Description

Recurrent breast cancer is breast cancer that comes back after initial treatment. Although the initial treatment is aimed at eliminating all cancer cells, some may have evaded treatment and survived. These undetected cancer cells multiply, becoming recurrent breast cancer.

Recurrent breast cancer may occur months or years after your initial treatment. The cancer may come back in the same place as the original cancer (local recurrence), or it can spread to other areas of your body (distant recurrence).

Learning has recurrent breast cancer can be more difficult to deal with the initial diagnosis. But to have recurrent breast cancer is far from desperate. The treatment can eliminate local, regional or distant recurrent breast cancer. Even if a cure is not possible, treatment can control the disease for long periods of time.

Symptoms

The signs and symptoms of recurrence of breast cancer vary depending on if the cancer comes back.

Local recurrence

In a local recurrence, the cancer comes back in the same area as their original cancer.

If you have undergone a lumpectomy, the cancer could recur in the rest of the breast tissue. If you have undergone a mastectomy, the cancer may come back in the tissue that lines the chest wall or the skin.

The signs and symptoms of local recurrence within the breast may include:

  • A new lump in the breast or irregular area of firmness.
  • Changes in the skin of his chest.
  • Inflammation of the skin or area of redness.
  • The discharge from the nipple.

The signs and symptoms of local recurrence in the chest wall after a mastectomy may include:

  • One or more nodules are painless, on or under the skin of the chest wall.
  • A new area of thickening along or near the scar of the mastectomy.

Regional Recurrence

Regional recurrence of breast cancer means that the cancer has come back in the lymph nodes nearby.

The signs and symptoms of regional recurrence may include a lump or swelling in the lymph nodes:

  • Under your arm.
  • Near the collarbone.
  • In the slot above the collarbone.
  • In your neck.

Distant recurrence

A distant (metastatic) recurrence means that the cancer has traveled to distant parts of the body, most commonly to the bones, liver and lungs.

Signs and symptoms include:

  • Persistent and worsening pain, such as the chest, back, or hip pain.
  • Persistent cough.
  • Difficulty breathing.
  • Loss of appetite.
  • The loss of weight without trying.
  • Severe headaches.
  • Seizures.

When to see a doctor

After your breast cancer treatment ends, it is likely that your doctor creates a program of follow-up exams for you. During the follow-up examinations, the doctor checks the symptoms or signs of recurrence of the cancer.

You may 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.

Causes

Recurrent breast cancer occurs when the cells that were part of your original breast cancer to break the original tumor and are hiding in the vicinity, in the breast or in another part of your body. Subsequently, these cells begin to grow again.

Chemotherapy, radiotherapy, hormonal therapy, or other treatment that you have received after her first diagnosis of breast cancer, was intended to kill cancer cells that may remain after surgery. But sometimes, these treatments are not capable of killing all of the cancer cells.

Sometimes, cancer cells may be dormant for years without causing damage. Then something happens that triggers the cells, so that they grow and spread to other parts of the body. It is not clear why this happens.

Risk factors

For survivors of breast cancer, the factors that increase the risk of a recurrence, which include:

  • Lymph node involvement. Find cancer in nearby lymph nodes at the time of their original diagnosis increases the risk of the cancer coming back.
  • Larger tumor size. People with larger tumors have a higher risk of recurrence of breast cancer.
  • Positive or close margins of the tumor.During breast cancer surgery, the surgeon tries to remove the cancer, along with a small amount of normal tissue that surrounds it. A pathologist examines the tissue of the edges of the tissue to look for cancer cells. If the borders are cancer-free when examined under a microscope, which is considered a negative margin. If any part of the border has cancer cells (positive margins), or the margin between the tumor and the normal tissue nearby, the risk of breast cancer recurrence is higher.
  • The lack of treatment of radiation after a lumpectomy. The majority of people who choose a lumpectomy (wide local excision) for breast cancer of the breast is subjected to the radiation therapy to reduce the risk of recurrence. Those who did not undergo radiation therapy have a higher risk of local breast cancer recurrence.
  • Younger age. Young people, particularly those under 35 years of age at the time of diagnosis of breast cancer, they face a higher risk of recurrence of breast cancer.
  • Inflammatory breast cancer. People with inflammatory breast cancer have a higher risk of local recurrence.
  • The lack of endocrine therapy for hormone receptor-positive breast cancer. In people who have a certain type of breast cancer, who do not receive endocrine therapy may increase your risk of recurrence.
  • Cancer cells with certain characteristics. If you had triple-negative breast cancer, you may have an increased risk of breast cancer recurrence. Triple-negative breast cancer cells do not have estrogen or progesterone receptors, and do not make too much of a protein called HER2.
  • Obesity. Having a higher body mass index increases the risk of recurrence.

