continue to grow again after. […] Following your first breast cancer diagnosis, you may have had chemotherapy, radiation, hormone therapy, or other treatments to kill any cancer cells that remained after surgery. However, these treatments may not always succeed in killing all cancer cells. […] Cancer cells can lie dormant for years without harming anyone. The cells are then activated, causing them to expand and spread to other body places. Its unclear why this happens.
  • #2 Secondary breast cancer: Why does cancer recur?
    https://www.medicalnewstoday.com/articles/in-conversation-what-makes-breast-cancer-come-back
    Sometimes, many years after the initial cancer treatment, dormant cells can reawaken and give rise to new tumors in different parts of the body. […] I think [doctors] assume [that] any cancer that is invasive has the ability to spread and move around the body and any woman with an invasive cancer may have a couple of cells that have left that cancer and have gone into the lymph or the blood, explained Dr. ORiordan. […] The surgery is removing all the physical cancer the we can see. And the aim of chemo and radiotherapy and hormone treatments is to mop up any of those little cells floating around the body. […] So theyve come from the original breast cancer, but theyre often dormant, they may start to wake up for whatever reason. […] And as they wake up, they can further mutate and change.
  • #2 Mayo Clinic Health Library – Recurrent breast cancer | Swiss Medical Network
    https://www.swissmedical.net/en/healtcare-library/con-20377118
    Recurrent breast cancer occurs when cells that were part of your original breast cancer break away from the original tumor and hide nearby in the breast or in another part of your body. Later, these cells begin growing again. […] The chemotherapy, radiation, hormone therapy or other treatment you may have received after your first breast cancer diagnosis was intended to kill any cancer cells that may have remained after surgery. But sometimes these treatments aren’t able to kill all of the cancer cells. […] Sometimes cancer cells may be dormant for years without causing harm. Then something happens that activates the cells, so they grow and spread to other parts of the body. It’s not clear why this occurs.
  • #2 Recurrent Breast Cancer: Signs, Symptoms, and Treatment Options
    https://www.compassoncology.com/blog/recurrent-breast-cancer-signs-symptoms-and-treatment-options
    Breast cancer recurrence is a second appearance of breast cancer, whether in the breast or another area of the body. […] While there may not be an exact reason that breast cancer recurrence happens, there are some things that could lead to it. Common reasons include: Incomplete removal or destruction of cancer cells during initial treatment. […] Biological characteristics of the cancer, such as aggressive tumor behavior or genetic mutations. […] Resistance to treatments, where some cancer cells adapt and survive therapies. […] The likelihood of recurrence depends on whether its fast-growing as well as the stage at the time breast cancer was initially diagnosed. […] Several factors can increase the likelihood of breast cancer returning. This includes the type of breast cancer found at the initial diagnosis, the stage at the initial diagnosis, and the size of the tumor that was initially found.
  • #2 Pathways to Breast Cancer Recurrence
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3603357/
    This is another indication of a complex relationship between EMT, CSCs, drug resistance, and the breast cancer recurrence. […] The causes for such breast cancer recurrence remain completely unknown, except for many putative molecular markers that are under active investigation for their possible role in determining the recurrence. […] The phenomena of drug resistance and tumor recurrence are intricately related because, in order to recur, cancer cells need to overcome the cytotoxic effects of drugs that are used to control the growth of these cancers in clinics. […] The last few years have seen an exponential increase in the number of investigations focused on the functionality of miRNAs in breast cancer progression. […] The cause(s) of breast cancer recurrence and the possible strategies to prevent it remain elusive.
  • #2 Recognizing and Managing Recurrent Breast Cancer: Signs and Treatment Options
    https://aocancer.com/blog/recognizing-and-managing-recurrent-breast-cancer-signs-and-treatment-options
    Recurrent breast cancer is caused by cancer cells that were not completely destroyed during the initial treatment process. […] While there is no way to determine for sure if breast cancer will come back, there are some possible risk factors to keep in mind, including: […] Larger tumors are associated with a higher risk of the cancer returning. […] Individuals under the age of 35 at the time of their original diagnosis have a higher risk of recurrent breast cancer. […] Skipping radiation therapy increases the risk of local recurrence. […] Individuals with triple-negative breast cancer (which lacks receptors for estrogen, progesterone, and HER2) are at a higher risk of recurrence. […] This type of breast cancer carries a higher risk of local recurrence. […] A higher body mass index (BMI) is linked to an increased risk of breast cancer recurrence.
