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How Often Does Breast Cancer Come Back

Locally Advanced Breast Cancer

Breast Cancer Recurrence On Mastectomy Site

If breast cancer has spread to the chest wall or skin of the breast, or the lymph nodes around the chest, neck and under the breast bone, but has not spread to other areas of the body, its called locally advanced breast cancer. Sometimes breast cancer is locally advanced when it is first diagnosed.

People who have locally advanced breast cancer are thought to have an increased risk of cancer cells spreading to other areas of the body, compared to those with stage 1 or 2 breast cancers.

What Are The Signs Of Breast Cancer Recurrence

If you have a local recurrence or new primary breast cancer, you may find symptoms similar to an initial breast cancer. This includes:

  • A new lump in the breast, armpit area or around the collarbone
  • A change in breast size or shape
  • Changes to the nipple, such as sores or crusting, an ulcer or inverted nipple
  • Clear or bloody nipple discharge
  • Changes to the skin including redness, puckering or dimpling
  • Breast tenderness or pain

If your breast cancer has spread to other parts to the body, known as distant recurrence, there are a number of possible symptoms, including:

  • Fatigue
  • Unexpected weight loss or change in appetite
  • Severe or ongoing headaches
  • Nausea

However, symptoms will vary depending on where the secondary cancer presents, and some primary and secondary cancers may not present any obvious symptoms. Sometimes recurrence is identified on a scan or blood test that was done for a reason other than breast cancer.

If you have any health concerns or symptoms that are new or persistent, speak with you GP or treating physician.

What Can You Do For Your General Wellbeing

It’s important for women with breast cancer to take good care of themselves. Here are some ways to actively enhance your treatment and to do something good for yourself:

  • Get regular exercise, if possible
  • Eat things that agree with you and that you enjoy
  • Find the right balance of activity and relaxation
  • Get as much restful sleep as you can
  • Generally do things you enjoy

A personalized exercise program is another way to reduce exhaustion and improve sleep, lightening your mood and seeing your body in a more positive way again. You can also take part in special sports activities offered as part of follow-up care after cancer treatment. It’s important to enjoy exercise, feel good while you’re doing it, and avoid overdoing it.

Many people think that certain diets can prevent cancer or speed up recovery. But reliable research on how nutrition influences breast cancer hasn’t yet found any direct effects on the risk of getting it or on how it progresses.

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Coping With Worries About Recurrence

Nearly everyone who has been treated for cancer worries about it coming back.

At first, every ache or pain can frighten you. But, as time passes, you may come to accept minor symptoms for what they are in most cases warning signs of a cold or flu or the result of over-exerting yourself.

Some events may be particularly stressful the days or weeks leading up to your check-ups, the discovery that a friend or relative has been diagnosed with cancer or the news that someone you met while having treatment is ill again or has died.

We all cope with such anxieties in our own way and there are no easy answers. But keeping quiet about them and not wanting to bother anyone is probably not the best approach.

Just as talking about your diagnosis and treatment may have helped you through the early days, talking about your fears relating to recurrence may help you later on.

Breast Cancer Nows Forum lets you share your worries with other people in a similar situation to you.

You can also read our tips on coping with anxiety and find suggestions in BECCA, our free app that helps you move forward after breast cancer.

Check On Whether You Need Medications

Breast cancer drug increases survival

After you complete your cancer treatment, if you have a high chance of your cancer returning, your doctor may prescribe you certain drugs to reduce your risk.

Tamoxifen and raloxifene are two such drugs. These drugs are approved for use in the U.S. and doctors usually prescribe them to lower the chances of estrogen-related breast cancer. Both drugs block estrogen hormone in breast cells. Studies show that they reduce your chances of getting breast cancer again by about 40%.

Tamoxifen. You take this once a day by mouth as a pill or liquid. It may make it less likely for you to get cancer in parts of your breast that werenât affected earlier. You may have side effects like hot flashes, vaginal discharge, irregular periods, loss of sexual interest, memory loss, fatigue, and joint pain.

Raloxifene. Itâs a pill you take once a day. Itâs usually given to women who are post-menopausal — those who stopped having their periods. It may also help you avoid or treat osteoporosis, when your bone density thins, putting you at risk of fractures.

While rare, these drugs can also cause blood clots in your leg veins or lungs. This can be a serious side effect that may need immediate medical attention. Contact your doctor as soon as possible if you think you have a blood clot.

Side effects can include vaginal discharge, muscle and joint pain, hot flashes, and night sweats. These drugs may also speed up osteoporosis and may raise your cholesterol.

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How Can I Prevent Breast Cancer Recurrence

Healthcare providers dont know why some people experience breast cancer recurrence. A recurrence isnt your fault. You didnt do anything wrong to cause it or fail to do something more to prevent it.

