Breast cancer recurrence at a glance

The success of breast cancer recurrence treatments, these are depends on a number of factors such as the stage and grade of your cancer, is the cancer hormone sensitive?, how long ago your original breast cancer was,  the size of the cancer and is the cancer HER2 positive?

If your breast cancer recurrence is found only in the area of the breast where your original cancer was removed and/or it’s been a long time since you were first treated, then it can often be successfully treated.

There is some uncertainty about whether having a local recurrence affects your overall prognosis. The doctor thinks that local recurrence does increase the risk of the cancer spreading elsewhere. Some others believe that a local recurrence does not in itself mean that that the cancer is more likely to spread in the future. Research is ongoing to try to answers this question and to pinpoint who may be at most risk.

People who have a regional recurrence are thought to have an increased risk of cancer cells spreading to other areas of the body. Treatments such as chemotherapy and hormone therapy are given because they work throughout the whole body.

Breast cancer can recur in the following ways

• Regional recurrence occurs in the lymph nodes near the affected breast. These “regional” lymph nodes include nodes found under the arm and in the chest wall, such as those under the breastbone or under the pectoral muscle at the front of the chest. With regional recurrence, the cancer grows from cells that were present but undetectable at the time of the original surgery
• Local recurrence occurs in the breast where the cancer first started, or in the skin and nearby tissues where the tumor used to be. This type of recurrence can happen even if you’ve had a mastectomy. In the soft tissues of the chest, cancer can grow from breast cancer cells close to the skin or behind the breast area, against the muscle of the chest wall. This type of local recurrence is called a chest wall recurrence
• Metastatic breast cancer recurrence occurs in other parts of the body, such as in the lungs, liver, bone, or brain

Treatment of breast cancer recurrence

The type of treatment for local breast cancer recurrences depends on the woman’s initial treatment. Since radiation therapy cannot be delivered twice to the same area. If she had a lumpectomy, local recurrence is usually treated with mastectomy. If the initial treatment was mastectomy, recurrence near the mastectomy site is treated by removing the tumor whenever possible, usually followed by radiation therapy.

In either case, hormone therapy and/or chemotherapy may be used after surgery and/or radiation therapy. If breast cancer is found in the other breast, it may be a new tumor unrelated to the first breast cancer. Treatment would include a lumpectomy or mastectomy and, sometimes, systemic therapy.

Women with distant recurrence involving organs such as the lungs, brain, bones, or other organs, are treated with systemic therapy using chemotherapy, hormonal therapy, or both. Radiation therapy or surgery also may be recommended to relieve certain symptoms.