KUALA LUMPUR: Breast cancer remains the most common cancer among women in Malaysia, accounting for about 30% of female cancers. For many women with a breast cancer diagnosis, completing treatment is not necessarily the end of their journey.
Even after surgery, chemotherapy, radiotherapy or hormone therapy, a lingering question often remains: will the cancer come back?
Concerns about recurrence are not unfounded. Among patients with hormone receptor-positive (HR+)/HER2-negative early breast cancer at stages 2 and 3, one in six faces a risk of recurrence within three years.
Indeed, a recent survey found that recurrence concerns remain common among patients. Nearly seven in 10 respondents said they were concerned or extremely concerned about the possibility of their cancer returning, while 41% reported thinking about it often.
Yet awareness about recurrence appears to be limited. Nearly eight in 10 respondents felt public understanding of early breast cancer recurrence was inadequate, while only about half felt informed about the factors that contribute to recurrence.
Consultant breast surgeon Dr Yip Cheng Har said recurrence remains a possibility even after successful initial treatment. “The reality is that even after a successful initial treatment, tumour cells may remain undetected,” he said.
“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.”
The survey also found that many patients do not fully understand the role of adjuvant therapies – treatments given after primary treatment to reduce the risk of cancer returning.
Only 57% of respondents said they fully understood the importance of therapies such as hormone therapy, chemotherapy and targeted treatment in reducing recurrence risk.
Consultant clinical oncologist Dr Kua Voon Fong said ongoing treatment and follow-up care can play an important role in improving long-term outcomes.
“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,” she said.
“However, these benefits are closely linked to treatment adherence. When patients are supported to maintain a good quality of life, they are more likely to continue recommended treatment, leading to improved outcomes.”
According to patient advocates, uncertainty about recurrence is one of the most common concerns among people living with breast cancer.
“Will my cancer come back?” is a question many patients carry throughout their journey, said Sumitra Selvaraj, general manager of the Breast Cancer Welfare Association Malaysia (BCWA).
She said patients benefit when doctors discuss recurrence risk openly and help them understand what it means for their individual circumstances.
“As patients navigate long-term treatment and survivorship, compassionate communication and ongoing follow-up play a vital role,” she stressed.
Experts, therefore, encourage patients to discuss recurrence risk with their healthcare providers and ask questions such as whether they are at risk, how they can reduce that risk, and what follow-up tests may be required.
While every patient’s experience is different, informed conversations and continued support can help reduce uncertainty and empower women to make decisions about their long-term care.