Certain medications may reduce the risk of breast cancer recurrence in people who have early stage breast cancer. For estrogen-receptive breast cancer, hormonal therapies including tamoxifen or aromatase inhibitors block either the activity of estrogen or the bodys production of estrogen. Chemotherapy may also be recommended to reduce risk of breast cancer recurrence.

Early diagnosis may make it easier to treat a recurrence. Follow your healthcare providers recommendations for mammograms and other screenings. You should also perform regular breast self-exams. Get familiar with how your breasts look and feel so you can see your provider quickly if you notice changes. And remember that most breast changes occur for reasons other than cancer.

What Are The Symptoms Of Breast Cancer Recurrence

You may experience different signs of breast cancer recurrence depending on where the cancer forms.

Local breast cancer recurrence may cause:

  • Breast lump or bumps on or under the chest.
  • Nipple changes, such as flattening or nipple discharge.
  • Swollen skin or skin that pulls near the lumpectomy site.
  • Thickening on or near the surgical scar.
  • Unusually firm breast tissue.
  • Biopsy of the site of suspected recurrence.

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Locally Advanced Breast Cancer Prognosis

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.

What Are Metastatic And Recurrent Breast Cancer

When should you get a mammogram to screen for breast cancer?

Breast cancer occurs when abnormal cells grow out of control in one or both breasts.

  • Metastatic breast cancer means that cancer has spread to other parts of the body.
  • Recurrent breast cancer means that cancer has come back in or near the original site or in another part of the body.

For most women who have had breast cancer, their greatest fear is that the cancer will come back or spread. Finding out that this has happened can turn your world upside down. But there is hope. Some recurrent breast cancers can be successfully treated. Other recurrent breast cancers and metastatic breast cancer usually cant be cured. But with treatment, some women live for many years.

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How Common Is Breast Cancer Recurrence

Most local recurrences of breast cancer occur within five years of a lumpectomy. You can lower your risk by getting radiation therapy afterward. You have a 3% to 15% chance of breast cancer recurrence within 10 years with this combined treatment. Based on genetic testing, your provider may recommend additional treatments to further reduce your risk.

Recurrence rates for people who have mastectomies vary:

  • There is a 6% chance of cancer returning within five years if the healthcare providers didnt find cancer in axillary lymph nodes during the original surgery.
  • There is a one in four chance of cancer recurrence if axillary lymph nodes are cancerous. This risk drops to 6% if you get radiation therapy after the mastectomy.

Why Do Recurrences Happen And What Can Trigger Them

Sometimes cancer cells can survive treatment. These cells may eventually reproduce enough to form a new tumor. If they manage to reach the blood stream or lymph system, they can spread to distant organs and tissues.

There are so many factors involved that its not possible to pinpoint exactly why an individual has a recurrence. We do know that the majority of recurrences happen within the first 5 years. The risk never completely goes away, but it does steadily decline over time.

The main factors that can influence your chance of recurrence are:

  • tumor size

Its likely that youll need a combination of therapies to treat a breast cancer recurrence. Treatment depends on many factors such as:

  • breast cancer type

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About Breast Cancer Recurrence

During surgery to remove early-stage breast cancer, surgeons remove all the cancer they can see. In some cases, there may be individual cells circulating in the bloodstream or hiding in the bones or other places in the body. These cells may be inactive and not growing, or what doctors call dormant. But at some point in the future, the cells may start growing and cause a recurrence.

Doctors prescribe treatments after surgery such as hormonal therapy, chemotherapy, and targeted therapies to destroy any cancer cells left behind and reduce the risk of recurrence.

The risk of recurrence is unique to each person diagnosed with early-stage breast cancer and depends on a number of factors, including:

  • cancer stage
  • number of positive lymph nodes
  • hormone receptor status
  • HER2 status
  • age at diagnosis

Doctors work very hard to estimate the risk of recurrence for each person. They use that estimate to tailor a treatment plan you can start after surgery to keep the risk of recurrence as low as it can be.

What Types Of Breast Cancer Have The Highest Recurrence Rates

What Did Your Breast Cancer Pain Feel Like

A study published in the Journal of Clinical Oncology found the risk of recurrence for all breast cancers was highest in the first five years from the initial cancer diagnosis at 10.4%. This was highest between the first and second years after the initial diagnosis. During the first five years after the initial diagnosis, patients with oestrogen receptor positive breast cancer had lower rates of recurrence compared with those with ER negative disease. However, beyond five years, patients with ER positive disease had higher rates of recurrence.

