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.
From Cured To Stage 4
Others, like Teri Pollastro, a 54-year-old stage 4 patient from Seattle, respond surprisingly well.
Diagnosed with early stage ductal carcinoma in situ in 1999, Pollastro underwent a mastectomy but did not receive chemotherapy, radiation or tamoxifen, since her cancer was ER negative.
âThey used the C-word with me, they told me I was cured,â she said. âEvery time I went back to my oncologist, he would roll his eyes at me when I had questions.â
In 2003, Pollastro switched to Seattle Cancer Care Alliance where she saw Dr. Julie Gralow, a breast cancer oncologist and clinical researcher at Fred Hutchinson Cancer Research Center. Gralow discovered Pollastroâs cancer had metastasized to her liver.
âMy husband and I were in shock,â said Pollastro of her mets diagnosis. âYou donât go from being cured to stage 4.â
Pollastro went on Herceptin, a type of immunotherapy for women with HER2-positive metastatic breast cancer, and did six months of chemotherapy.
âI felt better right away with the treatment,â she said. âBut the problem is, it stopped . Thatâs what you can expect with mets. And thereâs always some residual cancer. And that starts percolating.â
And along with mets, she also had to deal with many misconceptions regarding her disease.
The Mercer Island, Washington, mother of two, who often counsels newly diagnosed patients, sometimes even found it difficult to relate to early stage breast cancer survivors.
Lung Cancer In Men And Women
Men are more likely to be diagnosed with lung cancer than women, by a small margin.
The ACS estimates that 119,100 men and 116,660 women will be diagnosed with lung cancer in the United States during 2021.
This trend holds up for lung cancer-related deaths, too. Its projected that 131,880 people in the United States will die from lung cancer during 2021.
Of that number, the ACS projects a breakdown of 69,410 men and 62,470 women.
To put that into perspective, the chance a man will develop lung cancer in his lifetime is 1 in 15. For women, that chance is 1 in 17.
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What Is Stage 4 Cancer
- It can also be called metastatic or advanced cancer.
- Survival rates vary due to a variety of factors, including the type of cancer.
- Diagnosing a cancer stage helps your medical team determine treatment options.
If youve been diagnosed with stage 4 cancer, or love someone who has, youll naturally have a lot of questions ;and we want to help answer them in this expert-backed primer.
Lets start with the most basic among common questions: What does stage 4 cancer mean?
Also referred to as metastatic or advanced, it refers to cancer that has spread to other organs or parts of the body. The reason doctors diagnose cancer by its stages is to have a common language for discussion as well as to make a determination for the best and most appropriate treatment.
Stage 4 cancer is a serious diagnosis. But especially now in the age of immunotherapies and other new therapies, some stage 4 cancers, can have really profound, durable responses to treatment,;Dr. Irene Kang, who specializes in medical oncology at USC Norris Cancer Hospital, told SurvivorNet.
Lets take a closer look at some specifics.
How Is Breast Cancer Recurrence Managed Or Treated
Your treatment depends on the type of cancer recurrence, as well as past treatments. If cancer develops in a reconstructed breast, your surgeon may want to remove the breast implant or skin flap.
Treatments for local and regional breast cancer recurrence may include:
- Mastectomy: Your surgeon removes the affected breast and sometimes lymph nodes.
- Chemotherapy:Chemotherapy circulates in blood, killing cancer cells.
- Hormone therapy:Tamoxifen and other hormone therapies treat cancers that thrive on estrogen .
- Immunotherapy:Immunotherapy engages your bodys immune system to fight cancer.
- Radiation therapy: High-energy X-ray beams damage and destroy cancer cells.
- Targeted therapy: Treatments target specific cancer cell genes or proteins.
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Coping With Advanced Breast Cancer
Being told that you have advanced or metastatic breast cancer may be very confronting or overwhelming. Some women also find the news that their cancer has spread or come back is more devastating than their original diagnosis.
There are many resources available online to help you further understand the meaning of your diagnosis and how to manage the emotional, physical and practical issues arising from metastatic breast cancer. Below are some links where these resources can be accessed:
Connecting and speaking with others who have gone through a similar experience can also be helpful. Cancer Council runs support groups all across Australia which can provide support and information for people with cancer and their families. Groups in each state can be accessed here:
Although support groups can provide a safe place for people to express their feelings amongst others who share a similar experience, some people are more comfortable talking one-on-one, such as with a counsellor, therapist or trained volunteer . Your GP can also refer you to a psychologist, social worker or other trained therapist. Every person is different and it is important to find a healthy support system that works for you.
