Recurrent Breast Cancer

Overview

Breast cancer is cancer that begins in the breast tissue. Sometimes, even with effective treatment, cancer can return in the breast. This is known as recurrent breast cancer.

The two types of recurrent cancer are:

• Distant recurrence - this is when the cancer recurs in a different area of the body other than the breast where it first occurred.
• Local recurrence - this is when the cancer recurs in the same area of the body as it originally occurred.

Recurrent breast cancer causes

Breast cancer is caused by mutations (changes) to the DNA of the cells of the breast. Recurrent breast cancer is caused by cancer cells that somehow evaded and survived initial cancer treatment that was believed to have destroyed all cancer cells.

Recurrent breast cancer risk factors

The following factors may increase your risk for developing recurrent breast cancer:

• Being obese
• Being under age 35 when first diagnosed with breast cancer
• Finding cancer in your lymph nodes in your initial cancer diagnosis
• Having had a large breast tumor
• Having inflammatory breast cancer
• Not having undergone endocrine therapy for hormone receptor-positive breast cancer
• Not undergoing radiation therapy after surgical treatment of breast cancer

Recurrent breast cancer symptoms

Signs and symptoms of recurrent local breast cancer may include:

• A change in the shape or size of a breast
• A lump in the breast or underarm area
• A marble-like hardened area of skin on or around the breast
• Change in shape or position of a nipple
• Discharge from the nipple that is bloody or clear
• Nipple retraction, meaning that it’s pushed in rather than sticking out
• Red or scaly breast skin or nipple
• Skin of the breast that is dimpled or puckered
• Swelling in the breast

Signs and symptoms of recurrent distant breast cancer may include:

• Cough that won’t go away
• Decreased appetite
• Pain in your chest, back or hip that worsens over time
• Seizures
• Severe headaches
• Swelling of a lymph node
• Trouble breathing
• Unintentional weight loss

Recurrent breast cancer diagnosis

Your oncologist may use one or more of the following tests to diagnose this condition:

• Computerized tomography (CT) scan - this type of imaging test provides a 3-D image of the inside of the body that your doctor can use to determine if there is any cancer present.
• Bone scan - your oncologist may order a bone scan if it is suspected that the cancer may have spread to your bones.
• Biopsy - in this test, your doctor removes a biopsy (small tissue sample) from the suspicious area. This sample is sent to the laboratory, where a specialist closely checks the biopsy for abnormalities.
• Breast magnetic resonance imaging (MRI) - this type of imaging test uses high-powered magnets to create detailed images of the inside of your body. Your doctor can closely examine these images to look for any areas that could indicate cancer.

Recurrent breast cancer treatments

Depending on your personal health history, the extent of your recurrent breast cancer and other factors, your oncologist may recommend one or more of the following treatment options:

• Surgery - in most cases, your doctor will recommend a surgical procedure to remove the cancerous area. Your surgeon will work to preserve as much surrounding healthy tissue as possible. In some cases, you may opt to undergo reconstructive surgery following surgery to treat breast cancer.
• Chemotherapy - you may need to undergo chemotherapy to destroy any microscopic cancerous cells that couldn’t be removed surgically. During this treatment, medication is used to destroy cancerous cells. Chemotherapy can be taken via an oral (by mouth) pill or intravenously (through a vein).
• Hormone therapy - if you have hormone receptor-positive breast cancer, your oncologist may recommend you undergo hormone therapy for the hormone estrogen and progesterone.
• Radiation therapy - this treatment uses high-powered energy beams to destroy cancerous cells. You may need to undergo radiation therapy to destroy any microscopic cancerous cells that couldn’t be removed surgically.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing an oncologist for more specialized treatment.