Recurrent Breast Cancer

Breast cancer may re-occur months or years after your initial treatment and this is called recurrent breast cancer. Breast cancer if detected on time and given proper treatment will lead to the elimination of all cancer cells. 

Recurrent breast cancer has to do with the multiplication of undetected cancer cells from the original breast cancer that is supposedly have been treated or eliminated.

If your breast cancer recurrence is found only in the area of the breast where your original cancer was removed it is called local recurrence but if the recurrence appears or spreads to other areas of your body then it is called distant recurrence.

Most of the time, greater sadness and devastation is felt when you find out that your breast cancer has recurred compared to the first time you were diagnosed with breast cancer.

But, you must keep in mind that if initially you were cured from cancer then the probability of getting cured again is still high hence you should feel hopeful. Available treatment will allow better management of the condition which may prolong the person’s life.

Signs and symptoms of recurrent breast cancer would differ based on the location of the recurrence. Such as with local recurrence or if the cancer has been detected in the same area as where the original cancer was found. The cancer could return in the remaining breast tissue for people who underwent lumpectomy.

Signs and symptoms of local recurrence within the same breast previously affected include:

• A new lump is detected in your breast or irregular area of firmness,
• Changes to the skin of your breast,
• Skin inflammation or area of redness,
• Discharge in the nipple.

While for people who underwent mastectomy, the cancer could return in the tissue that surrounds the chest wall or in the skin.

Signs and symptoms of local recurrence on the chest wall after a mastectomy may include:

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

In cases wherein, the cancer that returned is now found in the nearby lymph nodes is called Regional recurrence.

Signs and symptoms of regional recurrence are the following:

• A lump or swelling in the lymph nodes that is located either under your arm, near your collarbone.
• In the groove above your collarbone or in your neck.

Another type of recurrent cancer is called a distant (metastatic) recurrence in which the cancer has moved or spread to distant parts of the previously cancerous location, usually are the bones, liver and lungs.

Signs and symptoms of distant recurrence are persistent and worsening pain especially on the chest or bone area, persistent or continuous cough, difficulty breathing, loss of appetite, weight loss, severe headaches and seizures.

Make sure that you continuously see your doctor through follow-up appointments even after you have been cured from cancer so that you can be continuous monitored for signs of cancer recurrence.

Also, even if it is not yet your scheduled appointment, once you have detected some changes or symptoms that are starting to develop then right away contact your doctor and make the necessary consultation.

Recurrent breast cancer is caused when some cells from the original breast cancer dislodge from the original tumor and hide in some of the closes structures to the breast or in another part of your body giving the impression that the person has been fully cured from the original cancer.

Over time, parts of the original cancer cells grow and multiple leading to the manifestations of symptoms. Although chemotherapy, radiation or hormone therapy have been proven to cure cancer and has the goal of killing all cancer cells but there are instances wherein some cancer cells break free and survive.

Sometimes cancer cells may be inactive for years without causing harm then will be activated at a certain point due to some triggers, in which they will start to grow and spread to other parts of the body, currently it is still unknown why this happens.

If you suspects signs and symptoms of a recurrent breast cancer, it would be best to contact your previous oncologist to receive a diagnosis. The things to prepare for prior to your appointment are as follows:

• List of your current and previous symptoms.
• If a new doctor is now handling your case then request for your medical records to be forwarded to your new doctor.
• Bring any previous laboratory results and imaging tests with you during the appointment.
• Write down all medications that you have taken or is taking including supplements, herbs, over-the-counter drugs and vitamins including the dosage as well as if you have tried alternative remedies.

It is best to bring a company to offer emotional support as the possible recurrent of breast cancer may be more taxing than the first time you were diagnosed, also having someone with you will help retain pertinent information discussed with the doctor.

For better management and coping with the condition, it is beneficial to understand it hence ask your doctor questions that you might find confusing or is concerned about regarding recurrent breast cancer, and such questions may be as follows:

• Has my breast cancer re-occurred?
• What are the causes of the recurrence?
• What additional test would I undergo?
• Are there any needed preparations prior to the tests?
• What is the hormone receptor status of the cancer recurrence?
• What is the best treatment option to kill the cancer cells and stop the recurrence?
• What side effects would I experience with the medications?
• Will there be an available alternative treatment?
• Are there any clinical trials that I am qualified to join?
• What's my prognosis?