Positive or close margins of the tumor. During breast cancer surgery, the surgeon tries to remove the cancer, along with a small amount of normal tissue that surrounds it. A pathologist examines the tissue of the edges of the tissue to look for cancer cells.

If the borders are cancer-free when examined under a microscope, which is considered a negative margin. If any part of the border has cancer cells (positive margins), or the margin between the tumor and the normal tissue nearby, the risk of breast cancer recurrence is higher.

Prevention

The strategies that have been associated with a lower risk of breast cancer recurrence include:

  • The hormone therapy. Hormone therapy after their initial treatment may reduce the risk of recurrence if you have hormone-receptor-positive breast cancer. Hormone therapy can continue for at least five years.
  • Chemotherapy. For people with breast cancer have a higher risk of recurrence of the cancer, chemotherapy has been shown to decrease the likelihood that the cancer will recur, and in those receiving chemotherapy live longer.
  • The radiation therapy. People who have had a breast-sparing operation for the treatment of her breast cancer and those who had a large tumor or inflammatory breast cancer have a lower chance of the cancer recurring, if they are treated with radiation therapy.
  • The targeted therapy. If your cancer does extra protein HER2, drugs that target the protein can help reduce the chance of the cancer coming back.
  • The construction of the bones of the drug. Taking the construction of the bones of the drug reduces the risk of recurrence of the cancer in the bones (bone metastases) in people with an increased risk of breast cancer recurring.
  • Maintain a healthy weight. Maintaining a healthy weight can help reduce the risk of recurrence of breast cancer.
  • Exercise. Regular exercise can reduce the risk of recurrence of breast cancer.
  • The choice of a healthy diet. Focus on the inclusion of a lot of vegetables, fruits and whole grains in your diet. If you choose to drink alcohol, limit yourself to one drink per day.

Diagnosis

If your doctor suspects that you may have recurrent breast cancer, based on the results of a mammogram or physical exam, or to cause the signs and symptoms, he or she may recommend additional tests to confirm the diagnosis.

Tests and procedures may include:

  • Imaging tests.What imaging tests shall be submitted will depend on your specific situation. Imaging tests may include magnetic resonance imaging (MRI), computed tomography (CT), X-ray, bone scan or positron emission tomography (PET). Not all people needs for each test. Your doctor will determine which tests are most useful for your particular situation.
  • The removal of a tissue sample for laboratory analysis (biopsy).Your doctor may recommend a biopsy procedure to collect cells suspicious for testing, as this is the only way to confirm if your cancer has returned. Work in a lab, a pathologist examines the tissue cells and determines the types of cells involved. A pathologist can determine if the cancer is a cancer recurrence or a new cancer. In addition, the tests show whether the cancer is sensitive to hormone therapy or targeted therapy, as these may have changed since the original diagnosis of cancer.

Imaging tests. What imaging tests shall be submitted will depend on your specific situation. Imaging tests may include magnetic resonance imaging (MRI), computed tomography (CT), X-ray, bone scan or positron emission tomography (PET).

Not all people needs for each test. Your doctor will determine which tests are most useful for your particular situation.

The removal of a tissue sample for laboratory analysis (biopsy). Your doctor may recommend a biopsy procedure to collect cells suspicious for testing, as this is the only way to confirm if your cancer has returned. Work in a lab, a pathologist examines the tissue cells and determines the types of cells involved.

A pathologist can determine if the cancer is a cancer recurrence or a new cancer. In addition, the tests show whether the cancer is sensitive to hormone therapy or targeted therapy, as these may have changed since the original diagnosis of cancer.

Treatment

Your treatment options will depend on several factors, including the extension of the disease, hormone receptor status, the type of treatment you received for your first breast cancer and your overall health. Your doctor also considers your goals and preferences for treatment.

The treatment of the local recurrence

The treatment of the local recurrence typically begins with an operation and can include radiation therapy, if you've not had before. Chemotherapy and hormone therapy may also be recommended.

