{"entity":{"id":"late-recurrence","kind":"term","name":"Late recurrence","aka":[],"tldr":"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).","asOf":"2026-09-07","wikipedia":"https://en.wikipedia.org/wiki/Relapse","links":[{"label":"Pan et al., 20-year risks of breast cancer recurrence after stopping endocrine therapy at 5 years (NEJM 2017)","url":"https://doi.org/10.1056/NEJMoa1701830"}],"tags":[],"related":[],"cancers":["breast-hr-positive"],"sections":[],"technologies":["mrd-testing"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":["paper-pan-n-engl-j-med"],"journals":[],"dependsOn":[],"notes":[],"category":"Clinical"},"route":"/terms/late-recurrence/","neighbours":{"cancer":[{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"},{"id":"testicular","kind":"cancer","name":"Testicular germ cell tumours","route":"/cancers/testicular/"}],"technology":[{"id":"rejuv-mind-scan-anxiety","kind":"technology","name":"Anxiety around scans, and what the evidence says about how often to scan","route":"/technologies/rejuv-mind-scan-anxiety/"},{"id":"rejuv-mind-fear-of-recurrence","kind":"technology","name":"Fear that the cancer will come back: how common it is, and when it stops being ordinary worry","route":"/technologies/rejuv-mind-fear-of-recurrence/"},{"id":"mrd-testing","kind":"technology","name":"MRD / molecular residual disease testing","route":"/technologies/mrd-testing/"}],"paper":[{"id":"paper-pan-n-engl-j-med","kind":"paper","name":"20-Year Risks of Breast-Cancer Recurrence after Stopping Endocrine Therapy at 5 Years","route":"/key-papers/paper-pan-n-engl-j-med/"}],"idea":[{"id":"idea-bio2-autophagy-block-mrd","kind":"idea","name":"Block the recycling that keeps dormant cells alive","route":"/ideas/idea-bio2-autophagy-block-mrd/"},{"id":"idea-bio2-il1-awakening-blockade","kind":"idea","name":"Blunt the inflammation that wakes sleeping cancer cells","route":"/ideas/idea-bio2-il1-awakening-blockade/"},{"id":"idea-late-recurrence-interception","kind":"idea","name":"Intercepting late recurrence with ctDNA surveillance and oral SERDs","route":"/ideas/idea-late-recurrence-interception/"},{"id":"idea-bio2-pro-dormancy-therapy","kind":"idea","name":"Keep dormant cells asleep instead of trying to kill them","route":"/ideas/idea-bio2-pro-dormancy-therapy/"},{"id":"idea-dormancy-maintenance-therapy","kind":"idea","name":"Keep them asleep: dormancy maintenance as adjuvant therapy","route":"/ideas/idea-dormancy-maintenance-therapy/"},{"id":"idea-bio2-mrd-guided-endocrine-duration","kind":"idea","name":"Use residual disease tests to decide who needs ten years of hormone therapy","route":"/ideas/idea-bio2-mrd-guided-endocrine-duration/"},{"id":"idea-dtc-colonisation-determinants","kind":"idea","name":"What decides which disseminated cells ever colonise?","route":"/ideas/idea-dtc-colonisation-determinants/"}],"bottleneck":[{"id":"b-dormancy-mrd","kind":"bottleneck","name":"Dormant cells and minimal residual disease","route":"/bottlenecks/b-dormancy-mrd/"},{"id":"b-survivorship","kind":"bottleneck","name":"Survivorship and late effects are neglected","route":"/bottlenecks/b-survivorship/"}],"pathway":[{"id":"pre-metastatic-niche","kind":"pathway","name":"The pre-metastatic niche","route":"/pathways/pre-metastatic-niche/"},{"id":"tumor-dormancy","kind":"pathway","name":"Tumour dormancy","route":"/pathways/tumor-dormancy/"}],"term":[{"id":"disseminated-tumor-cells","kind":"term","name":"Disseminated tumour cells (DTCs)","route":"/terms/disseminated-tumor-cells/"},{"id":"rejuv-second-what-is-not-a-second-cancer","kind":"term","name":"What is not a second cancer: recurrence, metastasis and field cancerisation","route":"/terms/rejuv-second-what-is-not-a-second-cancer/"}]}}