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Signs Of Breast Cancer Recurrence

How Does Recurrence Affect Treatment

Breast cancer recurrence signs, symptoms, and treatment with Dr Tasha

Itâs usually better if a recurrence remains in the breast . But the seriousness depends in part on how long it has been since the original cancer. If itâs been 7 years, your medical team may approach the new growth just as they would a new presentation of breast cancer. The new cancer cells may be the same as before or they could be a new type. Either way, if itâs been a while since the first cancer, your medical team will often treat it largely the same as it treated the first one. This often starts with surgical removal of the tumor.

If you have surgery, your doctor will likely want to follow up with some type of other therapy. Though radiation therapy often follows surgery, you may not be able to get it if the breast got radiation treatment after a prior surgery for breast cancer.

But there are other options that your doctor will likely consider:

  • Hormone therapy

If the time since your last cancer is much shorter, say 6 months, your team may assume the tumor could soon spread . This may change their approach to include more chemotherapy or other pharmaceutical approaches.

But you may not be ready for aggressive chemo if youâve recently been through a round. So your medical team will have to work around that.

And the type of chemo matters, too. For example, if, in a previous round of chemo, you had doxorubicin or another cancer drug known to weaken the heart, it may not be possible to get it again.

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What Factors Contribute To The Risk Of Breast Cancer Recurrence

Whilst it is never completely certain that breast cancer has been cured, there are many treatments available that reduce the risk of recurrence. There are a number of risk factors that can contribute to a breast cancer recurrence.

Your age at first diagnosis Younger women, particularly those who had their first diagnosis under the age of 35, have a greater risk of recurrence. This is because those diagnosed at a young age are more likely to have aggressive features in their breast cancer. Additionally women diagnosed with breast cancer before menopause have a greater risk of recurrence.

Tumour size Women who have a larger breast tumour have a greater risk of recurrence.

Lifestyle factors Lifestyle factors can influence the risk of recurrence. Excess weight is associated with a higher risk of postmenopausal breast cancer and is also associated with a higher risk of breast cancer recurrence and death. Smoking has also been shown to increase the risk of recurrence. Women who exercise regularly appear to have a lower rate of breast cancer recurrence.

Lymph node involvement If cancer is found in lymph nodes at the time of the original breast cancer diagnosis, there is an increased risk of breast cancer recurrence. This is the strongest prognostic factor, and the more nodes involved, the higher the risk of recurrence.

How Is Recurrent Breast Cancer Diagnosed

Many women who have had breast cancer in the past pay close attention to their bodies and are very aware of even the smallest changes. But many physical changes or health problems have nothing to do with the cancer they had before. Signs of breast cancer recurrence may include a lump in the breast, scar tissue or the chest area, as well as inflamed skin. Some women will notice these changes themselves, or a doctor might find them during an examination, for example during a check-up.

If you suspect that your breast cancer has come back, your doctor is the first person to go to. You might be referred to a hospital, tumor center or certified breast center for additional tests. If you are no longer at the same practice or center where you were treated for breast cancer the first time, it is important to bring along as much information as possible about your previous treatment. You can also consent to doctors sharing the relevant information about you with each other.

After a detailed talk about your medical history, you will have a physical examination, mostly to inspect the breast or the surgical scar. If breast cancer has come back, your doctor will also check whether the tumor has spread to the other breast or any other parts of your body. Any abnormalities in the body will be examined more closely. The breast cancer will then be classified using certain criteria, in the same way that it was when you first had this disease.

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Early Warning Signs Of Breast Cancer

Common symptoms of breast cancer include:

  • A lump in your breast or underarm that doesnât go away. This is often the first symptom of breast cancer. Your doctor can usually see a lump on a mammogram long before you can see or feel it.
  • Swelling in your armpit or near your collarbone. This could mean breast cancer has spread to lymph nodes in that area. Swelling may start before you feel a lump, so let your doctor know if you notice it.
  • Pain and tenderness, although lumps donât usually hurt. Some may cause a prickly feeling.
  • A flat or indented area on your breast. This could happen because of a tumor that you canât see or feel.
  • Breast changes such as a difference in the size, contour, texture, or temperature of your breast.
  • Changes in your nipple, like one that:
  • Unusual nipple discharge. It could be clear, bloody, or another color.
  • A marble-like area under your skin that feels different from any other part of either breast.
  • How Can You Cope With Negative Feelings

    What Are Signs Of Metastatic Breast Cancer / 2 / Staging of metastatic ...

