Recurrent breast cancer

Overview

When breast cancer recurs after initial treatment (mastectomy, chemotherapy, or other treatments), it is called recurrent breast cancer. A few cancer cells may have evaded treatment and survived, despite the initial treatment’s goal of eliminating all cancer cells.

Finding out you have recurring breast cancer could be more difficult to deal with than receiving the initial diagnosis. However, there is still hope if breast cancer returns. Treatment can get rid of local, regional, or distant recurrent breast cancer. Even if a cure is not feasible, medication may give the illness long-term control.

The breast cancer recurrence may not be the same as the initial diagnosis. The following are types of recurrent breast cancer:

• Local recurrence: the recurrences of the cancer at the same location as the initial diagnosis.
• Regional recurrence: recurrence near the original location, either at the lymph nodes at the armpit or at the collarbone area.
• Distant recurrence: this type of breast cancer spreads outside of the initial location to the bones, brain, lungs, or other organs (metastasis). This type is known as stage 4 breast cancer.

Symptoms

The location of the cancer recurrence affects the signs and symptoms of recurrent breast cancer.

• Local recurrence
  • Development of a new lump in the breast
  • Unusual firmness of breast
  • Skin changes at the breast
  • Redness or inflammation of the skin
  • Nipple changes or discharge
  • Few painless nodules on or under the skin of the chest wall
  • Thickening at a new location along or close to the surgical scar.
• Regional recurrence
  • Chest pain
  • Difficulty in swallowing
  • Lump or swollen lymph node under the armpit
  • Lump or swollen lymph node near the collarbone
  • Lump or swollen lymph node at the neck
• Distant recurrence
  • Constant and escalating pain at the hip, back, or chest
  • Persistent dry cough
  • Difficulty breathing
  • Loss of appetite
  • Unexplained weight loss
  • Severe headaches
  • Seizures
  • Dizziness
  • Fatigue or weakness

The specialist will recommend a follow-up checkup and examinations after the initial breast cancer treatment. Specialist will assess for any signs and symptoms of breast cancer recurrence during the follow up checkup.

If patient notice any persistent signs and symptoms, they need to have an appointment with their specialist.

Causes

When cancerous cells from your primary breast tumor separate and are still present nearby in the breast or another area of your body, this cell may grow over time and develop into recurrent breast cancer.

In order to eradicate any cancer cells that could have remained after surgery, patient may have to undergo chemotherapy, radiation, hormone therapy, or other forms of treatment after being initially diagnosed with breast cancer.

However, there are cases that these therapies are unable to completely eliminate the cancer cells. It is however possible for cancer cells to remain dormant for years without harming anyone.

Risk factors

Factors that increase the risk of a recurrence for breast cancer include:

• Lymph node involvement: risk of the cancer returning is increased if patient was initially diagnosed with cancer and further found cancer in the surrounding lymph nodes.
• Tumor size: Recurrent breast cancer is more likely in people with larger tumors.
• Positive margins: A negative margin is one in which, when inspected under a microscope, the borders are cancer-free. The likelihood of breast cancer returning is higher if the border contains cancer cells (positive margin) in any location or if the tumor margins are nearby the surrounding healthy tissue.
• Lacking radiation therapy: To lower the chance of recurrence, most patients who choose for a lumpectomy (wide local excision) for breast cancer also receive breast radiation therapy and those who did not undergo radiation are more likely to experience a localized breast cancer recurrence.
• Age: Younger persons have a higher risk of developing recurrent breast cancer, especially if they were under 35 at the time of their initial diagnosis.
• Inflammatory breast cancer: Greater risk of local recurrence occurs in patient with inflammatory breast cancer.
• Lack of hormone receptor-positive breast cancer. Not getting hormonal therapy can increase the chance of recurrence in patients with a specific kind of breast cancer.
• Obesity: Chances of recurrence increases with a higher body mass index.
• Cancer cells with specific characteristics: Higher chance of breast cancer recurrence may exist if you had triple negative breast cancer. The HER2 protein is not overproduced in triple negative breast cancer cells, nor are they filled with estrogen or progesterone receptors.