Understanding Breast Cancer Recurrence
- Pop star Kylie Minogue, 58, is enjoying a well-deserved “mini-break:” filled with beach days, sunshine, and simple pleasures after opening up about her private breast cancer recurrence in her docuseries.
- Minogue previously underwent a treatment that included a lumpectomy, where only the tumor and surrounding tissue are removed, and chemotherapy. It’s unclear how she battled breast cancer recurrence.
- According to Julie Lange, M.D., a breast cancer specialist at Johns Hopkins, “At the Johns Hopkins Breast Center, our team of breast cancer specialists monitors patients who are at risk of recurrence. The follow-up schedule depends on the stage of cancer, what kind of treatment has been received and prognostic factors. “The risk of recurrence decreases as time goes on, but never gets down to zero.”
- To help you on your cancer journey, explore SurvivorNet’s proprietary AI tool, “My Health Questions.” This powerful resource, embedded across the SurvivorNet website, was built to bridge that gap by offering on-demand explanations of treatment options, clinical trials, side effects, insurance concerns, and more.
Minogue, 58, shared a glimpse of her much-needed escape on social media, posting photos and videos from her relaxing retreat.
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Minogue shared another glimpse of her getaway, appearing to explore an island while dressed casually in a sun hat, ripped jeans, a comfortable tank top, and red flip-flops.
Fans commented with praise, with one writing, “Looks like you’re having a really lovely break, enjoy!”
Another wrote, “You look so lovely. Hope you’re enjoying your little holibobs.”
Singer Rita Ora also chimed in, saying, “Well deserved no one works harder then you!”
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It’s inspiring to see Minogue embracing this time to recharge, particularly after sharing in her Netflix docuseries that she experienced a breast cancer recurrence during the pandemic in 2021—a challenging period she navigated on her own.
She explained in the docuseries as per E! News, “My second cancer diagnosis was in early 2021. I was able to keep that to myself … Not like the first time.
“Thankfully, I got through it, again. And all is well. Hey, who knows what’s around the corner, but pop music nurtures me…my passion for music is greater than ever.”
Cancer Recurrence and Survivorship Resources
- ‘This Is Not for the Weary’: ‘Baywatch’ Star Nicole Eggert Reflects on ‘Scanxiety’ After Clear Breast Cancer Results
- How To Reduce the Risk Of A Breast Cancer Recurrence
- Preventing Early Breast Cancer Recurrence: Eli Lilly’s Head of Oncology On The Tremendous Potential Of CDK4/6 Inhibitors
- Using Drugs Known as CDK4/6 Inhibitors to Reduce Chance of Breast Cancer Recurrence — It’s Crucial to Understand Risks vs. Benefits
- Taking Kisqali Earlier Helps Prevent Recurrence For Patients With Hormone Receptor-Positive Breast Cancer Regardless of Subtype
Reflecting on why she waited to reveal her recurrence, Minogue said she struggled to find the right time to open up about what she had privately endured.
Minogue revealed that deciding when to speak about her second cancer diagnosis was difficult, as she wanted to share her story only when she felt ready.
“I don’t feel obliged to tell the world … and actually I just couldn’t at the time because I was just a shell of a person. I didn’t want to leave the house again at one point,” she said.
“‘Padam Padam’ opened so many doors for me, but on the inside I knew that cancer wasn’t just a blip in my life.”
Minogue reportedly continued, “I really just wanted to say what happened so I can let go of it. I’d sit through interviews and every opportunity I thought, ‘Now’s the time,’ but I kept it to myself.”
According to The Guardian, Minogue said she hopes sharing her cancer experience will encourage others to prioritize their health and remember the importance of routine checkups.
“Early detection was very helpful,” she said, referring to her cancer battles.
The famed musician, known for her hit song “Can’t Get You Out My Head,” was first diagnosed with breast cancer 21 years ago while in the middle of a tour, which she had to cancel to focus on her health and treatment.
