OBJECTIVE: To determine whether recurrence patterns based on estrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2) status have changed in contemporary times. PATIENTS AND METHODS: Female patients referred to the British Columbia Cancer Agency with biopsy-proven stage I to III breast cancer (BC), diagnosed between 1986 and 1992 (population 1 [C1]) and between mid-2004 and 2008 (population 2 [C2]), and with known ER and HER2 status were eligible. Prospective data collection. C2 patients were matched to C1 patients based on staging, grading, and ER and HER2 status. The primary endpoint was the risk of BC recurrence rate (HRR) in the study population based on biomarker status. Secondary regressions included HRR by stage, grade, and age, and risk of death (HRD). RESULTS: A total of 7178 patients were enrolled after matching (3589 patients were included in each population). the BC subgroup distribution was as follows: ER positive/HER2 negative 70.8%, ER positive/HER2 positive 6.9%, ER negative/HER2 positive 6.6%, and ER negative/HER2 negative 15.8%. For the overall population, the annual interval HRR was almost halved by 9 years in C2 compared to C1. For HER-2-positive and ER-negative/HER2-negative BC, the difference in HRR was greater between the populations at the most initial 5 intervals. All disease stages and staging HRRs were lower in C2 compared to C1. HRD was also lower in C2 compared to C1, but to a lesser extent. CONCLUSION: Although the pattern of recurrence remained similar, BC relapse-free survival showed a significant improvement. Improved regression was seen for all BC subtypes, especially for HER2-positive and ER-negative/HER2-negative BC, and the early peak of disease recurrence was significantly reduced. These current hazard rates have important implications for early BC treatment decisions, patient discussions, and clinical trial planning.