  • #2 Pathways to Breast Cancer Recurrence
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3603357/
    Axillary lymph node metastases remain a very important prognostic variable, and identification of molecular markers for development of lymph node metastases can potentially help intervene early reducing the chances of breast cancer recurrence. […] The choice for surgical intervention largely depends on the cancer stage. […] It seems that there are distinct risk factors of recurrence in breast cancer patients undergoing mastectomy versus those choosing breast conserving therapy. […] The distinct clinical and histopathological determinants result in differential response to radiotherapy and point to the need for more robust personalized therapies and follow-up procedures for patients opting for different surgical interventions. […] The role of TGF- in EMT of breast cancer is well understood.
  • #2 Breast Cancer Recurrence: Types, Rates, and More
    https://www.healthline.com/health/breast-cancer/what-type-breast-cancer-has-the-highest-recurrence-rate
    Aggressive, hard-to-treat breast cancers, such as inflammatory breast cancer (IBC) and triple-negative breast cancer (TNBC), are the types most likely to recur. […] Although the type of breast cancer you have plays a large role in its recurrence, its not the only factor. […] Breast cancer variables such as tumor size and stage at diagnosis can also influence your risk. Personal factors such as your age and your weight can affect your risk as well. […] Fast-growing cancers and cancers that were diagnosed at an advanced stage, are more likely to return. […] The two types of breast cancer most likely to recur are inflammatory breast cancer (IBC) and triple-negative breast cancer (TNBC). […] The type of breast cancer you have is a large risk factor for recurrence, but its not the only one.
  • #2 Late Recurrence of Breast Cancer
    https://www.verywellhealth.com/late-recurrence-of-breast-cancer-4766608
    Some breast cancers may come back 10, 15, or 20-plus years later […] The „late recurrence” or relapse of breast cancer refers to cancers that come back after five years, but may not return for 10 years, 20 years, or even more. […] For people who have estrogen receptor-positive breast cancer, the recurrence rate is actually higher after five years than in the first five years. […] In contrast to the common belief that surviving for five years after cancer treatment is equivalent to a cure, with hormone-sensitive (estrogen and/or progesterone receptor-positive) breast tumors, there is a steady rate of recurrence risk for at least 20 years after the original diagnosis, even with very small node-negative tumors. […] Overall, the chance that an estrogen receptor-positive tumor will recur (distant recurrence) between five years and 20 years after diagnosis ranges from 10% to over 41%. People with these tumors remain at risk for the remainder of their lives.
  • #2 Is Recurrent Breast Cancer Worse | Dr. Jay Anam
    https://drjayanam.com/blogs/recurrent-breast-cancer-worse/
    Factors that enhance the chance of a recurrence in breast cancer survivors include: Lymph node involvement Finding cancer in adjacent lymph nodes at your initial diagnosis raises your chances of cancer returning. Larger tumours A higher chance of recurrence of breast cancer. Positive tumour margins During breast cancer surgery, the surgeon seeks to remove cancer and a small quantity of surrounding normal tissue. A pathologist looks for cancer cells around the tissues borders. In cases where tumor is present on the margins have a high risk of recurrence as compared to those who do not have. Lack of radiation treatment after a lumpectomy People who do not complete the advised treatment protocol. Younger age People under the age of 35 at their initial breast cancer diagnosis had a higher risk of developing recurrent breast cancer. Inflammatory breast cancer has a higher chance of local recurrence than non-inflammatory breast cancer. Breast cancer cells with specific features If your breast cancer proved resistant to hormone therapy or treatments targeting the HER2 gene (triple-negative breast cancer), you might be at a higher risk of recurrence.
