Beyond Treatment: Why Breast Cancer Recurrence Needs More Attention
For many people diagnosed with breast cancer, completing treatment is often seen as the end of a difficult chapter. Yet for thousands of survivors, another challenge remains long after surgery, chemotherapy, radiation, or targeted therapy has ended: the fear that the cancer may return.
New findings shared at the recent Living Well, Living Longer: The Hidden Risk of Breast Cancer Recurrence roundtable discussion suggest that concerns about recurrence are common among Malaysian breast cancer patients, but conversations about those risks may not be happening often enough.
Breast cancer remains the most common cancer affecting women in Malaysia, accounting for approximately 30 per cent of female cancers and claiming nine lives every day. While advances in screening, diagnosis and treatment have improved outcomes, recurrence remains a reality for some patients, particularly those with certain forms of early breast cancer. One in six patients with Stage II and III HR+/HER2- early breast cancer face a risk of recurrence within three years.
According to a patient perception survey commissioned through IQVIA, nearly seven in ten breast cancer patients reported being concerned or extremely concerned about recurrence, with four in ten saying they think about it often. Yet many patients also reported that the topic is not discussed regularly during medical consultations, particularly when they are perceived to be at lower risk.
The survey also highlighted important gaps in awareness. Nearly eight in ten respondents felt that public understanding of breast cancer recurrence is inadequate, while only just over half felt informed about the factors that contribute to recurrence risk. Just 57 per cent said they fully understood the importance of adjuvant therapies in helping reduce the risk of recurrence.
Professor Emeritus Dato' Dr Yip Cheng Har, Consultant Breast Surgeon, believes these conversations are essential.
“The reality is that even after a successful initial treatment, tumour cells may remain undetected. A tumour as small as one cubic millimetre can contain up to 100,000 cells, and it only takes a single cancer cell for the disease to return. While recurrence risk differs from one person to another, normalising these conversations allows clinicians to better support patients in understanding their individual risk and long-term care needs.”
Experts emphasise that understanding recurrence risk is not about creating fear. Rather, it helps patients make informed decisions about follow-up care, monitoring and treatment adherence. Open and ongoing discussions between patients and healthcare providers can help ensure that individuals understand their personal risk profile and the steps they can take to reduce it.
Dr Kua Voon Fong, Consultant Clinical Oncologist, noted that many patients share a common goal after treatment: more time with their loved ones and greater peace of mind.
“What our patients consistently tell us is that they want more time. Time with their families, and time to live without constant worry about recurrence. Encouragingly, advances in post-treatment care are helping to address this.”
He added that treatment adherence remains an important part of improving outcomes, particularly for patients at higher risk of recurrence. When patients are supported in maintaining their quality of life, they are often better able to continue recommended treatments and follow-up care, ultimately leading to improved outcomes.
Patient advocates also stress the importance of emotional support throughout survivorship. Sumitra Selvaraj, General Manager of the Breast Cancer Welfare Association Malaysia (BCWA), said that fear of recurrence is a question many patients carry with them long after treatment ends.
Support from healthcare providers, family members, survivor communities and patient support organisations can help individuals better understand their risk, navigate uncertainty and feel less alone during their cancer journey. In addition to these support networks, digital tools such as the ICanCare app can provide access to educational resources, help patients keep track of questions and concerns between appointments, and connect them with reliable information throughout their survivorship journey.
Experts encourage patients to have open discussions with their healthcare teams and ask three important questions:
• Am I at risk of recurrence?
• How can I reduce my risk?
• Which tests do I need and how often should I take them?
For patients seeking more information, educational resources on early breast cancer and recurrence risk are available through the ICanCare app, which can be downloaded from the Google Play Store and Apple App Store.
As survivorship becomes an increasingly important part of cancer care, experts say awareness must extend beyond diagnosis and treatment. Understanding recurrence risk, maintaining follow-up care, and supporting patients emotionally and medically throughout their journey are all essential components of helping people not only survive breast cancer, but live well beyond it.
