Gone for Good? Breast Cancer Recurrence Debate Rages

A common public misperception about cancer is that once a person beats the disease, they are forever "cured." But the unfortunate reality for cancer survivors is that the risk of relapse remains a nearly constant threat throughout one's lifetime -- though some say media coverage of the disease often glazes over this fact.

Today, new research published in the Journal of the National Cancer Institute suggests that the risk of breast cancer relapse remains present even 15 years after a woman is initially diagnosed with the disease.

Still, ABC News medical editor Dr. Timothy Johnson believes that this study should provide breast cancer survivors with a realistic sense of hope.

"This study gives women a ballpark feel for what to look forward to at the point of five-year survival; they are not totally free from the risk of recurrence, as some women would like to believe, but they aren't totally doomed either," Johnson said. "And if you take these numbers at face value, [breast cancer survivors] have a pretty good chance of escaping recurrence after five years of survival."

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Lead study investigator Dr. Abenaa Brewster, assistant professor of clinical cancer prevention at M.D. Anderson Cancer Center at the University of Texas, said that the conclusions of the research, which looked at more than 2,800 breast cancer survivors, should be perceived as good news for breast cancer survivors who fear recurrence.

"The message I'd really like to get across is that these [recurrence] rates are actually pretty low, and I hope these numbers are reassuring to women because women who are five-year survivors [of breast cancer] often think they are still at high risk for recurrence," Brewster said.

But Lillie Shockney, assistant professor of breast cancer at the Johns Hopkins Avon Foundation Breast Center in Baltimore, said that boiling this figure down into a single percentage ignores the evidence that each breast cancer survivor's risk is different.

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"I'm a little concerned that the data is apples and pineapples," she said. "It just doesn't focus on recurrence rates, but includes local recurrence, metastatic disease and a new primary breast cancer. These are three different things."

Shockney's primary complaint was that the study lumped all breast cancer survivors into one category and reported the average risk. Shockney believes this could mean that the recurrence rate reported in the study is actually higher than it should be for patients with less aggressive forms of breast cancer. For women who have survived more difficult battles with the disease, the figure may be too low.

But cancer experts stressed that one of the most important things for a breast cancer patient to remember is that the disease should not be considered "cured" after surviving the disease.

"Clearly, it is widely understood that the risk of cancer recurrence after breast and other cancers extends beyond the previous traditional five-year landmark," said Dr. Stephen Edge, chair of the department of breast surgery and medical director of the Breast Center at Roswell Park Cancer Institute in Buffalo, N.Y.

"The public may still have the old notion that if you are free of cancer at five years, that it can't come back. All previous data, with this study providing more underscoring, shows that this notion is simply not true," Edge said.

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