Unfortunately, as you have probably already faced and realized, there are no guarantees when we discuss breast cancer. Your breast surgeon will remove all visible and known cancerous tissue, but there are not tests to detect the small clusters of cancerous cells that have not yet grown into tumors. Occasionally, one or a few of these cells do survive surgery, chemotherapy, and radiation. The fact is a single cell has the potential to multiply and become a tumor—a fact which unfortunately causes many women and their loved ones persistent anxiety over every bump, sniffle, and ache. It is normal to fear the return of the cancer.
However, it is important to understand, as your life begins to settle into cancer remission, that many women will never have to face breast cancer recurrence again. Here are a few facts to know:
- Most recurrences occur in the first five years, with the highest risk in the first two years. While recurrence can occur any time, you might breathe a sigh of relief once you pass the five year mark.
- Approximately 2/3 of all breast cancers include estrogen receptors. This is good news, because tumors with estrogen receptors tend to grow less aggressively, respond better to treatment, and have a lower rate of recurrence.
- The chance of recurrence over a ten year period among women with a lumpectomy plus radiation is about 12%. That means, 88% of women (or 22 in every 25) with a lumpectomy plus radiation will have no cancer recurrence during that first decade (and the likelihood of recurrence decreases with each year past therapy).
- In a mastectomy, the rate of recurrence depends largely on whether the cancer has spread to the lymph nodes.
- If cancer is not found in the lymph nodes, the chance of recurrence over a five year period is about 6%.
- If cancer is found in the lymph nodes, but the patient does not receive radiation therapy, the chance of recurrence over five years is 23%.
- With radiation therapy, the chance of recurrence in patients where cancer is found in the lymph nodes may drop to approximately 6%.
- Some factors which impact the likelihood of recurrence are within your control. For example, maintaining a healthy weight has been strongly associated with a reduced risk of cancer recurrence. Setting goals and working to be the healthiest version of yourself in diet, fitness level, and emotionally may be the best way to reduce your likelihood of recurrence and also to prepare you to be ready to face any possibility. Remember to take care of yourself during this new phase of post-cancer life.
The Roller Coaster
Over the next decade and beyond, you will face many emotions as a cancer survivor, and one of those will be fear of the cancer returning. That is normal. However, it is important to note that there’s also going to be so much more to your life during this time than just cancer. If you’ve reached the point of remission, do a happy dance and let the feeling settle in that for right now at this moment, no cancer can be detected in your body, and you get to spend these hours, weeks, months, and years with your friends and family. While it is true that no doctor will ever be able to look you in the eyes and promise you that the cancer won’t return, for many, many women, it never does.
That doesn’t mean everything has to go back to normal today. You’re allowed to grieve, to struggle with the side effects from on-going medication, and to wonder about the future. But now more than ever, hang onto the hope that a new “normal” will soon settle on your life. This phase of life has its own set of ups and downs, but thankfully chemotherapy and radiation are no longer a part of them.
The Johns Hopkins Breast Center has created a fantastic series of videos exploring life now as a survivor. As you move into this new phase of recovery, take the time to watch these videos, and maybe invite the loved ones that have been most integral in your support throughout this process to watch with you.
Being a Survivor
Lifestyle Changes After Breast Cancer
Survivorship Care Planning
If you are concerned about the symptoms of cancer recurrence, visit the Breastcancer.org’s page on Breast Cancer Recurrence. It is full of information on the signs and symptoms of recurrence so that you can educate yourself. Most importantly, if you have any questionable symptom, make an appointment to see your physician to discuss your symptoms.