Recurrent breast cancer

Diagnosis

The doctor may suggest additional investigation to confirm the diagnosis if they have reason to believe that the patient has recurrent breast cancer based on the findings of a mammogram or physical examination, or signs and symptoms.

Specific investigation and procedures could be the following:

• Imaging tests: To determine the extent of the tumor, the specialist may recommend imaging tests.
  • Magnetic Resonance Imaging (MRI)
  • Computerized tomography (CT)
  • Positron emission testing (PET) scan
• Biopsy: The only method to determine whether your cancer is recurrent is through testing suspicious cells with a biopsy. The pathologist will examine if the cancer is a new type of cancer or a recurrence. The tests will also help to determine whether the malignancy is responsive to hormone therapy or targeted therapy.
  Additionally, tests determine if the cancer is responsive to hormone therapy or targeted therapy because they may have changed since your initial cancer diagnosis.

Treatment

Treatment will vary depending on the severity of the condition, whether it has hormone receptors, the type of treatment that patient had for the initial breast cancer, and the general health will all affect the treatment options. The doctor also takes into consideration the patient treatment choices and goals.

Treatment for local recurrence

Operation is usually the first step in treating a local recurrence, though radiation therapy may also be used if you’ve never had it. Additionally, hormone treatment and chemotherapy might be suggested.

• Surgery: Surgical removal of the breast tissue is recommended if the cancer is located only at the breast.
  • Mastectomy: the doctor may advise a mastectomy to remove all of your breast tissue, including the lobules, ducts, fatty tissue, skin, nipple and some or all of the lymph nodes, if your initial malignancy was treated with a lumpectomy.
• Radiation therapy: this treatment uses high-energy beams, such X-rays or protons to kill cancer cells. The doctor might suggest radiation therapy if the patient didn’t receive it for the initial breast cancer. However, due to the danger of adverse effects, radiation is typically not advised to treat a recurrence if the patient had radiation after a lumpectomy.
• Chemotherapy: drugs are used in chemotherapy to kill cancer cells in order to lower the risk of developing another cancer recurrence.
• Hormone therapy: if the cancer is hormone receptor positive, medication that inhibits the growth-promoting actions of estrogen and progesterone will be recommended.
• Targeted therapy: medication that targets HER2 will likely be recommended if testing reveals that the cancer cells produce an excessive amount of the protein.

Treatment for regional recurrence

Regional breast cancer recurrence may be treated with:

• Surgery: the suggested course of treatment for a regional recurrence is surgery to remove the malignancy. If any lymph nodes are still present under the arm, then the surgeon may recommend removing them.
• Radiation therapy: After surgery, radiation therapy may occasionally be performed. Radiation therapy may be the primary treatment for the regional breast cancer recurrence if surgery is not an option.
• Drug treatments: In addition to being suggested as the primary course of treatment, chemotherapy, targeted therapy, or hormone therapy may be given after radiation or surgery.

Treatment for distant (metastatic) recurrence

There are options for treating metastatic breast cancer. The choices that the patient have will depending on how far the cancer has spread. The purpose of treatment for metastatic breast cancer is to help the patient live longer and relief their current cancer symptoms, not to completely cure them. The goal is to make sure the patient lives as long and as comfortably as they can. Treatment for distant recurrence may include:

• Hormone therapy: This therapy is helpful if the cancer has hormone receptors. Hormone therapy is usually the primary course of treatment for metastatic breast cancer since it has fewer adverse effects than chemotherapy.
• Chemotherapy: If the cancer lacks hormone receptors or if hormone therapy is no longer effective, the doctor might advise chemotherapy.
• Targeted therapy: The doctor may prescribe these this type of medications if the cancer cells exhibit characteristics that make them susceptible to targeted therapy.
• Immunotherapy: Cancer cells produce proteins that help them hide from immune system cells, your body’s disease-fighting immune system may not attack your cancer. Immunotherapy makes use of your immune system to combat cancer. Patient with triple negative breast cancer (breast cancer cells that does not have any of the hormone receptor), the treatment may be immunotherapy combined with chemotherapy.
• Bone-building drugs: to minimize bone fracture or lessen any potential bone discomfort, the doctor may prescribe a bone-building medication if case that cancer has spread to the bones.