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What Is The Likelihood Of Breast Cancer Returning

The risk of breast cancer returning after successful initial treatment will depend on things like

  • how many lymph nodes contained tumors the first time cancer was diagnosed,
  • how large the tumor was,
  • how quickly the cancer cells grew,
  • whether the cancer cell growth was influenced by hormones,
  • the womans age at the time the cancer was first diagnosed, and
  • whether cancer cells have spread through the lymph vessels in the skin .

About 5 to 10 out of 100 breast cancer patients will have local or locoregional recurrence after breast-conserving surgery and radiotherapy within ten years of first being diagnosed with breast cancer. If the breast was removed in the course of initial treatment, about 5 out of 100 women will have a local recurrence in the armpit or the chest wall within ten years.

Some women wonder whether their lifestyle may have been a contributing factor to the tumor coming back. But these worries are unfounded: Breast cancer recurrence has nothing to do with lifestyle choices, character traits or emotional stress.

How Is A Local Recurrence Or Metastasis Found

Breast cancer can recur at the original site . It can also return and spread to other parts of the body .

Local recurrence is usually found on a mammogram, during a physical exam by a health care provider or when you notice a change in or around the breast or underarm.

Metastasis is usually found when symptoms are reported to a provider.

If you have a local recurrence or metastasis, its not your fault. You did nothing to cause it.

Learn about follow-up care after breast cancer treatment.

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Limit Or Avoid Alcohol

Studies show that there is a link between moderate and heavy alcohol use and breast cancer. Alcohol is known to raise estrogen levels in your blood. This makes it more likely for you to get cancer again. If youâre a cancer survivor, itâs best to avoid alcohol altogether.

If you do choose to drink, make sure to limit it to only one drink a day to lower your chances of your cancer coming back.

What Else Can I Do

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When someone has a local or locoregional recurrence, their fear of the disease getting worse is often even greater than the first time they were diagnosed. But just as the disease and its treatment constantly pose new challenges, the way you deal with cancer may also keep changing. There is no one-size-fits-all solution. Everyone copes differently with a disease like this and needs to find their own way to deal with it.

Many women say they felt very down at first, but then gradually started to take stock of what was going on and began to see things differently often feeling more mature and more aware than before. They try to live in the moment, enjoying and making the most of every single day. Some women make big changes in their lives and pursue new interests. Others take comfort in continuing to live their lives as normally as possible and trying to make the best of each day.

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How Does Distant Recurrence Occur

Many patients find it hard to understand how they can be apparently cancer free one day and be diagnosed with recurrent cancer the next. If surgery got all of the cancer out and chemotherapy and radiation were supposed to have mopped up the rest, how can recurrence even happen?

In most cases, even the smallest breast cancer detected has been growing for some time before it was caught. During this period of growth, the cancer cells multiplied and divided over and over again, and some cancer cells may splinter off from the main tumour and escaped into the surrounding blood and lymphatic vessels. Cells that spread to lymph nodes can certainly be trapped in those lymph nodes and removed at the time of surgery, but cells can also go into the circulatory system. Even early-stage cancers that originally had no lymph node involvement can recur and develop metastatic disease.

While its less common, cancer cells can bypass lymphatics and lymph nodes and travel via surrounding blood vessels. Cancer cells can continue to circulate and go anywhere the blood vessels will take them, or they can home in on other organs in the body, where they take up residence and continue to grow and divide in that one particular spot.

If and when cancer comes back, the cancer cells that escaped the breast are to blame. Obviously if your recurrence is ten years after your diagnosis, we assume that the cells have been dormant all that time and missed the treatments aimed at dividing cells.

Where Can You Get Support

Coping with a diagnosis of local or locoregional recurrence, and working through the existential fears and worries that it may trigger, is anything but easy. Starting cancer treatment again can also take a heavy physical and emotional toll. Nowadays, good-quality treatment will also include the option of psycho-oncological counseling. Psycho-oncologists have special training in psychology, medicine and/or social work and are there to support patients and their family and friends in dealing with the illness.

In hospitals, psycho-oncological support is mainly provided by doctors and nurses. They may work together with psycho-oncological services. Psycho-oncological support is also offered as part of rehabilitation. Outpatient psycho-oncological help is available as well.

Various forms of psychotherapy may also be offered to help you if you are experiencing longer-term fears or other negative feelings. You can have therapy or counseling either individually, together with your partner, or in a group with others affected by breast cancer.

In Germany, you are entitled to a variety of services and financial support, including sickness benefit and help with nursing care, as well as home help and childcare. There are a number of places you can go to for advice and help if you want to apply for support. Experts can assist you with personal decisions as well as with financial and legal matters. Individual advice either over the telephone or in person is available from

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