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How Do You Know If Breast Cancer Has Returned

How Will My Prognosis Affect My Treatment

3 Signs Of Breast Cancer You Should Never Ignore | Ask The Doctor

Following surgery or radiation, your treatment team will determine the likelihood that the cancer will recur outside the breast. This team usually includes a medical oncologist, a specialist trained in using medicines to treat breast cancer. The medical oncologist, who works with your surgeon, may advise the use of tamoxifen or possibly chemotherapy. These treatments are used in addition to, but not in place of, local breast cancer treatment with surgery and/or radiation therapy.

Am I Still At Risk Of Local Recurrence If I Have Had A Mastectomy

Yes. Local recurrence can also happen after a mastectomy, although the likelihood is usually low.

Some of the signs of local recurrence after mastectomy include

  • A lump or raised bump in or under the skin, especially near the previous mastectomy scar
  • Changes to the skin, including redness or thickening

After reconstruction a local recurrence can appear at the suture line of the flap or in front of the implant. When its in the skin itself, it is red and raised. Reconstruction rarely if ever hides a recurrence. With implants, the recurrences are in front of the implant. With a flap, the recurrences are not in the flap itself but along the edge of the breast skin.

Local recurrence after mastectomy is often described as a chest wall recurrence, which isnt entirely accurate because it implies that the cancer is in the muscle or bone. But usually such a recurrence appears in the skin and fat where the breast was before, and only rarely does it include the muscle.

Ninety percent of local recurrences following mastectomy happen within the first five years after the mastectomy. Approximately 20 to 30 percent of women with local recurrences after mastectomy have already been diagnosed with metastatic disease, and another 20 to 30 percent will develop it within a few months of diagnosis. Therefore, just as with local recurrences after breast conservation, tests should be done to look for distant disease.

Risk Factors For Distant Recurrence

There are several risk factors that raise the risk of recurrence overall . These include:

  • Tumour size: Larger tumours are more likely to recur than smaller ones both early and late.
  • Positive lymph nodes: Tumours that have spread to lymph nodes are more likely to recur at any time than those that have not.
  • Age at diagnosis: Breast cancer recurrence is more common in younger women.
  • Treatments received and response to treatments: Both chemotherapy and hormonal therapy reduce the risk of recurrence
  • Tumour Characteristics: More aggressive cancers are more likely to recur than less aggressive tumours , especially in the first five years. We also take into account the receptor status and an estimate of proliferation .

There are also factors that do not appear to affect the risk of recurrence. Recurrence rates are the same for women who have a mastectomy or lumpectomy with radiation and are also the same for women who have a single vs. double mastectomy.

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How Do You Feel About It

You most likely will have many different emotions as you learn more about your diagnosis and begin to learn about treatment options. Its normal to wonder, Why me? or to feel sad, angry, or afraid. Physical and chemical changes from the treatment or the cancer itself can also affect your emotions. The first step is to admit to yourself how you feel. Its OK to let yourself feel the way you do.

Keep Life As Normal As Possible

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As much as you can, allow yourself and your family members to keep life as normal as possible while youre getting treatment. Encourage your family to keep doing the things they always did without feeling guilty . Children, especially, benefit from the routine, but adults also find that it offers them an anchor for day-to-day life.

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Introduction To Breast Cancer Recurrence

Breast cancer can recur at any time, but most recurrences occur in the first three to five years after initial treatment. Breast cancer can come back as a local recurrence or as a distant recurrence somewhere else in the body. The most common sites of recurrence include the lymph nodes, the bones, liver, or lungs.

When To Call The Doctor

Sometimes youll have physical side effects from your treatment that may mean you need help from your cancer care team. Learn more about the physical symptoms and side effects of cancer treatment, and when you should get help with them in the Treatments section of our website Talk to you doctor, nurse, or social worker if you have any concerns that seem too much to manage on your own. Also be sure that you know who to call or how to get help outside of normal office hours and on weekends or holidays.

For some people, having cancer and going through the stress it brings can start to make it seem that life isnt worthwhile. Please talk to your doctor or nurse right away if you have thoughts about hurting yourself. Cancer and cancer treatment can be hard to get through, and lots of people need extra help and support.

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Axillary Lymph Node Dissection

In this procedure, anywhere from about 10 to 40 lymph nodes are removed from the area under the arm and checked for cancer spread. ALND is usually done at the same time as a mastectomy or breast-conserving surgery , but it can be done in a second operation. ALND may be needed:

  • If a previous SLNB has shown 3 or more of the underarm lymph nodes have cancer cells
  • If swollen underarm or collarbone lymph nodes can be felt before surgery or seen on imaging tests and a FNA or core needle biopsy shows cancer
  • If the cancer has grown large enough to extend outside the lymph node
  • If the SLNB is positive for cancer cells after chemotherapy was given to shrink the tumor before surgery

Secondary Breast Cancer Prognosis

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If cancer has spread from the breast to another part of the body , it can be treated but it cant be cured.

