Complete and Partial Breast Cancer Remission

How the absence or reduction of cancer directs treatment and care

Many types of cancer can go into remission when they are treated. If you have had breast cancer, your doctor will use the term remission, rather than cure after your breast cancer has been successfully treated, even when there are no remaining signs of cancer in your body. This term is used because there remains a possibility that breast cancer may return after it's treated.

There are different types of breast cancer remission.

These include:

  • Complete remission: Tests, scans, and exams are unable to find cancer in the body
  • Partial remission: A tumor is still known to be present, but it is substantially reduced.

Each requires a different approach to management and treatment. Complete or partial remission means that you need ongoing monitoring to identify and treat a recurrence if it occurs.

Breast Cancer Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

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Complete Remission

Complete remission, also known as a complete response, means that cancer appears to be gone after treatment.

Breast cancer remission is determined by a battery of tests, including blood tests, tissue evaluations, and imaging studies (such as a breast MRI or PET/CT scan). As valuable as these tests are, they have their limitations. Even after complete remission has been declared, there may still be cancer cells below the detection levels of these tests. Some cancer cells may lie dormant indefinitely; others may suddenly multiply months or years later, resulting in disease recurrence.

Because of the potential for recurrence, many doctors will refer to complete remission as no evidence of disease, or NED.

Senior cancer patient talks with her doctor
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Partial Remission

If breast cancer is in partial remission, also known as a partial response, it means that the solid tumor has shrunk. Partial remission is usually declared when there is at least a 50% reduction in the tumor size or the number of cancer cells from the baseline value.

Partial remission is not the usual goal of breast cancer treatment. It is only when a tumor is inoperable or has metastasized (spread to other organs) that an oncologist will aim to control the tumor rather than eradicate it.

In all but stage 4 breast cancer, efforts will be made to remove the tumor and use radiation and/or chemotherapy to get rid of all remaining cancer cells.

To qualify as a complete or partial remission, the absence or reduction of cancer must last for at least one month. The absence of symptoms is neither a measure nor an indication of remission.

Treatment

The aim of treatment following cancer remission varies by whether you are trying to prevent recurrence or improve survival and quality of life. Prescribed treatments are largely based on whether you have had early-stage cancer (stages 1, 2, or 3) or stage 4 breast cancer.

Early-Stage Breast Cancer

If you've been diagnosed with early-stage breast cancer, you would receive local treatment that's intended to completely eradicate the disease.

Partial remission is a term that is usually used to describe stage 4 metastatic breast cancer treatment response, but, sometimes, partial remission may also apply to earlier stages.

Even if you are in complete remission, you may still need to take medication to keep your cancer from returning. Known as adjuvant therapy, the drugs are primarily for estrogen-receptor-positive breast cancer. This is a type of cancer whose growth is directly influenced by the hormone estrogen.

To reduce the risk of recurrence, your doctor may prescribe drugs that suppress either the production of estrogen or the stimulation of estrogen-sensitive cells.

If you have estrogen-sensitive cancer, your doctor may prescribe tamoxifen, which binds to the estrogen receptors on cells. After three to five years, you may be switched to another class of drug known as aromatase inhibitors for another five years (in part to avoid the long-term side effects of tamoxifen). Aromatase inhibitors block the enzyme that's used to produce estrogen in the liver, pancreas, breasts, brain, and other tissues.

Unlike tamoxifen, aromatase inhibitors are only effective in postmenopausal women or women whose ovaries are suppressed.

If your breast cancer is estrogen-receptor-negative, you may not need any medications. 

Metastatic Breast Cancer

If you have stage 4 breast cancer, you will be prescribed medications to better control the disease. While treatable, metastatic breast cancer cannot be cured. 

With that being said, recent advances in chemotherapy and immunotherapy have allowed people with stage 4 cancer to live longer without symptoms of the disease. This includes experimental adoptive cell therapy (ACT) in which your body's own cancer-fighting cells are harvested and cultured for use as immunotherapy.

A Word From Verywell

After any breast cancer diagnosis, you will need to see an oncologist on an ongoing basis to monitor your condition. This typically involves a doctor's visit every few months for the first five years, after which you may only need yearly appointments. You will also need an annual mammogram and possibly a breast MRI unless you've had a bilateral mastectomy,

Although there is no way to definitively prevent breast cancer recurrence, there are preventative medications that reduce the risk of a recurrence for some types of breast cancer. By remaining linked to medical care, any recurrence will have a higher chance of being caught early when it is most treatable.

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Article Sources
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  1. National Cancer Institute. Understanding Cancer Prognosis. Updated June 17, 2019.

  2. American Cancer Society. Managing Cancer as a Chronic Illness. Updated February 12, 2016.

  3. American Cancer Society. Treatment of Stage IV (Metastatic) Breast Cancer. Updated September 18, 2019.

  4. American Cancer Society. Treatment of Breast Cancer Stages I-III. Updated September 18, 2019.