    New fears and disappointment about this setback to your health, anger about the unfairness of your situation or being envious of healthy people are all perfectly natural reactions and are nothing to feel bad about. In the long run, however, it might be better for your general wellbeing to learn how to deal with negative feelings and thoughts so that you still have space for other things as well.

    Many women say that it comes as a relief to accept feelings of anxiety, worries and despair and to talk about them with people close to them. As well as talking to your partner, family and friends, professional counseling might also help. Religious organizations and hospitals also offer pastoral or spiritual support. Sharing your experiences with other women in a self-help group is another option.

    It can sometimes help to put anxieties and worries aside for a while. Concentrating on pleasant things or activities can help reduce fears and tension to a manageable level.

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    What Is The Outlook For Someone With A Breast Cancer Recurrence

    Overall survival rates for breast cancer are generally based on the stage of the cancer at initial diagnosis.

    Treatment for local and regional recurrence is often successful. However, theres still a risk of developing distant metastases. Because there are so many variables, its difficult to provide an overall prognosis. Your oncologist can provide a clearer understanding of what to expect for your exact situation.

    Metastatic breast cancer can be treated and go into remission, but its not considered curable.

    If All The Cancer Was Removed With Surgery Why Do I Need Any Additional Treatment

    It has long been recognized that breast cancer is not always cured by locoregional treatment alone.

    The goal of treating early breast cancer is to remove the cancer and keep it from coming back . Most people diagnosed with breast cancer will never have a breast cancer recurrence. However, everyone who has had breast cancer is at potential risk of recurrence, and that is why in most cases, there is a recommendation for treatment in addition to surgery, which is known as adjuvant therapy. The risk of recurrence can never be entirely eliminated, but the aim of adjuvant therapy is to reduce recurrence risk to the absolute minimum.

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    When To See A Doctor

    After your breast cancer treatment ends, your doctor will likely create a schedule of follow-up exams for you. During follow-up exams, your doctor checks for any symptoms or signs of cancer recurrence.

    You can also report any new signs or symptoms to your doctor. Make an appointment with your doctor if you notice any persistent signs and symptoms that worry you.

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    Breast cancer in the liver can cause these general symptoms:

    • extreme tiredness

    When breast cancer spreads to the liver, after some time it can have specific symptoms such as

    • swelling of your abdomen
    • jaundice, a condition that causes the skin or the white part of the eyes to turn yellow
    • discomfort or pain in the abdomen, especially along the right side

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    How Do You Know Cancer Has Returned

    Tests such as imaging scans, lab tests, and biopsies can help your doctor figure out if your cancer has recurred. A recurrence isnt the same thing as a second cancer. Thats a new cancer that develops in another type of cell. Special tests can show your doctor if your disease is recurrent or a new kind.

    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 Does The Brca1 Or Brca2 Gene Mutation Affect My Risk Of Breast Cancer Recurrence

    Women with a BRCA1 or BRCA2 gene mutation and who have already been diagnosed with breast cancer, have a higher-than-average chance of new primary breast cancers than those without this genetic mutation. The chance of local or distant recurrence depends on the type and stage of the original breast cancer, and is no different from a non-BRCA-mutated breast cancer.

    For women with a BRCA1 or BRCA2 gene mutation, the chance of a contralateral breast cancer, or cancer in the opposite breast to the original cancer, 10 years after diagnosis of the first cancer is about 10-30 percent compared to about 5-10 percent for women diagnosed with breast cancer who do not have a BRCA1 or BRCA2 gene mutation.

    Women who have a BRCA1 or BRCA2 gene mutation and have received a breast cancer diagnosis, should talk to their treatment team about their options to reduce the risk of breast cancer recurrence.

