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" ... The main limitation – to collecting this information – is that recurrent breast cancer is not a reportable condition; most U.S. registries just count new cases and cancer deaths. If and when a breast cancer patient has a recurrence, sometime after initial treatment, there is no national registry to which doctors must submit that information. Apart from individual healthcare systems or clinical trials – in which few early-stage patients participate – there's no organized tracking of all cases between diagnosis and death. This results in most cases of metastatic breast cancer going untallied, and survival of those affected being unmeasured. ... "