Shining a spotlight on the impact of breast cancer recurrence

Breast cancer recurrence, when the disease returns following a course of treatment for primary breast cancer, can be a devastating diagnosis, and affects around 1/5 of breast cancer patients in the UK.¹

Its impact is apparent right across the breast cancer pathway. Patients who have been treated for primary breast cancer face a lifelong risk and accompanying fear of recurrence, whilst at the time of diagnosis of recurrence, many individuals will have unfortunately progressed to incurable metastatic disease.

More support and focus on these patients is urgently needed if recent improvements in breast cancer outcomes are to continue in the coming years.²

Informed by consultation with leading stakeholders involved in the delivery of breast cancer care and those with lived experience of the disease, this new report – Shining a Spotlight on the Impact of Breast Cancer Recurrence – sets out a number of recommendations that could help support improvements and transform the way that the risk and incidence of breast cancer recurrence is managed across the NHS.

These recommendations are as follows: 

1. The overall emphasis of breast cancer policy needs to expand beyond early diagnosis and incorporate a greater focus on the later stages of the disease pathway, including the management of breast cancer recurrence. 
2. Joined-up action across breast cancer stakeholders is needed to accelerate the adoption of solutions to the system anti-cancer therapy (SACT) capacity challenges to ensure that patients can maximise the benefits of therapies that reduce the risk of recurrence or treat recurrent breast cancer.
3. There needs to be improved access to tailored mental health support for patients who are in the later stages of the breast cancer pathway to help them manage both the fear and a diagnosis of recurrence. 
4. Conversations about the risk of recurrence between patients and healthcare professionals should be given sufficient time and attention, and incorporate the following core elements
   •  take-away information about the risk of recurrence.
   •  guidance on adherence to therapies and lifestyle advice that can reduce a patient’s risk of recurrence. 
   •  information to empower patients to recognise the signs and symptoms of recurrence 
5. Ongoing evaluation of Patient-Initiated Follow-up (PIFU) approaches is needed to assess their suitability for patients who are at high risk of breast cancer recurrence.
6. There needs to be improved data collection across the pathway to better understand the true burden of recurrent breast cancer with appropriate incentives in place to ensure that this is consistent across local areas.