4 min readApr 7, 2025 05:36 PM IST
First published on: Apr 7, 2025 at 04:03 PM IST
Filmmaker Tahira Kashyap revealed on Instagram that her breast cancer had relapsed and that she had to brace up for a second round of therapies. In 2018, she had been treated for stage zero breast cancer, the earliest form of breast cancer where abnormal cells are confined to the breast ducts or lobules and haven’t spread to surrounding tissues.
Kashyap has been undergoing regular screening for years without fail, a fact that helped in detection, indicating how breast cancer survivors need to be vigilant for long many years.
Breast cancer recurrence happens when cancer cells that weren’t completely destroyed during initial treatment survive and multiply, potentially leading to a return of the cancer, either in the same location or elsewhere in the body. “Some cancer cells may remain dormant or undetected. These surviving cells remain inactive for years but under certain conditions, they can start getting reactivated and multiply again, leading to recurrence,” says Dr Sewanti Limaye, Director of Medical & Precision Oncology, at Sir H. N. Reliance Foundation Hospital, Mumbai. “‘In some cases, such dormant cancer cells can spread from the original site to other parts of the body. These cells can also cause recurrence,” she says.
What triggers recurrence of breast cancer?
Certain types of breast cancer, like inflammatory breast cancer, have a higher risk of recurrence. Breast cancer cells with certain characteristics, like resistance to hormone therapy or HER2-targetted treatments, may have a higher risk of recurrence.
What is the risk of breast cancer recurrence?
The breast cancer survivor has to be watched extremely carefully in the first five years of occurrence and therapy. Any body who has had HER2-positive breast cancer and triple negative breast cancer reports a recurrence in the first few years. About 15 per cent of HER2-positive cancer relapses. Hormone receptor-positive breast cancer, while often considered less aggressive, can recur many years after initial treatment, with some studies showing a risk of recurrence persisting for up to 20 years or more.
Hormone-positive cancer, where the cancer cells have receptors for hormones like estrogen or progesterone, happens when these hormones help the cancer grow. In post-menopausal women, when the ovaries stop producing estrogen, fat cells become a primary source of the hormone. So the cancer keeps getting fed. To reduce the risk of recurrence, women with hormone receptor-positive breast cancer are often prescribed long-term hormone therapy, sometimes for 5 to 10 years, or even longer. The risk of recurrence decreases as time goes on, but never gets down to zero.
The other reason is family history. About 20 per cent of breast cancer survivors with a family history report a relapse unless both their breasts are removed. Hereditary Breast and Ovarian Cancer syndrome (HBOC) is a genetic condition that significantly increases the risk of developing breast and ovarian cancers, as well as other cancers like prostate, pancreatic, and melanoma, due to mutations in genes like BRCA1 and BRCA 2.
How difficult is it to manage recurrence?
Recurrence, especially localised, may not be difficult to manage but recurrence at the systemic level — when the cancer cells have migrated to other organs — can result in advanced disease.
What is the treatment for breast cancer recurrence?
This, of course, depends on individual biology and gene markers. The therapy differs depending on the type of cancer and where it appears. But nowadays there are good treatment protocols for advanced cancer too. So depending on the type of cancer, there could be a combination of chemotherapy, hormone therapy, targetted therapies and small molecule inhibitors that can enter cancer cells and inhibit their growth.
How to prevent breast cancer recurrence?
There must be regular surveillance, even organ surveillance. Follow-up is very critical, do not miss a three-month follow-up in the first two years. Survivors should also go in for liquid biopsy for minimal residual disease. In this, cancer cells can be detected even before they become visible on a scan.
What about lifestyle changes?
A breast cancer survivor should watch her weight, losing it by at least 10 per cent. She must exercise regularly, and not compromise on walking 10,000 steps a day.
Filmmaker Tahira Kashyap revealed on Instagram that her breast cancer had relapsed for the second time. (File Photo) 
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