BConnected has been developed and funded by Novartis Pharmaceuticals UK Limited. This educational website is intended for UK healthcare professionals only.

It looks like you are using an older version of Internet Explorer which is not supported. We advise that you update your browser to the latest version of Microsoft Edge, or consider using other browsers such as Chrome, Firefox or Safari.

Rethinking communication

The importance of connecting with your patients and discussing the risk of recurrence

Many people with early breast cancer want their healthcare team to address the possibility of the disease returning. Yet for some, these conversations don’t go far enough to give them the clarity and confidence they need.

A YouGov survey initiated and funded by Novartis UK revealed:

pie chart showing 75% full

…of patients would like their doctor to discuss with them the possibility of their cancer coming backa,1

pie chart showing over 80% full

…of patients agreed that knowing details about their breast cancer, such as tumour stage and lymph node involvement, is crucial for developing a tailored treatment plan with healthcare providers2

a. Among patients who have not yet discussed risk of recurrence.

Taking the time to discuss recurrence risk and the role of adjuvant treatment can help patients make informed decisions and feel better prepared for the road ahead.

Poor adherence and persistence to ET in HR+ BC negatively impacts survival

It has been widely demonstrated that patient–physician communication plays a primary role in adherence to any medical treatment.3

As a healthcare provider, it has been recognised that you can have a significant effect on your patients’ adherence by delivering interventions where necessary.4

Suboptimal treatment adherence and persistence remain the biggest clinical challenges in management of BC survivors.5

Among patients starting adjuvant endocrine therapy:6

pie chart showing upto 55% full

…are non-persistent at 5 years (gaps in treatment or medication supply of 60, 90 or 180 days)b
 

pie chart showing upto 67% full

…have poor adherence at 5 years 
(whether patients take their medications as prescribed; e.g., late, skipped, extra or reduced doses)

BIG 1-98 trialc,7

The clinical significance is that poor adherence and persistence with adjuvant endocrine therapy reduce its protective effect, leaving patients at increased risk of recurrence and death.

Effective communication between healthcare professionals and patients about the consequences of non-adherence is critical to sustaining therapy. The BIG 1-98 trial demonstrated that decreased endocrine therapy persistence and compliance in HR+ EBC directly translate into poorer outcomes.7

Understanding risk of recurrence may support adherence to adjuvant ET.8

b. Based on definitions of adherence across studies included in the meta-analysis

c. Based on a randomised double-blind trial assessing treatment adherence and its impact on DFS in 6144 post-menopausal women with HR+ EBC in the four-arm option to 5 years of Tam, Let or the agents in sequence, who received at least one dose of study treatment.

There is a need to strengthen communication between healthcare professionals and patients to ensure they understand their own risk of recurrence and the role of treatment in reducing it.

Host a risk of recurrence meeting at your trust

  • Educate/update your MDT
  • Discuss case studies
  • Address gaps in knowledge
ENQUIRE HERE
meeting room with laid out tables and a projector screen

Patients with HR+/HER2− EBC are at risk of both early and late recurrence

pie chart showing roughly 50% full

of recurrences occur early, within 5 years of diagnosis9,10

breast cancer metastasis chart

The majority of these invasive disease events are distant recurrences (metastasis) for which no cure currently exists11,12

Connect with the team

Our medical team can support your MDT with non-promotional medical education on the latest breast cancer research and therapeutic approaches, respond to specific medical enquiries and support clinical trial initiatives.

ENQUIRE HERE

Factors affecting risk of recurrence in HR+/HER2− EBC13-15

Anatomical risk factors

ruler icon

Tumour size

nodal involvement icon

Nodal involvement

Biological risk factors

tumour icon

Tumour grade

proliferation icon

Proliferation markers (High Ki-67 levels)

microscope icon

Oncotype DX and NHS predict

bar levels icon

ER/PR expression levels

hourglass icon

Age at diagnosis

No consensus was reached on what to deem high-risk of recurrence in the Delphi consensus panel, which consisted of 45 breast cancer oncologists and surgeons from across the UK.

Anatomical risk factors impact overall risk of recurrence16

Distant recurrence by tumour size in patients with ER+ EBCd,e

T1 tumours

T1 tumour chart

T2 tumours

T2 tumour chart

Figures adapted from Pan H, et al. 2017.
d. Bars show 95% CI; Dashed lines indicate that event rate is that for whole 5-year period; 
e. N1–3 denotes 1–3 positive lymph nodes; N4–9 denotes 4–9 positive lymph nodes.

Recent real-world evidence has shown the effect of biological risk factors on overall risk of recurrencef,17

overall recurrence charts and key

High-risk was defined as T4N0, T3N0 or T2N0 with additional criteria (grade 2 with Ki-67≥20% or high genomic risk, or grade 3). All other patients with N0 disease were non–high-risk

f. Adult patients with stage I-III HR+/HER2− EBC in the US Flatiron Health EBC de-identified electronic health records-derived database (2011-2023) were included; 
g. Kaplan–Meier analysis started at initial diagnosis date. Patients without an event were censored on their last confirmed structured activity date; 
h. Overall and distant RoR log-rank differences were evaluated between N0, N1 and N2–3 groups.