As part of the doctor’s assessment, you will be asked questions such as:

• When did symptoms first start?
• Have you noticed any changes with the symptoms as the days pass?
• Do you feel any resemblance or difference in the symptoms that you have now from what you had in the past?
• How do you feel about this condition?
• Have you noticed any weight loss or loss of appetite?
• Are you experiencing any pain at any point?

After a thorough medical history and physical exam, you will need to undergo a mammogram as well as other diagnostic tests.

Imaging tests may include:

• A magnetic resonance imaging (MRI)
• Computerized tomography (CT) scan
• X-ray
• Bone scan or positron emission tomography (PET) scan

Not all of these tests will be run for all individuals with suspected recurrent breast cancer as it will depend on the presenting symptoms and the particular situation.

Your doctor may recommend a biopsy procedure to collect suspicious cells for testing if it is benign or malignant as well as if the cancer cells are a recurrence of cancer or a new type of cancer.

This tests will also help determine sensitivity to hormone treatment or targeted therapy which will dictate next course of action.

You would need to closely work with your doctor to decide on the best treatment plan for your recurrent breast cancer. Some of the treatments may been recommend or done in the past just like the possibility of another surgery.

Treatment may include:

• Surgery,
• Radiation Therapy,
• Chemotherapy,
• And combination of medication.

Surgery may be recommended to remove the remaining breast tissue that is now affected by the cancer cells, such as if previously you have had lumpectomy then a mastectomy may now be necessary.

Radiation therapy uses high-energy beams, such as X-rays, to kill cancer cells. If did not undergo radiation therapy during the first breast cancer then more likely will this be recommended. However, if you have undergone radiation therapy before then it is unlike to be used again as it increases the risk of acquiring side effects.

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be recommended after surgery to kill remaining cancer cells. Hormone therapy. If your cancer causes increase production of hormones then a medication that block the growth-promoting effects of the hormones estrogen and progesterone may be recommended.

Treatment of metastatic cancer may a combination of medication, radiation or chemotherapy depending on the location of the new cancer cells. The goal for the treatment of metastatic cancer is to allow the person to live longer and reduce the effects or discomforts caused by the symptoms of cancer.

The main idea with the treatment is that there is no specific one treatment that will ensure effective as multiple treatments may be employed depending on the symptoms and severity of the cancer recurrence.

Hormone therapy have been linked to prevent recurrent breast cancer and that hormone therapy can be continued for at least five years.

Chemotherapy has also shown positive result in the prevention of the recurrence of breast cancer as there are evidence that those who received chemotherapy had higher survival rate.

Radiation therapy has also generated positive results on the prevention of recurrence.

Lastly, maintaining a healthy lifestyle puts a person at a reduced risk of recurrent breast cancer through proper nutrition and regular exercise which can prevent other medical conditions from developing.

There is no available alternative remedy for recurrent breast cancer. There are alternative therapies that may help you cope with the side effects of treatment which may improve the person’s quality of life and relieve some discomforts.

Before engaging in any alternative remedy or therapy, it is best to consult your doctor first to check if there wouldn't be any contraindications to getting the alternative treatment with your current treatment plan.

People diagnosed with cancer especially with recurrent breast cancer may feel despair, sadness and even hopelessness and such emotions can lead to difficulty sleeping, eating or concentration on your daily activities.

Complementary and alternative treatments that can help with this negative emotions, include: art therapy, dance or movement therapy, exercise, meditation, music therapy, relaxation, and yoga.

Lifestyle modifications are necessary in order to cope with recurrent breast cancer.

Dealing with a recurrent breast cancer may be more difficult than the first time you were diagnosed as possibly you have believed that you have been completed cured then over time it would recur.

Here are some ways to help deal with the condition:

• Educate yourself about the condition as well the different treatment options.
• Making the decision for yourself can be empowering which help you have a more positive outlook about your condition.
• Closely work with your doctor about your condition and the best possible treatment.
• Do not hesitate to ask for further explanation is something is confusing or unclear to you.
• Stay connected with your family and friends, do not push them away because of your condition.
• Strengthen your bond your family as emotional support you gain from them will motivate you and strengthen you. Also, they can support or assist you during hospitalization or when you feel weak or having discomforts.
• Look into joining a support group to have a venue to talk about your feelings to people who are also experiencing the same condition and may offer useful advice or wisdom which you may find helpful.

If many lymph nodes are affected by the cancer cell, the tumor size is larger and women with larger tumors at an increased risk of recurrent breast cancer.

Lack of radiation therapy after a lumpectomy puts women at greater risk of developing recurrent breast cancer.

Women who were diagnosed with breast cancer under the age 35 are at higher risk of recurrent breast cancer.