Minogue’s decision to publicly share her breast cancer diagnosis in 2005 sparked the “Kylie Effect,” inspiring more young women to seek screenings and leading France’s culture minister to praise her courage when she received the Order of Arts and Letters.
Kylie Minogue’s Breast Cancer Battle
While Minogue was diagnosed with breast cancer at age 36 on May 17, 2005, her cancer was originally misdiagnosed.
“Because someone is in a white coat and using big medical instruments doesn’t necessarily mean they’re right,” she said during an appearance on The Ellen DeGeneres Show.
“It’s like the earth had kind of slipped off its axis,” Minogue said in 2020 of her diagnosis. “You see everything differently.”
The diagnosis came right before she was set to perform at the famous Glastonbury Festival that year, so she had to put her career on hold. Instead of headlining the iconic event, she watched it on TV from Australia with her mom, Carol, and dad, Ron.
“My memory’s so strong of so much around that time and while my focus had moved on from Glastonbury, I was watching and going, ‘I’m meant to be there,'” she said. “It would have been pretty mega at the time to headline the next woman to do it was Beyonce.”
Minogue underwent a lumpectomy, an eight-month cycle of chemotherapy and radiation for treatment. She was declared cancer-free in February 2006 and then continued to take medication for five years.
She hasn’t offered additional details into her cancer recurrence journey, which began in 2021.
Understanding Breast Cancer Recurrence
According to Julie Lange, M.D., a breast cancer specialist at Johns Hopkins, “At the Johns Hopkins Breast Center, our team of breast cancer specialists monitors patients who are at risk of recurrence. The follow-up schedule depends on the stage of cancer, what kind of treatment has been received and prognostic factors.
“The risk of recurrence decreases as time goes on, but never gets down to zero.”
Meanwhile a study published in the Journal of Clinical Oncology, titled “Annual Hazard Rates of Recurrence for Breast Cancer During 24 Years of Follow-Up,” concluded, “For the entire group, the annualized hazard of recurrence was highest during the first 5 years (10.4%), with a peak between years 1 and 2 (15.2%). During the first 5 years, patients with estrogen receptor (ER) – positive disease had a lower annualized hazard compared with those with ER-negative disease. However, beyond 5 years, patients with ER-positive disease had higher hazards.
“Among patients with ER-positive disease, annualized hazards of recurrence remained elevated and fairly stable beyond 10 years, even for those with no axillary involvement and for those with one to three positive nodes.”
The Susan G. Komen foundation also explains that that most local recurrence, (the return of cancer to the breast, chest wall or nearby lymph nodes after treatment), occurs within the first 5 years after diagnosis.”
And an earlier study from 2016, published in the World Journal of Surgical Oncology, concluded that, “ER+/PR+ and HER2− patients have higher risk of recurrence later than 5 years, especially in patients with high ER titer and low nuclear grade. Larger and node-positive tumors had higher risk of early recurrence.”
How To Reduce the Risk Of A Breast Cancer Recurrence
You beat breast cancer. You battled the beast and are healthy, strong and ready to tackle the rest of your life. But what about breast cancer recurrence?
As triumphant as breast cancer survivors can feel after learning they are cancer free, many worry about recurrence. What are their chances of the cancer returning and what, if anything, can they do to help prevent it from doing so?
While the chance of recurrence varies based on the biology of the tumor, the stage it was when diagnosed and the treatment received, according to the Susan G. Komen organization, “Most people diagnosed with breast cancer will never have a recurrence.” That’s the good news.
“Once a patient has finished his or her active therapy for breast cancer, we will often refer to that time as breast cancer survivorship,” says Dr. Erica Mayer, a breast cancer medical oncologist at Dana Farber Cancer Institute.
“This is a time when patients are still being actively monitored by their treatment team, not only to ensure that they remain healthy and cancer-free in the years ahead, but also making sure that they have recovered from any side effects of their initial treatment, and that they are pursuing healthy behaviors for example, getting regular exercise, eating a healthy diet, and keeping up with all their other routine medical care.”