Get in contact to receive our medical events calendar

You will receive information on all the upcoming events over the next 12 months.

CONTACT US NOW

Connect with us to receive patient materials

Want to explore the full set of patient materials? 
Click the button below to request the complete resource pack, designed for HCPs to share with patients to support discussions surrounding the risk of recurrence.

EMAIL US NOW

These patient resources have been created and funded by Novartis Pharmaceuticals UK Limited.

Contact us for patient tear off resources
patient and doctor getting close

Connecting with patients: communicating the risk of recurrence

Having open conversations about recurrence risk helps ensure you and your patients are aligned on treatment goals, potential side effects and quality of life considerations. This shared understanding can support treatment adherence and ultimately reduce the risk of recurrence.18

External resources

For healthcare professionals:

Cancer Research UK - Health professional resources

Access Cancer Research UK’s evidence-based information, tools and resources to support you in delivering best practice in prevention and early diagnosis.

VISIT NOW

Breast Cancer Now

Visit Breast Cancer Now’s website for helpful resources, research updates, evidence-based information and support tools tailored for healthcare professionals. Stay up to date with the latest advancements and enhance your breast cancer care expertise to better support your patients.

VISIT NOW

For patients:

Macmillan Cancer Support – Support for your patients

Information about treatment, money, mental health and more, this guide can help you in the support of your breast cancer patients. 
 

VISIT NOW

OWise – The patient breast cancer app

OWise supports patients from their first diagnosis. It provides safe and reliable information while collating valuable insights about their day-to-day wellbeing to assist healthcare professionals in making informed decisions about ongoing treatment.

VISIT NOW

About us

BConnected is a medical communication programme designed to deliver customised educational resources and knowledge-sharing platforms to foster a cohesive, supportive and collaborative environment that empowers HCPs to drive improvements in breast cancer care.

References:

  1. Data based on YouGov survey of 1004 UK adults aged 18 and above (5–17 October 2023, initiated and funded by Novartis Pharmaceuticals UK Ltd)
  2. Early Breast Cancer Online Patient Survey (N=219). 3 November–6 December 2023.
  3. Rosso R, D’Alonzo M, Bounous VE, Actis S, Cipullo I, Salerno E, Biglia N. Adherence to Adjuvant Endocrine Therapy in Breast Cancer Patients. Curr Oncol. 2023 Jan 21;30(2):1461-1472. doi: 10.3390/curroncol30020112. PMID: 36826073; PMCID: PMC9955792. [Last accessed: November 2025]
  4. Verma S, Madarnas Y, Sehdev S, Martin G, Bajcar J. Patient adherence to aromatase inhibitor treatment in the adjuvant setting. Curr Oncol. 2011 May;18 Suppl 1(Suppl 1):S3-9. doi: 10.3747/co.v18i0.899. PMID: 21698059; PMCID: PMC3119895. [Last accessed: November 2025]
  5. Moon Z, et al. Patient Prefer Adherence. 2017;11:305–22
  6. Yussof I, et al. Breast. 2022;62:22–35
  7. Chirgwin JH, et al. J Clin Oncol. 2016;34(21):2452–9
  8. Janssen AM, et al. Eur J Cancer Care (Engl). 2022;31(6):e13721.
  9. Foldi J, et al. J Clin Oncol. 2019;37(16):1365–9;
  10. Gomis RR, Gawrzak S. Mol Oncol. 2017;11(1):62–78; 3
  11. Johnston SRD, et al. Lancet Oncol. 2023;24(1):77–90;
  12. Gnant M, et al. J Clin Oncol. 2022;40(3):282–93.
  13. Fasching PA, et al. Geburtshilfe Frauenheilkd. 2024;84(2):164–84;
  14. Loibl S, et al. Ann Oncol. 2024;35(2):159–82;
  15. Copson ER, et al. Breast. 2023;72:103582
  16. Pan H, et al. N Engl J Med. 2017;377(19):1836–46 (and suppl. info).
  17. Jhaveri K, et al. ESMO 2024;292P:poster.
  18. Wengström Y, et al. Breast. 2007;16(5):462–8.

UK | November 2025 | FA-11514180

Terms of use Cookies and Data Privacy Cookie Settings

Reporting side-effects
Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard.

©2025 Novartis Pharmaceuticals UK Ltd

BConnected has been developed and funded by Novartis Pharmaceuticals UK Limited

This website is part of a programme that is funded by Novartis Pharmaceuticals UK Limited. Novartis Pharmaceuticals UK Limited is a private limited liability company registered in England and Wales under number 119006. Registered office 2nd Floor, The WestWorks Building, White City Place, 195 Wood Lane, London, W12 7FQ. 
Use of this website is governed by our Terms of Use and the Cookies and Privacy Policy.