No two cancers progress in the same way, and as treatments have improved more and more people are living longer after a diagnosis of secondary breast cancer.

Your specialist will have an understanding of the likely progression of your secondary breast cancer and can talk to you about what you might expect.

Find out more about secondary breast cancer.

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What Is Paget’s Disease Of The Breast

Paget’s disease of the breast is a rare type of cancer of the nipple area of the breast. It presents as eczema affecting the nipple and is often associated with an underlying in-situ or invasive carcinoma of the breast.

Breast Cancer

Many women find that their breasts become more lumpy and tender before periods. Breasts also alter their size and shape with increasing age, pregnancy and marked weight changes. What is important is that you get to know your own breasts – how they look and feel – and report any changes promptly to a doctor.

There are a number of things to look out for which might be breast cancer signs:

What Is My Prognosis

This is a very common question that isnt always easy to answer. There are many factors involved in working out prognosis. Remember that a prognosis is just a figure at the point at which you receive it. For most people, the prognosis gets better with time.

Sometimes we use a five-year figure because we know that if cancer comes back, most of the time it comes back within five years. If the cancer has not come back within five years, then the chance of it coming back within ten years is quite low, and if it does not come back within ten years, then you have an almost normal life expectancy.

Its a bit like buying a second hand car. You dont really know how long its going to last, but if it lasts year after year without breaking down, then the car starts to look more and more reliable to make that long trip.

Working out prognosis can be difficult.

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Where Does Breast Cancer Recur

Breast cancer recurrence can be categorized by where in the body it occurs when it returns. These categories include:

  • Local recurrence This type of recurrence describes breast cancer that develops in or near the same area where it originally developed, such as scar tissue, the chest wall or other nearby tissue.
  • Regional recurrence Breast cancer that returns in a nearby region, such as the lymph nodes in the armpit or collar bone, is known as a regional recurrence.
  • Distant recurrence Also called metastatic recurrence, this type of recurrence describes breast cancer that returns in a distant area of the body, such as the bones, lungs or liver.

Dealing With Cancer Recurrence

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When youve had cancer, you should have regular follow-up appointments with your oncology or cancer team.

If you experience worrisome symptoms or notice changes to your health, talk to your doctor as soon as possible.

Because some cancers can become resistant to chemotherapy, you may need to try different treatments. Your doctor will help you choose the best one depending on the type of cancer, when and where it recurs, how much it has spread, and your overall health.

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Where Can Breast Cancer Spread

The most common places for breast cancer to spread to are the lymph nodes, bone, liver, lungs and brain. The symptoms you may experience will depend on where in the body the cancer has spread to. You might not have all of the symptoms mentioned here.

Remember other conditions can cause these symptoms. They don’t necessarily mean that you have cancer that has spread. But if you have symptoms that you are worried about, discuss them with your GP, cancer specialist, or breast care nurse so that you can be checked.

What Are The Chances Of Breast Cancer Returning

Each persons risk of breast cancer recurrence is different and depends on many factors, such as the size, type, grade and features of the cancer and whether the lymph nodes were affected.

Your treatment team can tell you more about your individual risk of recurrence if you want to know this.

The risk of breast cancer recurring is higher in the first few years and reduces as time goes on.

However, recurrence can happen even many years after treatment, which is why its important to be breast and body aware, and report any changes to your treatment team or GP.

In the UK, the number of people surviving breast cancer has risen greatly over the past decade and most people diagnosed with primary breast cancer will not have a recurrence.

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Further Prayer And Meditation About Treatment Options:

Here are some specific treatment options that you can discuss with your doctor. Then meditate and pray for Gods specific guidance to discover whats right for you:

What is the purpose of a suggested treatment?

Should I get a second opinion?

Do I want to participate in a medical trial?

Who are the important people in my life who can help me make treatment decisions together as a team?

Is there someone who can walk with me, listen to me and help me gain perspective during this time?

Chaplains, ministers and counselors can be of great help during a cancer recurrence. Another source of help is Stephen Ministries. Churches of many denominations have Stephen Ministry groups where individuals have been trained in giving emotional and spiritual support to those going through a crisis period. This service is free of charge and you are paired with someone who will meet with you weekly to listen to you and pray with you.