    Surveillance And Monitoring For Signs And Symptoms Of Recurrence

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    One goal of follow-up care is to check for a recurrence, which means that the cancer has come back. Treatment for early-stage or locally advanced breast cancer is given to get rid of as many cancer cells in the body as possible. However, cancer recurs because small areas of cancer cells that don’t respond to treatment may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms.

    Many survivors feel worried or anxious that the cancer will come back after treatment. While it often does not, its important to talk with your doctor about the possibility of the cancer returning. Most breast cancer recurrences are found by patients between doctor visits. The American Society of Clinical Oncology does not recommend routine screening for cancer at distant sites.

    During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return and will help you make decisions about your treatment. Learn more about coping with the fear of recurrence.

    Your doctor will ask specific questions about your health at your follow-up care appointments. Regular follow-up care recommendations depend on several factors, including the type and stage of cancer first diagnosed and the types of treatment given.

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    Types And Symptoms Of Recurrence

    A breast cancer recurrence happens when breast cancer returns months or years after youve finished treatment and are in remission. Breast cancer that is found in the untreated, opposite breast is not a recurrence but a new cancer. When breast cancer recurs, it can be local, regional, or distant and the signs and symptoms of a breast cancer recurrence varies, depending on where it comes back.

    Local A local breast cancer recurrence happens when the cancer comes back in the same breast or chest area as the initial tumor. If you had a lumpectomy, a recurrence can happen in the left-over breast tissue. If you had a mastectomy, there is no left-over breast tissue, but a recurrence can occur in the tissue lining the chest wall or skin.

    Signs and symptoms of a local breast cancer recurrence may look like:

    • Breast lump or bumps on or under the chest
    • Unusually firm breast tissue
    • Swelling on your chest, in your armpit, or around your collarbone
    • A change in the shape or size of the breast or chest area
    • Nipple changes, such as flattening or nipple discharge
    • An inverted nipple or a nipple that looks different
    • Redness or a rash on or around the nipple or on the skin
    • Swollen, thickening skin or skin that pulls near or on the lumpectomy scar
    • A change in skin texture, such as puckering or dimpling
    • Swelling in the arm or hand
    • One or more painless nodules on or under the skin of your chest wall

    Signs and symptoms of a regional breast cancer recurrence may look like:

    Treating A Metastatic Recurrence

    Many treatments exist for metastatic breast cancer. Your options will depend on where your cancer has spread. If one treatment doesnt work or stops working, you may be able to try other treatments.

    In general, the goal of treatment for metastatic breast cancer isnt to cure the disease. Treatment may allow you to live longer and can help relieve symptoms the cancer is causing. Your doctor works to achieve a balance between controlling your symptoms while minimizing toxic effects from treatment. The aim is to help you live as well as possible for as long as possible.

    Treatments may include:

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    Address Any Sleep Problems You Have

    According to a 2017 study, cisgender women who experience regular sleep difficulties, as well as those who have a prolonged sleep duration have a greater all-cause as well as breast cancer mortality rate.

    There are a number of different types of sleep disorders, and these, in turn, are often addressed in different ways. For starters, practicing good sleep hygiene habits can sometimes resolve minor sleep problems.

    If problems persist, however, talking to a sleep expert may be in order. We often think of sleep as inconsequential , but given the link between sleep disturbances and survival it might be considered as important as some of the treatments we use to battle the disease.

    What Is The Likelihood Of Breast Cancer Returning

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    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.

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    Treatments For Local Recurrences

    Local breast cancer recurrence is when cancer comes back in the same area that the first tumor was found.

    Suppose you had a lumpectomy, surgery to remove the cancer and abnormal tissue, and radiation during your first experience with breast cancer. In that case, you cannot be treated with radiation again. The standard treatment, in this case, would be a mastectomy.

    Suppose you didnt have radiation along with the original lumpectomy. In that case, your medical practitioner may recommend another lumpectomy followed by radiation treatment.

    Depending on your oncologists evaluation, they may also recommend chemotherapy, hormonal therapy , or both.

    Research has shown that the characteristics of breast cancer may be different if it comes back. For example, the hormone-receptor status may change, or your HER2 status might be different. Your oncologist may want to biopsy the area to check for changes in these two important indicators.


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