# Late recurrence

Source: https://onco.cc/terms/late-recurrence/  
OnCo record `late-recurrence` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Hormone-driven breast cancer can come back 10 or even 20 years after treatment, unlike most cancers, which is why hormone therapy lasts so long.

## Summary

About half of recurrences in HR+ disease occur after year 5; risk continues at 1-2% per year to year 20 (EBCTCG, Pan 2017), driven by tumour size and nodal status. Motivates extended endocrine therapy (ATLAS, aTTom, MA.17), adjuvant CDK4/6 inhibitors for high-risk disease, and research into dormancy, ctDNA surveillance, and late-recurrence prediction assays (Breast Cancer Index).

## Fields

- Kind: Term
- Last checked: 2026-09-07

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Relapse
- Pan et al., 20-year risks of breast cancer recurrence after stopping endocrine therapy at 5 years (NEJM 2017): https://doi.org/10.1056/NEJMoa1701830

## Connected records

- cancers: [HR-positive / HER2-negative breast cancer](https://onco.cc/cancers/breast-hr-positive/), [Testicular germ cell tumours](https://onco.cc/cancers/testicular/)
- technologies: [Anxiety around scans, and what the evidence says about how often to scan](https://onco.cc/technologies/rejuv-mind-scan-anxiety/), [Fear that the cancer will come back: how common it is, and when it stops being ordinary worry](https://onco.cc/technologies/rejuv-mind-fear-of-recurrence/), [MRD / molecular residual disease testing](https://onco.cc/technologies/mrd-testing/)
- key papers: [20-Year Risks of Breast-Cancer Recurrence after Stopping Endocrine Therapy at 5 Years](https://onco.cc/key-papers/paper-pan-n-engl-j-med/)
- ideas: [Block the recycling that keeps dormant cells alive](https://onco.cc/ideas/idea-bio2-autophagy-block-mrd/), [Blunt the inflammation that wakes sleeping cancer cells](https://onco.cc/ideas/idea-bio2-il1-awakening-blockade/), [Intercepting late recurrence with ctDNA surveillance and oral SERDs](https://onco.cc/ideas/idea-late-recurrence-interception/), [Keep dormant cells asleep instead of trying to kill them](https://onco.cc/ideas/idea-bio2-pro-dormancy-therapy/), [Keep them asleep: dormancy maintenance as adjuvant therapy](https://onco.cc/ideas/idea-dormancy-maintenance-therapy/), [Use residual disease tests to decide who needs ten years of hormone therapy](https://onco.cc/ideas/idea-bio2-mrd-guided-endocrine-duration/), [What decides which disseminated cells ever colonise?](https://onco.cc/ideas/idea-dtc-colonisation-determinants/)
- bottlenecks: [Dormant cells and minimal residual disease](https://onco.cc/bottlenecks/b-dormancy-mrd/), [Survivorship and late effects are neglected](https://onco.cc/bottlenecks/b-survivorship/)
- pathways: [The pre-metastatic niche](https://onco.cc/pathways/pre-metastatic-niche/), [Tumour dormancy](https://onco.cc/pathways/tumor-dormancy/)
- terms: [Disseminated tumour cells (DTCs)](https://onco.cc/terms/disseminated-tumor-cells/), [What is not a second cancer: recurrence, metastasis and field cancerisation](https://onco.cc/terms/rejuv-second-what-is-not-a-second-cancer/)

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