  • Surgery.The recurrence of breast cancer that is confined to the breast, treatment usually involves the removal of any remaining breast tissue. If your first cancer was treated with a lumpectomy, your doctor may recommend a mastectomy to remove the entire breast tissue — lobules, ducts, fatty tissue, the skin and the nipple. If your first breast cancer was treated with mastectomy and the cancer comes back in the chest wall, you may have surgery to remove the cancer along with a margin of normal tissue. Local recurrence can be accompanied by occult cancer in nearby lymph nodes. For this reason, the surgeon may remove some or all of the nearby lymph nodes if they are not removed during your initial treatment.
  • The radiation therapy. Radiation therapy uses high-energy rays, such as X-rays or protons, to kill cancer cells. If you do not have radiation therapy for their first breast cancer, your doctor may recommend now. But if you had radiation after a lumpectomy, radiation for the treatment of recurrence is generally not recommended due to the risk of side effects.
  • Chemotherapy. Chemotherapy uses drugs to destroy cancer cells. Your doctor may recommend chemotherapy after surgery to reduce the risk of a new cancer recurrence.
  • The hormone therapy. Drugs that block the growth promoting effects of the hormones estrogen and progesterone may be recommended if your cancer is hormone receptor positive.
  • The targeted therapy. If the test shows that cancer cells produce excess HER2 protein, drugs that target the protein is likely to be recommended.

Surgery. The recurrence of breast cancer that is confined to the breast, treatment usually involves the removal of any remaining breast tissue.

If your first cancer was treated with a lumpectomy, your doctor may recommend a mastectomy to remove the entire breast tissue — lobules, ducts, fatty tissue, the skin and the nipple.

If your first breast cancer was treated with mastectomy and the cancer comes back in the chest wall, you may have surgery to remove the cancer along with a margin of normal tissue.

Local recurrence can be accompanied by occult cancer in nearby lymph nodes. For this reason, the surgeon may remove some or all of the nearby lymph nodes if they are not removed during your initial treatment.

The treatment of a regional recurrence

Treatments regional recurrence of breast cancer include:

  • Surgery. If possible, surgery to remove the cancer is the recommended treatment for a regional recurrence. The surgeon may also remove the lymph nodes under the arm, if they are still present.
  • The radiation therapy. Sometimes radiation therapy may be used after surgery. If surgery is not possible, radiation therapy may be used as the main treatment for regional recurrence of breast cancer.
  • Drug treatments. Chemotherapy, targeted therapy, or hormone therapy may also be recommended as the primary treatment or it may follow surgery or radiation.

The treatment of a metastatic recurrence

There are many treatments for metastatic breast cancer. Your options depend on where the cancer has spread. If a treatment doesn't work or stops working, you may be able to try other treatments.

In general, the goal of treatment for metastatic breast cancer is not to cure the disease. The treatment can allow us to live longer, and can help relieve the symptoms the cancer is causing. Your doctor works to achieve a balance between the control of their symptoms, while minimizing the toxic effects of the treatment. The goal is to help you live as well as possible for as long as possible.

Treatments may include:

  • The hormone therapy. If your cancer is hormone receptor positive, you may benefit from hormone therapy. In general, the hormone therapy has fewer side effects than chemotherapy, so that in many cases it is the first treatment for metastatic breast cancer.
  • Chemotherapy. Your doctor may recommend chemotherapy if the cancer is hormone receptor negative or if hormone therapy is not working.
  • The targeted therapy. If the cancer cells have certain characteristics that make them vulnerable to targeted therapy, your doctor may recommend these medications.
  • Immunotherapy.Immunotherapy uses your immune system to fight cancer. From your body to fight off diseases immune system will not attack the cancer because the cancer cells produce proteins that help to hide from the immune system cells. Immunotherapy works by interfering with that process. Immunotherapy may be an option if you have triple-negative breast cancer, which means that the cancer cells do not have receptors for estrogen, progesterone or HER2. For the triple-negative breast cancer, immunotherapy combined with chemotherapy to treat advanced cancer that has spread to other parts of the body.
  • The construction of the bones of the drug. If the cancer has spread to your bones, your doctor may recommend a bone-building drugs to reduce their risk of bone fractures or reduce bone pain you may experience.
  • Other treatments. Radiation therapy and surgery may be used in certain situations to control the signs and symptoms of advanced breast cancer.

Immunotherapy. Immunotherapy uses your immune system to fight cancer. From your body to fight off diseases immune system will not attack the cancer because the cancer cells produce proteins that help to hide from the immune system cells. Immunotherapy works by interfering with that process.

