Impact of Symptomatic Versus Asymptomatic Breast Cancer Recurrence on Survival: A Retrospective Study of 238 Patients

Background The relationship between symptoms at breast cancer recurrence and post-recurrence survival remains poorly understood. This study aimed to evaluate factors influencing survival after recurrence based on the presence or absence of symptoms at the time of breast cancer recurrence. Methods We retrospectively reviewed the records of 238 patients diagnosed with the first distant recurrent breast cancer between January 2000 and December 2019. Post-recurrence survival was analyzed based on whether the first distant recurrence was symptomatic or asymptomatic and stratified by clinical and pathologic characteristics. Significant prognostic factors related to post-recurrence survival were identified. Results For the entire cohort, the median overall survival after recurrence was 2.06 years for symptomatic patients at recurrence and 3.58 years for asymptomatic patients at recurrence (p = 0.006). Among symptomatic patients at recurrence, those aged > 50 years, with positive lymph nodes, or with hormone receptor-positive/HER2-positive subtype exhibited significantly worse prognoses than those without symptoms at recurrence. In asymptomatic patients at recurrence, the first distant recurrence was detected significantly earlier using imaging modalities than using blood tests. Conclusion Symptom status at first distant breast cancer recurrence may be associated with post-recurrence survival, with asymptomatic recurrence showing more favorable outcomes.