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, it’s 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.
In this article, we take a closer look at the types of breast cancer most likely to recur and other factors that can increase your risk of recurrence.
What is recurrence in breast and other cancers?
Cancer can sometimes come back after initial treatment is completed. The cancer might come back in:
- the place it started (local recurrence)
- the lymph nodes near the site of your original cancer (regional recurrence)
- another part of your body (distant recurrence)
Fast-growing cancers and cancers that were diagnosed at an advanced stage, are more likely to return.
Aggressive breast cancers are harder to treat, more likely to spread, and more likely to recur. The two types of breast cancer most likely to recur are inflammatory breast cancer (IBC) and triple-negative breast cancer (TNBC). These cancers are described in more detail below.
- IBC: IBC is a rare and invasive type of breast cancer. About
1–5% of all people’s breast cancer is IBC. IBC causes cancer cells to block lymph vessels in your breast tissue. Lymph vessels are the small tubes that drain lymph fluid from your breast. IBC spreads quickly and is usually stage 3 at the time of diagnosis. - TNBC: About
10–15% of all people’s breast cancer is TNBC. Cancer cells that cause TNBC don’t have estrogen receptors (ERs) or progesterone receptors (PRs) and don’t make any, or much, of a breast cancer-associated protein called HER2. TNBC spreads faster than most other types of breast cancer and has few treatment options.
The type of breast cancer you have is a large risk factor for recurrence, but it’s not the only one. There are many other factors that can increase your chances of recurrence. These include:
- Stage at diagnosis: The stage of your cancer at diagnosis influences your risk of recurrence. A high stage increases your risk.
- Lymph node involvement: Cancers that spread to your lymph nodes are more likely to recur.
- Tumor size: Large tumors increase your risk of recurrence.
- Tumor margins: A tumor margin is a border between a tumor and the healthy tissue that surrounds it. After a tumor is removed, a sample of the border area is removed and studied in a lab. If any cancer cells are found in this area, it’s called a “positive tumor margin.” This increases your risk of recurrence.
- ER status: ER-positive breast cancer cells can use estrogen to grow and reproduce. These cancers have a higher risk of recurrence and can sometimes recur decades later.
- HER2 status: HER2 is a protein often found in people who have breast cancer. High amounts of this protein can increase your risk of recurrence.
- BRCA status: Having BRCA1 and BRCA2 gene mutations puts you at a greater risk of recurrence and developing other types of cancers.
- Radiation therapy: Electing not to have radiation therapy after a lumpectomy can increase your risk of recurrence. Not completing or receiving other recommended treatments, such as chemotherapy, immunotherapy, endocrine therapy, or targeted therapy, can also increase your risk of recurrence.
- Endocrine therapy: If you have hormone-positive breast cancer, your doctor will typically recommend receiving endocrine therapy treatment. Not completing or receiving other recommended treatments, such as chemotherapy, immunotherapy, radiation therapy, or targeted therapy, can also increase your risk of recurrence.
- Age: Developing breast cancer while younger than 35 years of age increases your risk of developing breast cancer again.
- Obesity: A higher body mass index (BMI) increases your risk of recurrence.
- Sedentary lifestyle: A sedentary lifestyle can increase your risk of recurrence.
- Smoking:
Smoking can also increase your risk of recurrence.
If you had a lumpectomy or a partial mastectomy, you’ll typically have a mammogram 6 months to a year after surgery and radiation. During this first year, you’ll likely also have monitoring appointments with your doctor or oncologist.
After your initial postcancer mammogram, yearly mammograms are recommended. If you’ve had a complete mastectomy, you won’t need a mammogram on that side, but you’ll still need to have yearly mammograms on your remaining breast.
Depending on your individual breast cancer risk factors and your breast density, a doctor may also recommend yearly ultrasounds, MRIs, or both.
The symptoms of breast cancer recurrence depend on where the breast cancer recurs, as noted in this table:
| Local symptoms (cancer recurs in the same location as original cancer) | Regional symptoms (cancer has spread to nearby lymph nodes) | Distant symptoms (cancer has spread to a distant body of your body) |
| changes to breast skin | a swelling or lump in the lymph nodes located: – under your arm – near your collarbone – above your collarbone – in your neck | severe headaches |
| a new lump in your breast | loss of appetite | |
| skin inflammation | unintentional weight loss | |
| skin redness | difficulty breathing | |
| nipple discharge | chronic cough | |
| nodules (solid masses) on the chest wall | chronic and worsening pain | |
| thickening near your mastectomy scar | seizures | |
| bone pain | ||
| shortness of breath |
Which breast cancer recurs the most?
Although all types of breast cancer can recur after treatment, the two types of breast cancer that are most likely to come back are inflammatory breast cancer (IBC) and triple-negative breast cancer (TNBC).
What type of breast cancer is most likely to metastasize?
HER2 positive and TNBC both have higher rates of metastasis compared to other types of breast cancer, according to this
Which type of breast cancer has the best outlook?
Ductal carcinoma in situ, which is stage 0 (noninvasive), has the
What percentage of people with breast cancer in remission have a recurrence?
It’s difficult to pinpoint recurrence percentage rates. This is because many individual factors affect these rates, such as the stage of their cancer at the time of treatment, the type of treatment they get, or the particular subtype of their cancer.
It’s best to speak with your doctor about your risk of recurrence and how to screen for that possibility.
What risk factors can increase your chance of breast cancer recurrence?
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.
Does the risk of breast cancer recurrence decrease over time?
Yes. 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.
Does the outlook for a person with recurrent breast cancer get worse?
The outlook for a person with recurrent breast cancer depends on multiple factors. For instance:
- whether the recurrence is local, regional, or distant
- the particular subtype of the cancer (ER, PR, or HER2 positive)
- how long it’s been since they received diagnosis and treatment for their initial breast cancer
Your treatment team can look at all the factors specific to your recurrence and give you an idea of your overall outlook.
Aggressive and hard-to-treat breast cancers are the types most likely to recur. This includes IBC and TNBC.
The type isn’t 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.
The chance of breast cancer recurrence is highest in the first 2 years and decreases with each passing year. But regular mammograms are still important for you if you have breast cancer in remission, no matter how much time has passed.