Understanding Recurrent Breast Cancer
Breast cancer recurrence refers to the return of breast cancer after treatment, whether it happens months or years later. The risk of breast cancer recurrence is different from person to person and is based on several factors, including the type of breast cancer you are diagnosed with and its stage. Typically, recurrent breast cancer is treated differently than your initial breast cancer.
Types of Recurrence
There are three main types of breast cancer recurrence, categorized by where the cancer reappears in the body:
Local recurrence: The cancer returns in the same breast, which includes the chest wall, skin, remaining breast tissue, or within the surgical scar.
Regional recurrence: The cancer reappears in the lymph nodes near the breast but has not spread to other parts of the body.
Distant recurrence: The cancer has metastasized, spreading to other areas of the body such as the brain, lungs, liver, or bones. This advanced stage is known as stage 4 breast cancer or metastatic breast cancer.
What Is The Risk for Recurrent Breast Cancer?
In general, the longer it has been since your initial diagnosis, the lower the risk of recurrence. However, it is important to understand that certain factors may be associated with a higher risk of breast cancer returning:
Type of breast cancer
Tumor size
Breast cancer stage at diagnosis
Age at diagnosis
Being overweight
Smoking
Lack of physical activity
Poor overall health
Previous breast cancer treatments
Signs and Symptoms of Breast Cancer Recurrence
The signs of breast cancer recurrence can vary depending on where the cancer has returned. While a local recurrence may not show any symptoms, a regional or distant recurrence is more likely to do so. Because cancer can recur without symptoms it’s important to go to your annual mammograms and other oncology follow-up appointments. Finding recurrent breast cancer early makes it easier to treat.
Pay attention to the following symptoms, that could indicate breast cancer has come back:
Fatigue
New lumps, swollen areas, or irregular firmness
Changes in the nipple
Unexplained weight loss
Persistent chest pain
Bone pain
Severe headaches
Swollen lymph nodes (in the armpit or collarbone area)
Difficulty swallowing
Shortness of breath or wheezing
Loss of appetite or nausea
Seizures
Numbness or weakness
Jaundice (yellowing of the skin or whites of the eyes)
Diagnosing Recurrent Breast Cancer
Your breast cancer specialist may find recurrent breast cancer during a routine physical or mammogram. Or you may notice new symptoms. To determine if your breast cancer has returned, your breast cancer doctor may perform one or more of the following tests:
Breast physical examination
Mammogram
Biopsy
Ultrasound
Breast MRI
If a recurrence is confirmed, your oncologist will recommend additional tests like blood tests, bone scans, a PET scan, or other imaging studies to check for cancer in other parts of the body before starting treatment.
Treatment Options for Recurrent Breast Cancer
Just as when you were initially diagnosed, a personalized treatment plan will be developed. It’s okay if you don’t return to the same cancer center where you originally received treatment, especially if you’ve moved since your first diagnosis.
Our care team will work with you to determine which treatments are best based on the type of cancer and where it’s located.
Treating Local Recurrence Breast Cancer
In cases of local recurrence, treatment usually begins with surgery. If you previously had breast-sparing surgery (lumpectomy), a mastectomy is often performed. If you initially had a mastectomy, any recurrence near that area will be treated by removing the tumor along with a margin of healthy tissue. Additionally, lymph nodes that were not previously removed may be taken out. If radiation therapy was not part of your initial treatment, it might be recommended after the mastectomy for the recurrent tumor. Other treatments that some patients may need to receive include:
Hormone therapy: This aims to eliminate any hormone-receptor-positive cancer cells throughout the body.
Targeted therapy: This focuses on cancer cells that produce excess HER2 protein, which can promote the growth, spread, and survival of breast cancer cells.
Immunotherapy: This treatment boosts your immune system’s ability to attack cancer cells effectively.
Chemotherapy: This helps eliminate lingering cancer cells that could increase the risk of further recurrences.
Treating Regional Breast Cancer Recurrence
For regional breast cancer recurrence, treatments may include:
Surgery: This involves removing cancerous lymph nodes if they were not previously removed.
Radiation therapy: This may be administered after surgery or as the primary treatment if radiation is not part of your initial treatment plan.
Drug treatments: These may include chemotherapy, targeted therapy, or hormone therapy as primary treatments for regional recurrent cancer or following surgery or radiation.
Treating Distant Breast Cancer Recurrence
Distant recurrence of breast cancer is the most challenging to treat, as it affects areas beyond the original tumor, including the bones, lungs, or brain. Treatment for distant recurrence typically focuses on extending the patient's life and alleviating symptoms rather than curing the cancer. If you have distant recurrent breast cancer, you may receive:
Hormone therapy: This is often the first treatment if your cancer is hormone receptor-positive.
Chemotherapy: This is used if your cancer is hormone receptor-negative or if hormone therapy is no longer working.
Targeted therapy: This can be administered if your cancer cells respond to specific targeted medications.
Immunotherapy: This interferes with cell proteins that help cancer cells evade the immune system. Immunotherapy may also be used in combination with chemotherapy.
Bone-building medications: These help reduce the risk of bone fractures and alleviate bone pain.
Radiation therapy: This is used to relieve symptoms.
Recurrent and Metastatic Breast Cancer Clinical Trials
Breast cancer clinical trials are available through Cancer Care Centers of Brevard, offering treatments that are not yet available to everyone for specific types of recurrent and metastatic breast cancer. This can include testing your cancer cells for biomarkers. The results of the test can qualify you for certain targeted therapy or immunotherapy clinical trials. Your oncologist will discuss your options with you.
Breast Cancer Treatment in Brevard County
The breast cancer doctors at Cancer Care Centers of Brevard offer the latest treatment, including clinical trials, making it possible to provide individualized treatment plans. If you or a loved one has been diagnosed with recurrent breast cancer, our specialists in Melbourne, Merritt Island, Palm Bay, and Rockledge, Florida, are available for a consultation about the best treatment plan for you.