But recurrence does happen, so it’s important to do everything you can to reduce your risk. Here are some tips:
1. Follow Treatment Guidelines
“The best way to reduce your risk of recurrence with breast cancer is to follow treatment guidelines and complete the course of treatment that’s given,” says Dr. Elisa Port, a surgical oncologist specializing in breast cancer at Mount Sinai, recently sat down with SurvivorNet and offered the following advice.
For example, she says many women have breast cancer that’s hormonally driven, and there are treatments that they give, such as pills like Tamoxifen or aromatase inhibitors, to reduce the risk of these hormonally-driven cancers coming back. The issue is that the course of treatment may call for patients to take the pills for 5-10 years. While some have no side effects, others may experience a host of unpleasant side effects, even to the point where they’re severely debilitated and have no quality of life on these medications.
“So the challenge is to work with every individual person to make sure we give her the best chance of getting through these treatments and enjoying the benefits of these treatments, which is the lowest rate of cancer coming back,” Port says.
2. Maintain a Healthy Weight
Maintaining a healthy weight may also reduce the risk.
“We know that obesity or being overweight can increase the risk of cancer recurrence in breast cancer,” Port says. “And so I say, maintaining a healthy body weight, whatever that is for the individual… You know, we talk a lot about healthy body weight, and there’s a very big range of this, but there are certain numbers beyond which, it does affect one’s health. So we try to keep people within a range of a healthy body weight.”
3. Limit Alcohol
Port says the other lifestyle factor that may increase one’s risk of breast cancer recurrence is heavy alcohol intake.
“We say alcohol in moderation is probably fine, which is defined as three to five drinks a week,” Port told SurvivorNet. “More than that can also potentially increase the risk of recurrence. So the big lifestyle factors are healthy body weight and moderate alcohol intake.”
4. Eat a Healthy Diet
She says there’s no one dietary element that you can eat or consume to give you an edge against breast cancer recurrence. It’s not eating more broccoli or eating more blueberries or becoming a vegetarian. She says the fact that sugar feeds cancer is a big myth too. However, everything you eat does contribute to your overall health.
“These things are all really helpful in maintaining an overall healthy well-balanced diet and also to maintain healthy body weight. We know that diets that are heavy in sugar content are also usually unhealthy and can lead to weight issues. So it all really funnels back to maintaining a healthy body weight when it comes to lifestyle factors.”
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5. Exercise
This goes hand-in-hand with maintaining a healthy weight. Dr. Erica Mayer, a breast cancer medical oncologist at Dana Farber Cancer Institute, previously told SurvivorNet, “Once a patient has finished his or her active therapy for breast cancer, we will often refer to that time as breast cancer survivorship.
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“This is a time when patients are still being actively monitored by their treatment team, not only to ensure that they remain healthy and cancer-free in the years ahead, but also making sure that they have recovered from any side effects of their initial treatment, and that they are pursuing healthy behaviors for example, getting regular exercise, eating a healthy diet, and keeping up with all their other routine medical care.”
CDK4/6 Inhibitors Can Help Reduce Chance of Breast Cancer Recurrence
In the breast cancer space, there are constant efforts from researchers and drug makers to develop therapies that can not only treat cancer better, but reduce the risk of it returning. And many promising advancements in breast cancer have arose in recent years.
For women with a common subtype of breast cancer — hormone-receptor-positive and HER2-negative (HR+ and HER2-) — a newer class of drugs called CDK4/6 inhibitors are showing promise.
CDK4/6 inhibitors work to interrupt the growth of cancer cells. SurvivorNet sat down with Dr. Eleonora Teplinsky, Head of Breast Medical Oncology at Valley Health System, to discuss how a CDK4/6 inhibitor, Ribociclib (sold under brand names Kisqali and Kryxana), is being studied for women with this specific type of breast cancer.
