> Return of Cancer after Treatment (Recurrence, Relapse)
The main goal of treating breast cancer is to keep the cancer from coming back (recurrence). Treatment can be a difficult and draining process. If it fails and the cancer returns, you may feel a strong emotional, as well as physical, effect. A breast cancer support group, especially one focused on recurrent breast cancer, may help you address these concerns. For more on support groups, visit the Support section.
Regular follow-up tests help find breast cancer that has returned to the original area (local recurrence), as well as cancer that has spread to other parts of the body (distant recurrence). Local recurrence is usually found during mammograms or physical exams, either by a health care provider or by yourself. Distant recurrence is usually found when people report symptoms during follow-up office visits. Blood and imaging tests (other than mammography or digital mammography) are not effective ways to detect recurrence and are not a standard part of follow-up care. For more on recommended follow-up care, visit the After Treatment section.
Local Recurrence
When a local recurrence is found, it is treated in much the same way as the first tumor. It is removed, examined by a pathologist and tested for known predictive markers such as hormone receptor status and HER2/neu status. If a local recurrence is found, either after mastectomy or lumpectomy (also called breast conserving surgery), tests will be done to see if there is also distant recurrence.
Most people who have a local recurrence after lumpectomy can be treated successfully. Treatment for local recurrence in this group generally includes surgery, usually a mastectomy. Radiation therapy can be considered for those who did not have it as part of their initial treatment.
Even though the entire breast is removed in a mastectomy, cancer can still return to the chest area. The more cancerous lymph nodes a person had at the time of the mastectomy, the higher the chance of a local 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). Hormone therapy, targeted therapy and/or chemotherapy may be used as well.
Distant Recurrence
Distant recurrences (also called metastases) are most often found when people report symptoms. These may include shortness of breath, weight loss or bone pain. Based on these symptoms, tests are done to see if, in fact, the cancer has metastasized (that is, spread to other organs). Common tests include blood tests, bone scans, CT scans, PET scans and chest X-rays. Other tests may also be done depending on the situation. For more information on testing for metastases, see the Diagnosis section.
Common places where breast cancer may spread are the bones, lungs, liver and central nervous system (brain). 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. For details on treatment, visit the Metastatic Breast Cancer section.
Distant Recurrence and Pain Management
Metastatic breast cancer can cause pain in the areas where the cancer has recurred. It is important to manage any pain related to metastatic breast cancer. Even it is 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.
Updated 08/26/09