Factors That Affect The Risk Of Breast Cancer Recurrence Following A Mastectomy

Cancer Returns for Breast Cancer Survivor Years Later

Your individual risk for breast cancer recurrence after receiving a mastectomy will depend on several factors, including the type of breast cancer you have and whether it is affected by hormones, the size and location of your tumor, how quickly the cancer cells grew and the stage of cancer at the time of treatment. In particular, if breast cancer has spread to nearby lymph nodes, such as those in the underarm area, the likelihood of recurrence may be higher.

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Cancer Recurrence Prayer When Cancer Comes Back

When cancer comes back or you have a cancer recurrence prayer can be an important part of your treatment plan. Prayer for guidance in cancer recurrence is vital because of the decisions about treatment options that need to be made. Prayer is also extremely important to maintain a positive, hopeful attitude when cancer comes back. Prayer also serves as a healthy emotional outlet and helps you know that you are not alone. Prayer helps you recall and meditate on how God gave you strength in the past. And finally, prayer is a safe place to talk honestly with God about the things that you worry about.

Complete Remission Vs Partial Remission

There are different kinds of remission:

Complete remission is when there are no more signs of cancer. If tests show your tumor is gone, or too small to see or measure, it means youre in complete remission.

Another term for complete remission is complete response.

Partial remission is when your treatment reduced the cancer but didnt make it go away completely. Doctors usually consider at least a 50% reduction in the size of a tumor to be partial remission.

Another term for partial remission is partial response.

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Who Is At Risk Of Breast Cancer Recurrence

Everyone who has received a breast cancer diagnosis is at risk of recurrence, however the risk differs markedly depending on a number of factors listed below. Some breast cancers, when diagnosed very early when small and without lymph node involvement, have an excellent prognosis and are very unlikely to recur. On the contrary, larger cancers, with lymph node involvement or with a more invasive behaviour, are unfortunately at a higher risk of recurrence.

Locally Advanced Breast Cancer Prognosis

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If breast cancer has come back and spread to the tissues and lymph nodes around the chest, neck and under the breastbone, there may be an increased risk of cancer cells spreading to other areas of the body.

This means the overall prognosis can be harder to predict.

Treatments such as chemotherapy, hormone and targeted therapies are given for locally advanced breast cancer because they work throughout the whole body.

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Tests To Diagnose Metastatic Breast Cancer

If you have any of the symptoms of metastatic breast cancer, your doctor may recommend one or more of the following tests:

  • blood tests
  • whole-body bone scan, with or without X-rays of specific bones
  • MRI of the spine or brain
  • CT scan of the chest, abdomen, pelvis, and/or brain
  • PET scan
  • X-ray or ultrasound of the abdomen or chest
  • bronchoscopy if you have a constant cough or trouble breathing
  • biopsy of any suspicious area
  • a “tap,” removal of fluid from the area with symptoms to check for cancer cells a pleural tap removes fluid between the lung and chest wall and a spinal tap removes fluid from around the spinal cord

You can read the following pages for information on symptoms of breast cancer metastasis and diagnosis:

Grade Of The Cancerous Cells

A sample of breast cancer tissue can be looked at under the microscope. By looking at certain features of the cells, the cancer can be graded.

  • Grade 1 – the cancer cells tend to be slow-growing and less aggressive.
  • Grade 2 – is a middle grade.
  • Grade 3 – the cancer cells tend to be fast-growing and more aggressive.

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How Does My Doctor Know If My Breast Cancer Has Spread

Dr. Anthony Elias answers: ‘How Does My Doc Know if the Cancer Has Spread?’

How Does My Doc Know if the Cancer Has Spread?

Question: How does the doctor know if my breast cancer has spread or metastasized?

Answer: Breast cancer, like most other cancers can spread to many parts of the body.

A tumor that has actually spread and set up shop in a different part of the body is called a metastasis. And usually we talk to the patient and listen to whether you have any symptoms, any special symptoms that relate to something going wrong elsewhere in the body — for example, pain, or lump or bump or headaches that are unusual.

It’s very important to tell the doctor if you have any unusual symptoms, things that have come up that you’re not used to. We’re all entitled to our usual aches and pains, but if there’s something that’s persistent or nagging or interfering with you life that’s something you need to let the doctor know.

We then use various scans to document that there are tumor cells elsewhere. For example, things like chest x-rays, bone scans, CAT scans and other specialized scans. Sometimes blood tests help us with this as well.

It’s also important to know that even when the tumor hasn’t obviously spread, that we give things like chemotherapy or hormone therapy to try to reduce the risk of relapse because we know that some of the time there can be microscopic tumor cells that we can’t see.


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