The goal of treating early and locally advanced breast cancer is to remove the cancer and keep it from coming back (breast cancer recurrence).
Breast cancer can recur at the original site (called local recurrence). It can also return and spread to other parts of the body (called metastasis or distant recurrence).
Local recurrence is usually found on a mammogram, during a physical exam by a health care provider or if you notice a change.
Metastasis is usually found when symptoms are reported during follow-up office visits with your provider.
Learn about follow-up care after breast cancer treatment.
When a local recurrence is found, it is treated in much the same way as the first breast cancer.
The tumor is removed by the surgeon, examined by the pathologist and tested for hormone receptor status, HER2 status and other characteristics.
Tests are also done to be sure there is no sign of metastasis.
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 chemotherapy, hormone therapy and/or targeted therapy.
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 with surgery followed by radiation therapy (if radiation therapy was not part of initial treatment). Treatment may also include chemotherapy, hormone therapy and/or targeted therapy.
Metastasis (distant recurrence) is most often found when people report symptoms. These may include:
Do not panic if you have symptoms like weight change or 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 may include:
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 spreads 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 status and HER2 status of the tumor. Then, you and your provider can discuss treatment options.
Learn more about treatment of metastatic breast cancer.
Metastatic breast cancer can cause pain in the areas where the cancer has spread.
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.
Treatment for breast cancer can be a trying and draining process.
If the cancer returns, you may have a strong emotional and physical response. A cancer support group may help you address these concerns.
Learn more about support groups.
Komen Support Resources
Breast Cancer 101: Survivorship and Recurrence
If Breast Cancer Returns
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