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  • Survival and Risk of Having Cancer Return after Treatment (Recurrence)

    Making Treatment Decisions
    Fact Sheet

    Treatment type and breast cancer survival

    One major decision you may face with early breast cancer is whether to have a mastectomy or a lumpectomy (also called breast conserving surgery) plus radiation therapy. Both surgeries are equally effective in treating early breast cancer.

    Overall survival is the same for mastectomy versus lumpectomy plus radiation therapy. This means both treatments lower the risk of dying (from breast cancer or other cause) by the same amount. 

    For a summary of research studies on mastectomy versus lumpectomy plus radiation therapy in the treatment of early breast cancer, visit the Breast Cancer Research.Studies section

    Risk of breast cancer recurrence

    Although the choice between mastectomy and lumpectomy plus radiation therapy will not affect your survival, it may affect your risk of breast cancer recurrence (the return of cancer).

    Local recurrence

    Local recurrence is the return of cancer to the breast, chest wall or lymph nodes after treatment. Most local recurrences occur within the first five years after diagnosis [98]. If you have a recurrence, you will need more treatment.

    Learn more about treatment for local recurrence.

    Distant recurrence (metastasis)

    Distant recurrence (metastasis) occurs when cancer spreads beyond the breast to other organs such as the bones, liver, lungs or brain. The risk of distant recurrence is the same for people who have mastectomy and those who have lumpectomy plus radiation therapy [13].

    Learn about treatment for distant recurrence (metastatic or advanced breast cancer).

    Lumpectomy plus radiation therapy and local recurrence

    The chance of local recurrence in 10 years is about seven to 12 percent for women who have lumpectomy plus radiation therapy [4].

    The risk of local recurrence depends on whether or not the tumor margins and the lymph nodes in the underarm area contain cancer cells. The chance of local recurrence is lower when [4,13]:

    • Tumor margins do not contain cancer cells
    • Lymph nodes do not contain cancer

    Chemotherapy, hormone therapy and/or targeted therapy can lower the risk of breast cancer recurrence after lumpectomy plus radiation therapy [13].

    Mastectomy and local recurrence

    With mastectomy, the best predictor of local recurrence is whether the lymph nodes in the underarm area contain cancer. The more lymph nodes with cancer, the higher the risk of recurrence tends to be [98].

    The chance of local recurrence in five years when the lymph nodes do not contain cancer is about six percent [98]. When there is cancer in the lymph nodes, the chance of local recurrence in five years is about 23 percent without radiation therapy [98]. Radiation therapy can reduce this risk to about six percent [98].

    Learn more about breast cancer recurrence.

    Updated 07/30/15

     previous Treatment of Early Breast Cancer
     previous Recommended Treatments for Early Breast Cancer
      Questions for Your Provider – Early Breast Cancer next

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