Breast cancer has the highest chances of recurring within the first five years after initial treatment. Recurrence beyond this period, known as late recurrence, which is more common in women with high lymph node involvement, large tumor size, triple-negative tumors, and estrogen receptor positive tumors. We present a very rare case of estrogen receptor-positive breast cancer recurrence for the second time nearly four decades after the primary diagnosis. In our opinion, two unconventional approaches contributed to keeping the cancer cells dormant for four decades: first one was bilateral hystero-salpingography and the second one was the administration of Ramoxifenfor additional five years after completing treatment with Tamoxifen. While with newer advancements this approach might seem dated but in developing countries and in population who cannot afford chemotherapy, Immunotherapy for breast cancer, these approaches can be helpful to keep the estrogen receptor positive breast cancer cells to stay dormant.