Recurrent Breast Cancer – Symptoms and Causes
Overview
Recurrent breast cancer happens when cancer returns after the first treatment. Some cancer cells may survive and grow again, even after doctors try to remove them all. This can happen months or years after the initial diagnosis.
The cancer might come back in three main ways:
- Local Recurrence: Returns in the same place as before.
- Regional Recurrence: Appears in nearby lymph nodes.
- Distant Recurrence: Spreads to other parts of the body.
Facing recurrent breast cancer can be emotionally harder than the first diagnosis. However, there are still effective treatment options. Many treatments can eliminate the cancer completely. Even when a cure isn’t possible, treatments often control the disease for long periods.
Signs of Cancer Return
New Lump or Growth After Treatment
If breast cancer comes back where it first appeared, you might notice a new lump or firm area in your remaining breast tissue after a lumpectomy. After a mastectomy, cancer could return in the chest wall tissue or skin.
Look for these warning signs in the same breast:
- A new lump or irregular firm area
- Skin changes on your breast
- Redness or inflammation of the skin
- Fluid coming from the nipple
After a mastectomy, watch for:
- Painless bumps on or under the chest wall skin
- Thickened area near or along the surgery scar
Lymph Node Involvement
Sometimes breast cancer returns in nearby lymph nodes. This is called a regional recurrence.
Watch for swelling or lumps in these lymph node areas:
- Under your arm
- Near your collarbone
- In the groove above your collarbone
- In your neck
Cancer Spread to Other Body Parts
When cancer travels to distant parts of the body, it often affects the bones, liver, and lungs. This is called metastatic recurrence.
Common signs include:
- Ongoing pain that gets worse (chest, back, or hip)
- A persistent cough
- Breathing problems
- A reduced appetite
- Unexplained weight loss
- Severe headaches
- Seizures
When To Contact Your Doctor
Your doctor will schedule regular follow-up visits after your breast cancer treatment ends. These checkups help catch any signs of cancer return early.
Don’t wait for your next appointment if you notice worrying symptoms. Make an appointment right away if you find any persistent changes that concern you.
Causes
Breast cancer can return after initial treatment, which medical experts call recurrent breast cancer. This happens when some cancer cells escape the original tumor and hide in breast tissue or elsewhere in the body.
These hidden cells may later begin growing again. After a first breast cancer diagnosis, doctors typically recommend treatments like chemotherapy, radiation, or hormone therapy.
These treatments aim to destroy any remaining cancer cells following surgery. However, sometimes these treatments cannot eliminate all cancer cells completely.
In some cases, cancer cells become dormant (inactive) for years without causing problems. During this time, they don’t grow or spread. Then, for reasons not fully understood by scientists, something triggers these dormant cells to become active again.
When this activation occurs, the cells begin to multiply and potentially spread to other body parts.
Risk Factors
Several factors can increase the chance of breast cancer coming back after treatment. Understanding these risks helps patients and doctors make better treatment plans.
Breast cancer that has spread to nearby lymph nodes at diagnosis puts patients at higher risk for recurrence. The size of the tumor also matters – larger tumors generally have a greater chance of returning.
The edges of removed tumor tissue, called margins, are important too. When doctors remove a tumor, they check if cancer cells reach the edge of the removed tissue:
- Negative Margins: No cancer cells at the edges (lower risk).
- Positive Margins: Cancer cells found at the edges (higher risk).
- Close Margins: Cancer cells very near the edges (higher risk).
After a lumpectomy (removal of the tumor while keeping most of the breast), radiation therapy helps reduce recurrence risk. Skipping this treatment increases the chances of cancer returning.
Age plays a significant role as well. People diagnosed before age 35 face a higher risk of recurrence compared to older patients.
Other important risk factors include:
| Risk Factor | How It Affects Recurrence Risk |
|---|---|
| Inflammatory breast cancer | Higher risk of local recurrence |
| Missing endocrine therapy | Increases risk in hormone-positive cancers |
| Triple negative breast cancer | Higher recurrence risk due to fewer treatment options |
| Obesity | Higher body mass index linked to greater recurrence risk |
Patients with inflammatory breast cancer, a rare but aggressive type, have higher rates of local recurrence. For hormone receptor-positive cancers, not taking prescribed endocrine therapy raises recurrence risk substantially.
Triple negative breast cancer (lacking receptors for estrogen, progesterone, and HER2 protein) tends to have higher recurrence rates. This type has fewer targeted treatment options available.
Body weight also matters. Studies show that obesity increases the likelihood of breast cancer returning after treatment.
Ways to Reduce Risk
There are several steps to help lower the chances of breast cancer coming back after treatment.
Medication Options
Several types of medicines can help prevent breast cancer recurrence:
- Hormone treatments for hormone-positive breast cancers, typically taken for five years or more.
- Chemotherapy for patients with higher recurrence risks.
- Targeted drugs specifically for cancers that produce excess HER2 protein.
- Bone-strengthening medications to reduce the risk of cancer spreading to bones.
Treatment Approaches
Medical treatments play a key role in prevention:
| Treatment | Benefit |
|---|---|
| Radiation therapy | Reduces recurrence risk after breast-conserving surgery or for large/inflammatory breast cancers |
| Hormone therapy | Helps prevent the return of hormone receptor-positive cancers |
Lifestyle Changes
Daily habits can make a significant difference:
- Maintain a Healthy Weight: Extra pounds may increase recurrence risk.
- Exercise Regularly: Physical activity helps reduce cancer recurrence rates.
- Eat a Balanced Diet: Include plenty of vegetables, fruits, and whole grains.
- Limit Alcohol: If you drink, restrict to one drink per day.
These prevention strategies work best when followed consistently. They also work best when combined with regular medical check-ups and screenings.