Invasive Lobular Carcinoma Stages
When diagnosing breast cancer, staging becomes an important thing. When we talk of staging, it is process used to find out how much the cancer has advanced or spread and where its located.; The details on staging also help plan for the cancer treatment and come up with a prognosis.
Staging provides a way of ensuring that a cancer patient gets the best possible treatment. In a majority of cancers, staging is based on these three main factors:2
- The size of the tumor as well as its growth into the areas around it
- The spread of the cancer to lymph nodes close to it
- The spread of the cancer to other areas of the body distance areas from its original location
When the TNM are established, the stage can be assigned to the cancer. That said, here are the different stages of invasive lobular carcinoma:
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Where Do These Numbers Come From
The American Cancer Society relies on information from the SEER* database, maintained by the National Cancer Institute , to provide survival statistics for different types of cancer.
The SEER database tracks 5-year relative survival rates for breast cancer in the United States, based on how far the cancer has spread. The SEER database, however, does not group cancers by AJCC TNM stages; . Instead, it groups cancers into localized, regional, and distant stages:
- Localized: There is no sign that the cancer has spread outside of the breast.
- Regional: The cancer has spread outside the breast to nearby structures or lymph nodes.
- Distant: The cancer has spread to distant parts of the body such as the lungs, liver or bones.
Policy Context And Use
The policy area which is most likely to be influenced by these results is early diagnosis. The National Awareness and Early Diagnosis Initiative 16 aims to improve cancer survival by getting cancers diagnosed earlier. The data from this bulletin can help show the improvement in survival which could be made if more cancers were diagnosed earlier. It also shows the pattern of survival and stage, which may help show where most improvement can be made, for example when the survival from a certain cancer is much worse at stage 4.
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A Disease No One Gets
Sadly, people donât âgetâ mets. In fact, a recent survey sponsored by Pfizer Oncology shows just how misunderstood it is. Sixty percent of the 2,000 people surveyed knew little to nothing about MBC while 72 percent believed advanced breast cancer was curable as long as it was diagnosed early. Even more disheartening, a full 50 percent thought breast cancer progressed because patients either didnât take the right treatment or the right preventive measures.
âTheyâve built an industry built on four words â early detection equals cure â and that doesnât even begin to define breast cancer,â said Schoger, who helped found Breast Cancer Social Media, a virtual community for breast cancer patients, caregivers, surgeons, oncologists and others. âWomen are blamed for the fate of bad biology.â
The MBC Alliance, a consortium of 29 cancer organizations including the biggest names in breast cancer , addressed this lack of understanding and support as well as what many patient advocates term the underfunding of MBC research in a recently published landmark report.
When Can Metastatic Breast Cancer Occur
Most often, metastatic breast cancer arises months or years after a person has completed treatment for early or locally advanced breast cancer. This is sometimes called a distant recurrence.
Some people have metastatic breast cancer when they are first diagnosed . This is called de novo metastatic breast cancer.
Komen Perspectives
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More Women Are Living With Metastatic Breast Cancer And Living Longer
According to research from the National Cancer Institute , the number of women living with metastatic breast cancer in the United States is increasing; at the same time, women with metastatic disease are living longer, especially younger women.
The research was published online on May 18, 2017 by the journal Cancer Epidemiology, Biomarkers & Prevention. Read the abstract of Estimation of the Number of Women Living with Metastatic Breast Cancer in the United States.
Metastatic breast cancer is breast cancer that has spread to parts of the body away from the breast, such as the bones or liver. Metastatic breast cancer is stage IV cancer. A woman can be diagnosed with metastatic disease when first diagnosed. Breast cancer also can come back in a part of the body away from the breast. This is called metastatic recurrence.
“Even though this group of patients with metastatic breast cancer is increasing in size, our findings are favorable,” said Angela Mariotto, Ph.D., chief of the Data Analytics Branch of the Division of Cancer Control and Populations Sciences at the NCI. “This is because, over time, these women are living longer with metastatic breast cancer. Longer survival with metastatic breast cancer means increased needs for services and research. Our study helps to document this need.”
The study compared 5-year survival rates from 1992 to 1994 and from 2005 to 2012:
Survival Rates Of Stage 4 Breast Cancer
Unfortunately, cancer cells often become more difficult to treat and may develop drug resistance once they spread. According to the Australian Institute of Health and Welfare , the 5-year survival rate for women whose breast cancer is metastatic at first diagnosis is 32%, compared to the 91% on average for all breast cancer patients.
