Life After Treatment

Reducing Risk of Recurrence

Anyone who has had breast cancer can experience a recurrence, even many years after finishing treatment. Your risk of recurrence depends on several factors, some of which are related to the biology and stage of your original cancer, and others to your overall health and treatment history.

Recurrence is never your fault. Even if you did everything right, cancer can still return.

What Affects the Risk of Recurrence

Age at Diagnosis
Being diagnosed before age 35 may increase your risk, especially if the cancer was aggressive.

Stage at Diagnosis
The stage of your cancer affects recurrence risk. Larger tumours and cancers that have spread to the lymph nodes carry a higher risk of recurrence.

• If cancer has not spread to lymph nodes, the risk of return is about 6%.
• If it has spread, the risk can be around 25%, but radiation after mastectomy can lower it again to about 6%.

Cancer Type
Certain types of breast cancer are more likely to recur.

• Triple negative and inflammatory breast cancers are more likely to come back and spread.
• Hormone receptor positive cancers may return many years later.
• Hormone receptor negative cancers tend to come back sooner.

Surgical Margins
If cancer cells were found near the edge of the tissue removed during surgery (called “positive margins”), your risk is higher. You may need more treatment to lower the risk.

Original Treatment Plan
The type of treatment you received for your original breast cancer can affect the chance of recurrence:

• Radiation after a lumpectomy lowers the risk of cancer returning in the same breast to levels similar to a mastectomy.
• Chemotherapy helps lower risk if your cancer was high-risk.
• Hormonal therapy (like tamoxifen or aromatase inhibitors) lowers the chance of HR positive cancer returning, but only if taken as prescribed. These are often taken for 5–10 years after treatment.
• HER2-targeted therapy, like trastuzumab (Herceptin), lowers risk for HER2 positive cancer.

Stopping treatment early can raise your risk. If side effects are a problem, talk to your doctor. There may be other options.

Prevention and Lifestyle

While you can’t eliminate the risk of recurrence, some healthy habits may help lower it:

• Maintain a healthy weight (a high BMI is linked to higher risk)
• Stay physically active
• Eat a balanced diet (fruits, vegetables, whole grains)
• Limit alcohol
• Don’t smoke

Medications and Bone Health

• Bone-strengthening drugs (like bisphosphonates or denosumab) may help prevent recurrence in the bones, especially for postmenopausal women.
• Other medications (like low-dose aspirin or melatonin) are being studied but are not yet part of standard care.

Learn More

• Watch our webinar on Understanding Breast Cancer Recurrence: The Clinical Perspective

The Canadian Cancer Society has a database that can be used to find local support services in your area. You can access it below:

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