Immunotherapy may be an option if you have triple-negative breast cancer, which means that the cancer cells do not have receptors for estrogen, progesterone or HER2. For the triple-negative breast cancer, immunotherapy combined with chemotherapy to treat advanced cancer that has spread to other parts of the body.

Alternative medicine

There is No alternative medicine treatments have been found to cure breast cancer. But the complementary and alternative medicine therapies may help you cope with the side effects of treatment when combined with your doctor.

For example, many people diagnosed with cancer experience distress. If you are distressed, you may feel sad or worried. You may find that it is difficult to sleep, eat or concentrate on your normal activities.

Complementary and alternative treatments that can help deal with the anxiety include:

  • Art therapy.
  • Dance or movement therapy.
  • Exercise.
  • Meditation.
  • Music therapy.
  • The relaxation exercises.
  • Yoga.

Your doctor can refer you to professionals who can help you understand and test these alternative treatments. Tell your doctor if you are experiencing distress.

Coping and support

Find the breast cancer has returned may be equally or more troubling than that of their initial diagnosis. As you sort through your emotions, and make decisions about treatment, the following suggestions may help you cope:

  • Learn enough about the recurrent breast cancer to make decisions about your care. Ask your doctor about your recurrent breast cancer, including treatment options and, if you like, your prognosis. As you learn more about recurrent breast cancer, you can be more confident in making treatment choices.
  • Keep friends and family close. Keep your close relationships strong will help you deal with your recurrent breast cancer. Friends and family can provide the practical support you need, such as help to take care of your house if you're in the hospital. And that you can serve as emotional support when you feel overwhelmed by the cancer.
  • Find someone to talk to.Find a good listener who is willing to listen to you talk about your hopes and fears. This can be a friend or family member. The concern and understanding of a counselor, medical social worker, clergy member or cancer support group may also be useful. Ask your doctor about support groups in your area. Or look in your telephone directory, or the library of a cancer of the organization, such as the National Cancer Institute or the American Cancer Society.
  • To find a connection to something beyond itself. Having a strong faith or a sense of something greater than themselves helps many people deal with cancer.

Find someone to talk to. Find a good listener who is willing to listen to you talk about your hopes and fears. This can be a friend or family member. The concern and understanding of a counselor, medical social worker, clergy member or cancer support group may also be useful.

Ask your doctor about support groups in your area. Or look in your telephone directory, or the library of a cancer of the organization, such as the National Cancer Institute or the American Cancer Society.

Preparing for your appointment

If you have signs or symptoms that worry you, make an appointment with your primary care physician or family doctor.

Your doctor may recommend the necessary tests and procedures to confirm a diagnosis of recurrent cancer. Then it is likely that you will have to be referred to a doctor who specializes in the diagnosis and treatment of cancer (oncologist).

What you can do

  • Be prepared to talk about your new symptoms and any other health problems you've had since her first diagnosis of cancer.
  • If you are seeing a new doctor, request your medical records from your former provider. If you already have them, be sure to bring your medical records and any imaging tests that you have with you. Otherwise, you will need to sign a release of information form so that your new provider's office, you can buy records.
  • Make a list of all medications, vitamins or supplements you are taking. Let your doctor know if you have tried alternative treatments for cancer.
  • Consider asking a family member or friend to come with you. It can be difficult to remember all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
  • Write questions to ask their doctor.

If you could have recurrent breast cancer, some basic questions to ask your doctor include:

  • Has my cancer came back?
  • There are other possible causes of the symptoms?
  • What kinds of tests do I need? Do these tests require any special preparation?
  • What are the hormone receptor status and HER2 status of the recurrence of cancer?
  • What treatments are available for me at this stage, and I recommend?
  • What types of side effects can I expect from treatment?
  • Are there alternatives to the approach that you're suggesting?
  • Clinical trials are open to me?
  • What is my prognosis?

What to expect from your doctor

Your doctor may ask you a series of questions. Be ready to answer them may reserve time to go over points you want to spend more time. Your doctor may ask:

  • When did you first begin to experience the symptoms again?
  • There has been a change in symptoms over time?
  • Do these symptoms feel different when the cancer was first diagnosed?
  • How do you feel in general?
  • Have you had any unexpected weight loss? You have lost your appetite?
  • Are you experiencing any pain?
Symptoms and treatment of the recurrence of breast cancer