  • #2 Understanding breast cancer recurrence | Geisinger
    https://www.geisinger.org/health-and-wellness/wellness-articles/2018/10/04/19/31/understanding-breast-cancer-recurrence
    There are several types of breast cancer recurrence, all of which have a different prognosis and require a different treatment. Local recurrence happens when the cancer comes back in the same area it originally appeared. […] Regional recurrence happens when the cancer is found in the lymph nodes near the armpit or collarbone. […] Metastatic recurrence is marked by the spread of breast cancer outside the breast and regional nodes to other areas of the body. […] The risk of getting a second, unrelated breast cancer depends on whether you carry a genetic mutation which caused the first cancer as well as the age at which the first cancer developed. Patients who carry a BRCA mutation are 10 times more likely to experience a second opposite breast cancer.
  • #2 When Breast Cancer Comes Back
    https://www.webmd.com/breast-cancer/breast-cancer-comes-back
    Lots of body fat (obesity) as measured by the body mass index, or BMI, can raise your risk of breast cancer recurrence. […] Recurrence is a risk for up to 32 years after a first diagnosis of breast cancer, according to a recent study. Your risk of recurrence after 10 years of remission depends on a number of things like: […] In general, once you have a breast cancer diagnosis, even if you are years in remission, its a good idea to be watchful and consult your doctor for regular breast exams and other screenings they think are appropriate. Early detection is the best way to get the best outcome from treatment.
  • #2 Breast Cancer Recurrence: Types, Symptoms and Risk
    https://www.cancercenter.com/cancer-types/breast-cancer/types/rare-breast-cancer-types/recurrent-breast-cancer
    Certain types and characteristics of the original breast cancer also may also lead to a higher risk of recurrence: […] Women may be at higher risk for late recurrence if they had: […] Research is mixed on whether or not drinking alcohol increases the risk of breast cancer recurrencesome studies have found there is a link and others have not. Regardless, avoiding excessive drinking is a good idea for everyone’s general health. […] If the care team suspects a cancer recurrence, theyll recommend diagnostic tests, like lab tests, imaging or biopsies, both to be sure the cancer has come back and to get more information to guide treatment.
  • #2 Breast Cancer Recurrence: Symptoms, Causes, and Prognosis
    https://www.verywellhealth.com/breast-cancer-recurrence-3576787
    The return of breast cancer after a period of remission, referred to as a recurrence, occurs when cancer returns after treatment, despite best efforts to eradicate it. […] There are many factors that figure into the risk of recurrence. The breast cancer type, the stage, the extent of the initial malignancy, and treatment choices can all influence the risk of recurrence. […] It’s not clear whether lifestyle factors (such as diet and weight) play a role in recurrence, although some studies suggest that obesity can worsen outcomes. […] Key factors associated with breast cancer recurrence: Lumpectomy followed by radiation is associated with a 3% to 15% risk of a local recurrence within 10 years, according to a 2017 study from the Dana-Farber Cancer Institute. […] Mastectomy is associated with a 6% risk of recurrence within five years if cancer has not spread to lymph nodes. If cancer has spread to lymph nodes, the risk increases to 23% if there’s no radiation treatment.
  • #2 Late Recurrence of Breast Cancer
    https://www.verywellhealth.com/late-recurrence-of-breast-cancer-4766608
    Hormonal therapy can have a significant effect on the risk of recurrence. […] Factors such as initial tumor size, number of nodes involved, and receptor status play into the risk of late recurrence, but tumor biology appears to have the greatest effect. […] The risk of recurrence is linked to the size of the original tumor as well as the number of positive lymph nodes, although these factors alone can’t explain all recurrences. […] The constant rate of recurrence means that the risk that an estrogen receptor-positive breast cancer will recur between 15 years and 16 years post-diagnosis is the same as the risk that it will recur between five years and six years after diagnosis. […] The impact of late distant recurrence cannot be stressed enough. Once breast cancer is metastatic, it is no longer curable.
