Return of Cancer after Treatment (Recurrence, Relapse)

	If Breast Cancer Returns PDF, 124KB
	Breast Cancer 101 (Interactive Multimedia)  - Survivorship and Recurrence Macromedia Flash

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 during a mammogram or 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.  

Blood and imaging tests (other than mammography or digital mammography) are not good ways to detect recurrence or metastasis and are not a standard part of follow-up care. Learn about follow-up care after breast cancer treatment.  

Local recurrence    

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 markers. 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 metastasis.  

Most people who have a local recurrence after lumpectomy 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.  

Even though the entire breast is removed in a mastectomy, cancer can still return to the chest area. The more lymph nodes with cancer a person had at the time of the mastectomy, the higher the chance of a 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

Metastasis (distant recurrence) is most often found when people report symptoms. These may include:

• Shortness of breath
• Weight loss
• Bone pain

Based on these symptoms, tests are done to see if the cancer has returned and spread to other organs (metastasized). Common tests include blood tests, bone scans, CT scans, PET scans and chest X-rays. Other tests may also be done.  

Breast cancer most often metastasizes to the bones, lungs or liver. 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 recurrent breast cancer, may help you address these concerns.

Learn more about support groups.

Updated 04/17/12

Clinical Trials

Unique Issues for Young Women with Breast Cancer