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? about late onset metastatic disease
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? about late onset metastatic disease

I am about 10 years post mastectomy for infiltrating ductal carcinoma with neg nodes, ER/PR+.  I was 35 at the time, and was unable to tolerate Tamoxifen.  No chemo was recommended by my oncologist; I believe at that time it wasn't standard of care for my early stage disease.  
However, he did mention that late onset metastatic disease was certainly a possibility; but that chemo at diagnosis would not necessarily PREVENT late onset disease.  
He described a "curve" of recurrence risk, with the greatest risk being up to 2-4 years post diagnosis--then the risk drops dramatically for up to 10 years.  Then, he said there was again a small but definate rise in the chance of metastatic diease.

Do you believe this is true?  This info was given to me 10 years ago, and perhaps thinking has changed.  My doctor (family practitioner) was astonished to hear I was concerned and asking about follow up at this late date--didn't I know I was "cured"? "Why on earth are you worried"?  No need for any follow up of any sort.

I don't obsess about it, it just makes me uneasy from time to time that I am blithly dismissed as cured with no higher risk of cancer than the next person.  The oncologist mentioned to me that with the unusually high amount of colon cancer in my family, and with my personal history of breast cancer, that I may be at higher risk for ovarian cancer, too.  But my GP says this is ridiculous.  My GYN says she has never heard of an association, either.
(I DO get my colonoscopies, don't worry!)  Just wondering if I should quit worrying for good.
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Avatar_n_tn
Dear Christie:  Any person who has had cancer is at higher, though how high may not be clear, risk for developing a recurrence or another cancer.  Clearly women who have had one breast cancer are at higher risk of developing another primary breast cancer and it is true women who have had breast cancer MAY be at higher risk for developing ovarian cancer.  There probably is not enough risk to do anything other than standard screening.  But a physician should have a low threshold for doing additional testing if a problem should arise.  Although the more years that pass after a diagnosis the lower the chance of recurrence, that possibility never goes away completely.  There is no rise that I am aware of after 10 years.  The risk keeps dropping but is always there.  What does this mean?  You should continue to have your remaining breast screened through clinical breast exam, self-examination and mammography.  If you should develop symptoms that do not go away in a reasonable amount of time, additional evaluation should be done.  Continue to be screened for colon cancer as any other person would.  A good and thorough physical is probably adequate for follow-up.
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Avatar_n_tn
PS--I worry FAR more about the colon cancer issue;  my mother had it (still living), grandfather, uncle, aunt, and great aunt all died from this disease at an early age.  

I have never had so much as a polyp, though.
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Avatar_n_tn
there may be an association with endometrial (uterine) cancer. As to late recurrance of breast cancer; it's true that it can occur many years later. However, the risk is very small, and even less having had negative nodes. Other than very fine print, most anyone would could consider you cured.
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