  • #2 Survival and Risk of Recurrence – Susan G. Komen®
    https://www.komen.org/breast-cancer/treatment/recurrence/survival-and-risk-of-recurrence/
    Everyone whos had breast cancer is at risk of recurrence (return of breast cancer). However, most people diagnosed with breast cancer will never have a recurrence. […] If you have a breast cancer recurrence, its not your fault. You did nothing to cause it. […] The risk of distant recurrence is the same for people who have a lumpectomy plus radiation therapy and those who have a mastectomy. […] For women with early breast cancer who have a lumpectomy plus radiation therapy, the risk of local recurrence depends on tumor characteristics, including biomarkers (such as hormone receptor status and HER2 status). […] With a mastectomy, the best predictor of local breast cancer recurrence is whether the axillary lymph nodes (the lymph nodes in the underarm area) contain cancer.
  • #2 Breast Cancer Symptoms, Signs, Types, Risk Factors and Prevention PACE Hospitals – Best Hospitals in Hitech City, Hyderabad, India | Near Madhapur, Kukatpally, KPHB, Kondapur, Gachibowli, Jubilee Hills, Banjara HillsPACE Hospitals Contact
    https://www.pacehospital.com/breast-cancer-symptoms-causes-risk-factors-and-prevention
    Mutations or changes in genes can cause normal breast cells to develop into cancer. However, there is only a 10% familial link between breast cancer and known abnormal genes (inherited). […] Women with a strong family history of breast cancer may have inherited a mutation in a gene that is not yet detectable by genetic testing. Around 90% of breast cancers result from acquired (rather than inherited) gene changes.
  • #3 Recurrent Breast Cancer – Causes, Symptoms and Treatment | Apollo Hospitals
    http://www.apollohospitals.com/diseases-and-conditions/recurrent-breast-cancer-causes-symptoms-and-treatment#!
    Breast cancer that returns after treatments is known as recurrent breast cancer. Although the initial treatment is intended to eliminate all cancer cells, some may have evaded treatment and survived. These cancer cells multiply undetected, leading to recurrent breast cancer. […] The term recurrence refers to the return of the same kind of breast cancer. […] Several strategies may be followed to decrease the risk of breast cancer recurrence, such as the following: […] Yes, women exposed to stress have a greater chance of recurrent breast cancer than those who are not.
  • #3 Secondary breast cancer: Why does cancer recur?
    https://www.medicalnewstoday.com/articles/in-conversation-what-makes-breast-cancer-come-back
    Sometimes, many years after the initial cancer treatment, dormant cells can reawaken and give rise to new tumors in different parts of the body. […] I think [doctors] assume [that] any cancer that is invasive has the ability to spread and move around the body and any woman with an invasive cancer may have a couple of cells that have left that cancer and have gone into the lymph or the blood, explained Dr. ORiordan. […] The surgery is removing all the physical cancer the we can see. And the aim of chemo and radiotherapy and hormone treatments is to mop up any of those little cells floating around the body. […] So theyve come from the original breast cancer, but theyre often dormant, they may start to wake up for whatever reason. […] And as they wake up, they can further mutate and change.
  • #3 Secondary breast cancer: Why does cancer recur?
    https://www.medicalnewstoday.com/articles/in-conversation-what-makes-breast-cancer-come-back
    So you may have very different receptors to the original breast cancer, but they have come from that original tumor. […] There are so many different types of breast cancers. […] So youve got ER-positive, negative HER2-positive, negative lobular, ductal, triple negative, the different complications And when they mutate and come back, a triple negative [breast cancer] can suddenly develop ER-positive cancers and the positive [metastases] can develop resistance, she later added. […] Researchers are still unsure what stimuli dormant cancer cells respond to that trigger them to reawaken and form new tumors, and this is one of the questions that Dr. Natrajan would like to see an answer to. […] Theories about the factors that may facilitate their reawakening range from exposure to stress at the cellular level, the erosion of a kind of collagen blanket that surrounds dormant cells, to the protective effect of the microenvironment of dormant cells, which is made out of healthy cells.
