> Survival and Risk of Having Cancer Return after Treatment (Recurrence)
One of the major decisions you will face with early breast cancer is whether to have mastectomy or lumpectomy (also called breast conserving surgery) plus radiation. Both of these surgeries are effective in treating early breast cancer. And, there appears to be no difference in survival between the two treatments: they both lower the risk of dying from breast cancer by the same amount.
If you are making treatment decisions, you should consider how the treatment you choose will affect your risk of recurrence (the return of cancer). Local recurrence is the return of cancer to the breast, chest wall or lymph nodes after treatment. On average, between five and ten percent of women with early breast cancer have a local recurrence [41]. These women will need more treatment.
For those who have a mastectomy, the best predictor of local recurrence is how far the cancer has spread in the lymph nodes. The chance of local recurrence in five years is three to five percent for women who do not have cancer in their lymph nodes. For those who have cancer in one to three nodes, the chance is 10 to 15 percent. The chance of local recurrence increases to 20 to 30 percent when cancer is in more than three nodes [41]. Radiation therapy to the chest wall after mastectomy is given routinely when there are more than three positive nodes. This reduces the risk of local recurrence by about two thirds [13].
For those who have lumpectomy plus radiation, the best predictor of local recurrence is whether or not the margins of the tumor are negative (they do not contain cancer cells). If the margins are negative, the chance of recurrence in five years is five to 10 percent. If not, the chance is 15 to 30 percent [41]. In either case, the risk of local recurrence can be lowered with chemotherapy and/or hormone therapy after surgery. It is important that the cancer be entirely removed with clean margins (no cancer at the edges) before radiation therapy begins.
For more on recurrence, visit the Return of Cancer after Treatment.
Updated 09/12/09