What are CDK4/6 inhibitors? Understanding Risks vs. Benefits
Referencing data obtained from the NATALEE phase III clinical trial, Dr. Teplinsky explained how breast cancer patients who received Ribociclib along with endocrine therapy (the current recommended treatment) had a 25% lower risk in recurrence or death.
Prior to the study, “Ribociclib was already approved for metastatic hormone receptor-positive breast cancer, but this study was looking to see if it has benefits in reducing recurrence in earlier stage breast cancer,” she explained.
The study looked at something called disease-free survival, which means patients are alive without their cancer recurring.
“In the group that received Ribociclib and endocrine therapy … at three years their disease-free survival was 90.4% compared to 87.1% in the group that received endocrine therapy alone,” Dr. Teplinsky said. This translates to a 3.3% “absolute improvement.”
It’s important to note that this therapy option is not currently FDA-approved.
The Importance of Breast Cancer Screening
Screening for breast cancer is normally done through a mammogram, which looks for lumps in the breast tissue and signs of cancer.
While there is some disagreement about the exact age a woman should start getting mammograms, doctors generally agree it should happen in their 40s.
The American Cancer Society (ACS) suggests women should begin annual mammogram screenings for breast cancer at age 45 if they are at average risk for breast cancer.
However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) now says that women should start getting mammograms every other year at the age of 40, suggesting that this lowered the age for breast cancer screening could save 19% more lives
WATCH: Mammograms are still the best tool for detecting breast cancer.
The ACS also advises:
- Women aged 40-44 have the option to start screening with a mammogram every year
- Women aged 55 and older can switch to a mammogram every other year
- Women aged 55 and older could also choose to continue yearly mammograms
For screening purposes, a woman is considered to be at average risk if she doesn’t have a personal history of breast cancer, a strong family history of breast cancer, a genetic mutation known to increase risk of breast cancer such as a BRCA gene mutation or a medical history including chest radiation therapy before the age of 30.
Experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk for developing breast cancer, you should begin screening earlier.
Don’t delay speaking with your doctor to make sure you are staying on top of your breast health.
Understanding Provider Bias & Advocating for Your Health
While your doctor has undergone years of training and practice, she or he is ultimately still human and may come with their own set of biases that can impact how they treat patients.
To combat these biases and really the most out of your interactions with your doctor, you should provide her or him with plenty of information about your life and ask plenty of questions when things aren’t clear.
To better understand how you should approach conversations with your doctor, we spoke with Dr. Dana Chase, gynecologic oncologist at Arizona Oncology.
Avoiding Provider Bias – Is Your Doctor Understanding You?
According to Dr. Chase, physicians, like many of us, can be a bit biased when seeing patients. Dr. Chase makes clear that these biases are rarely sinister, but rather unconscious and more subtle. She says, “We have certain beliefs that we don’t know about. We might look, for example, at an older woman, and just by the way she looks we might make certain assumptions, and we might not even know that we’re making these assumptions.”
Sometimes, these assumptions can lead to differences in the care that doctors provide. That is the point at which you, the woman, should advocate for yourself and clear up any misconceptions the doctor may have, says Dr. Chase.
“Say things to your doctor like, ‘I may not seem healthy because I’m 92, but I want you to know that I play tennis three times a day,’” she explains.
This type of discourse can be really helpful when building a relationship with your physicians and even more important when it comes to creating a treatment plan.
“In order to avoid situations where potentially the doctor is making assumptions about you that you don’t even really know about, reminding yourself to tell the doctor who you are, to explain your life situation, I think is really important.”
It’s equally as important that you’re understanding your doctor as much as you want them to understand you.
“It’s never a bad thing to ask for something to be repeated, or to ask the doctors to explain it in different terms,” Dr. Chase adds.
So next time you go to your physician, we think you should feel empowered to speak up, both so she or he understands you and you understand them.
Contributing: SurvivorNetStaff
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