Factors affecting survival rate of metastatic breast cancer
Survival rates can provide an estimate of what percentage of patients with the same stage of breast cancer are still alive after a certain period of time . However, they cannot predict how long any specific individual with breast cancer will live. The length of survival time for people with metastatic breast cancer can vary significantly from person to person, but there are a number of factors which can influence this including:
- Response to treatment
- The extent and location of metastases
- The presence of other health issues not related to cancer
- The specific subtype of breast cancer . This is very important, as some types of cancer can be more aggressive than others and respond differently to treatment.
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Things You Need To Know
The main purpose of this statistical release is to show how cancer survival varies at different stages for a variety of cancers. Because of improvements in cancer registration and the completeness of stage data during this 3-year period, we do not recommend looking at the data in this briefing as representing the trends in survival over the 3 years examined . Such analyses will be undertaken in the future, when enough comparable data are available. This will bring the stage-specific survival statistics in line with other series that currently publish in 5 year aggregations, such as the National Statistics on Cancer Survival. The main focus of this release is on how survival differs by stage of diagnosis.
Data are presented for the whole of England.
Figure : Oneyear Net Cancer Survival For Men Diagnosed With Lung Cancer By Stage At Diagnosis
England, 2012 to 2014, followed up to 2015
Notes:
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Relative Survival Rate By Stage
The survival rates by stage are based on the stage at the time of diagnosis. Youve probably been given a number and letter for your cancer stage. Here, the terms localized, regional, and distant are used instead of numbers and letters. Heres what they mean and the 5-year relative survival rates for each:
- Localized breast cancer is only in the breast. This includes stage IA , some IIA , and some IIB . The 5-year relative survival rate is 99%.
- Regional breast cancer has spread to nearby tissue or lymph nodes. This includes stage IB , some IIA , some IIB , and all stage III . The 5-year relative survival rate is 86%.
- Distant breast cancer has spread to other parts of the body. This includes stage IV, pronounced stage 4). The 5-year relative survival rate is 28%.
Breast Cancer In The Spine Understanding Metastatic Breast Cancer
If you are a music fan or hear the news, by this time you must have come across this very disheartening news that Olivia Newton Johns breast cancer has returned in her spine which is why her concerts are being canceled. Ms. Newton John has been an advocate in the breast cancer community and she established the ONJCC in Australia where active research to combat breast cancer is happening . As a woman dealing with metastatic breast cancer for the last year, I wish she hadnt joined this club and I am truly saddened for her. She was first diagnosed with Breast Cancer in 1992 and now 25 years later, she has been found to have breast cancer in her spine. I can imagine how devastating it must be for her and her family as I too live with metastatic breast cancer. I wish her great success in her upcoming treatment and sincerely pray that she will go in remission.
So what is happening when breast cancer is diagnosed in the spine? Is it now bone cancer? The answer is no. There is generally a lack of awareness about breast cancer that has spread to other organs called Metastatic Breast Cancer or MBC . A lot of people unfortunately dont understand the reality of metastatic breast cancer which is the fact that incurable stage 4 of breast cancer . More importantly, although stage 4 breast cancer is incurable, it is treatable and many sub-types of breast cancer respond to treatment for a number of years.
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What Questions Should I Ask My Healthcare Provider
You may want to ask your provider:
- What type of breast cancer recurrence do I have?
- Has the cancer spread outside the breast?
- What stage is the breast cancer?
- What is the best treatment for this type of breast cancer?
- What are the treatment risks and side effects?
- Should I look out for signs of complications?
A note from Cleveland Clinic
Most breast cancer recurrences respond well to treatments. You may be able to try new drugs or combination therapies in development in clinical trials. Your healthcare provider can discuss the best treatment option based on your unique situation.
Last reviewed by a Cleveland Clinic medical professional on 03/24/2021.
References
What Is Stage Iv Cancer
Stage IV cancer is the most severe form of cancer in which cancer has spread to a distant part of the body from its origin. Thus, testicular cancer may have spread to the lungs and bones, thyroid cancer may have spread to the brain, and so on. It is also known as metastatic or advanced disease.
The staging system often used for most types of cancer is the American Joint Committee on Cancer ;TNM system. In these staging systems, three types of key information are used.
- T : It refers to the size of the original tumor.
- N : It describes whether cancer has spread to the lymph nodes.
- M : It refers to the spreading of cancer to other parts of the body.
A number or the letter X is allocated to each factor. A higher number means the cancer is advanced. For instance, a T1 score refers to a smaller tumor than a T2 score. The letter X indicates that information could not be assessed. M1 indicates that cancer has spread to a distant part of the body.
The physician combines T, N, and M results and other factors specific to cancer to determine the stage of cancer for each person. Most cancer types have four stages: stages I-IV, with stages I and IV being the least severe and most severe forms of cancer, respectively. Some types of cancer also have a stage 0 .
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