  • #3 Pathways to Breast Cancer Recurrence
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3603357/
    This is another indication of a complex relationship between EMT, CSCs, drug resistance, and the breast cancer recurrence. […] The causes for such breast cancer recurrence remain completely unknown, except for many putative molecular markers that are under active investigation for their possible role in determining the recurrence. […] The phenomena of drug resistance and tumor recurrence are intricately related because, in order to recur, cancer cells need to overcome the cytotoxic effects of drugs that are used to control the growth of these cancers in clinics. […] The last few years have seen an exponential increase in the number of investigations focused on the functionality of miRNAs in breast cancer progression. […] The cause(s) of breast cancer recurrence and the possible strategies to prevent it remain elusive.
  • #3 Factors associated with breast cancer recurrences or mortality and dynamic prediction of death using history of cancer recurrences: the French E3N cohort | BMC Cancer | Full Text
    https://bmccancer.biomedcentral.com/articles/10.1186/s12885-018-4076-4
    The number of recurrent events greatly affected the risk of death: for the medium risk profile, the probability of death (P1) between 5 and 10 years after cancer diagnosis was 6% for no recurrence in the first 5 years after diagnosis, 19% for one recurrence, 36% for two recurrences and 53% for three previous recurrences. […] Smoking exposure after breast cancer diagnosis was associated with an increased risk of relapse but not with the risk of death. […] The tumor characteristics (high grade, high tumor size, nodal involvement) were also associated with a higher risk of those two failure times. […] The proposed approach (with joint model) is really appropriate to both study their link and to predict the prognosis of patients suffering from a primary breast cancer and with possible relapses.
  • #3 Pathways to Breast Cancer Recurrence
    https://pmc.ncbi.nlm.nih.gov/articles/PMC3603357/
    Axillary lymph node metastases remain a very important prognostic variable, and identification of molecular markers for development of lymph node metastases can potentially help intervene early reducing the chances of breast cancer recurrence. […] The choice for surgical intervention largely depends on the cancer stage. […] It seems that there are distinct risk factors of recurrence in breast cancer patients undergoing mastectomy versus those choosing breast conserving therapy. […] The distinct clinical and histopathological determinants result in differential response to radiotherapy and point to the need for more robust personalized therapies and follow-up procedures for patients opting for different surgical interventions. […] The role of TGF- in EMT of breast cancer is well understood.
  • #3 Breast Cancer Recurrence: Symptoms, Causes, and Prognosis
    https://www.verywellhealth.com/breast-cancer-recurrence-3576787
    Younger age is also a key risk factor. A 2015 study from Emory University reported that women under 40 had higher rates of local or regional recurrence (20% vs. 7%) and distant metastases (18% vs. 5%) than women 75 or older. […] The risk of recurrence is generally low if lymph nodes are unaffected and the surgical tumor margins (the tissues surrounding a tumor) are cancer-free. That said, even small stage 1A breast cancers may sometimes recur. […] Breast cancers may recur at any time. In fact, estrogen-receptor-positive breast cancers are more likely to recur after 5 years than in the first 5 years. […] A 2018 study looking at recurrence after 5-years of hormonal therapy (tamoxifen or an aromatase inhibitor) found that the risk of recurrence remains constant for at least 20 years. […] The prognosis after a recurrence depends on whether the recurrent is local, regional, or distant. Generally speaking, more advanced malignancy is associated with shorter anticipated survival. […] A 2019 study in PLoS One reported that women with triple-negative breast cancer (an especially aggressive form of the disease) have a higher risk of recurrence and death if regional lymph nodes are involved.
  • #3 Breast Cancer Causes and Risk Factors
    https://www.cancercenter.com/cancer-types/breast-cancer/risk-factors
    Breast cancer is caused when the DNA in breast cells mutate or change, disabling specific functions that control cell growth and division. […] The key to lowering your risk for breast cancer is to focus most of your prevention efforts on those modifiable risk factors, and to be proactive in various ways to monitor the ones you cant change. […] Risk factors are characteristics and conditions that increase your risk for a disease. […] Doctors dont know why some women with risk factors dont get breast cancer and why others with no risk factors, other than being female, do get breast cancer. […] Breast cancer is on the list of diseases and conditions caused or worsened by being overweight or obese after menopause. […] The more fat you have, the more estrogen you make, and estrogen feeds some breast cancers, causing them to grow.

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