> Return of Breast Cancer after Treatment (Recurrence, Relapse)
The goal of treating early stage and locally advanced breast cancer is to remove the cancer and keep it from coming back (called recurrence or relapse).
How is a recurrence or metastasis found?
Breast cancer can recur at the original site (called recurrence or local recurrence), as well as spread to other parts of the body (called metastasis or distant recurrence).
- Local recurrence is usually found on a mammogram or during a physical exam, either by a health care provider or by yourself.
- Metastasis is usually found when symptoms are reported during follow-up office visits.
Learn about follow-up care after breast cancer treatment.
When a local recurrence (recurrence) is found, it is treated in much the same way as the first tumor. It is removed by the surgeon, examined by the pathologist and tested for hormone receptor status, HER2/neu status and other characteristics. When a local recurrence is found, tests are done to be sure there is no sign of metastasis.
Local recurrence after lumpectomy
Local recurrence after lumpectomy (breast conserving surgery) most often can be treated successfully. Treatment generally includes surgery, usually a mastectomy. Radiation therapy may be given if it was not part of the initial breast cancer treatment. Treatment may also include hormone therapy, chemotherapy and/or targeted therapy.
Local recurrence after mastectomy
Even though the entire breast is removed in a mastectomy, breast cancer can still return to the chest area. The more lymph nodes with cancer at the time of the mastectomy, the higher the chances of breast cancer recurrence. Local recurrence after a mastectomy is usually treated effectively with surgery followed by radiation therapy (if radiation therapy was not part of initial treatment). Treatment may also include hormone therapy, chemotherapy and/or targeted therapy.
Metastasis (distant recurrence) is most often found when people report symptoms. These may include:
- Shortness of breath
- Weight loss
- Bone pain
Do not panic if you have symptoms like weight change and bone pain. These are common and most often do not mean that the breast cancer has spread. However, you should discuss any symptoms with your health care provider.
Based on the symptoms above, tests are done to see if the breast cancer has returned and spread to other organs (metastasized). Depending on the symptoms, follow-up tests, such as blood tests (including tumor marker tests) and imaging tests (including bone scans, CT scans, PET scans and chest X-rays) may be used to check for metastases. Other tests may also be done. For people with no symptoms of metastases, blood and imaging tests (other than mammography) are not a standard part of follow-up care. Using blood or imaging tests to check for early metastases in people with no symptoms of metastases does not increase survival .
Breast cancer most often metastasizes to the bones, lungs, liver or brain. Although it has spread to another part of the body, it is still considered and treated as breast cancer. For example, breast cancer that has spread to the bones is still breast cancer (not bone cancer) and is treated with breast cancer drugs, rather than treatments for a cancer that began in the bones.
When metastases are present, tests are done to determine which organs are involved and the hormone receptor- and HER2/neu-status of the tumor. Then, you and your provider can discuss treatment options.
Learn more about tests for metastases.
Learn more about treatment of metastatic breast cancer.
Metastasis and pain management
Metastatic breast cancer can cause pain in the areas where the cancer has recurred. It is important to control any pain related to metastatic breast cancer. Even mild pain can interfere with daily life and make other side effects, such as fatigue, seem worse.
Learn more about management of pain related to metastatic breast cancer.
Recurrence and support
Treatment for breast cancer can be a difficult and draining process. If the cancer returns, you may feel a strong emotional and physical effect. A breast cancer support group, especially one focused on breast cancer recurrence, may help you address these concerns.
Learn more about support groups.