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The possibility of breast cancer recurrence can be stressful, but fortunately, the rates are relatively low and it can often be successfully managed. Additionally, the longer it has been since the initial cancer diagnosis, the lower the chances of recurrence. This guide will cover risk factors, screening methods, symptoms of recurrence and frequently asked questions.
For those looking to take proactive control of their breast health, PocketHealth can help. With secure, easy access to your breast imaging records, PocketHealth allows you to better understand your breast health. In addition, PocketHealth offers personalized estimated breast cancer risk scores to help you and your doctor make informed decisions about preventive measures and future screenings.
Breast cancer recurrence is when a patient has previously had breast cancer and it returns later. While anyone who has previously had this condition may have a risk of recurrence, most patients will not experience this.
However, if a patient successfully overcomes cancer in one breast and then in the future the other untreated breast develops cancer, this is not categorized as a recurrent cancer. It is treated as an entirely new case and it is frequently termed as second primary breast cancer.
Recurrence can occur if the initial cancer treatment didn’t eliminate all of the cancer cells. Medical treatments and therapies can shrink tumors so much that the remaining weakened cells are undetectable on tests. If any cancer cells remain, they may grow and cause new tumors over time.
Additionally, if cancer cells spread to other areas, such as the bloodstream or lymph nodes, they may return and lead to recurrence. Overall, recurrence is most common within the first two years after initial treatment, though it can happen later, albeit rarely.
There are three types of breast cancer recurrence, which may affect treatment decisions, imaging methods and additional testing.
This occurs when cancer returns to the area where the original tumor was located, such as the breast tissue or, in cases where a mastectomy was performed, the chest wall. Treatment may be similar to how the initial cancer was addressed, including assessing factors like hormone receptors.
Depending on specifics such as tumor grade, size and stage, more aggressive treatment may be necessary. For example, if a lumpectomy was done for the first occurrence, a mastectomy may be recommended for the recurrence. Since each patient is unique, there is no one-size-fits-all approach. Patients should consult their doctor to determine the best course of action.
Regional cancer recurrence occurs when the disease returns near the original tumor, often around the collarbone or in the underarm (axillary) lymph nodes. While it remains local to the general area of the first cancer, it has spread to nearby regions rather than the exact location of the original tumor.
When breast cancer recurs, it may spread to other areas of the body, such as organs or bones. This can make treatment more challenging, so patients need to discuss their options with their doctor, including exploring new clinical trials or targeted therapy approaches. Fortunately, the majority of recurrent breast cancer cases remain local and do not develop metastatic lesions.
Symptoms may vary depending on where the new cancer cells are located in relation to the original tumor. Local cancer may cause different symptoms compared to cancer that has spread to the lymph nodes, as seen with regional recurrence. Here are some general symptoms of recurrence, keeping in mind that some are more likely to occur with specific types:
A breast screening MRI
Recurrence is typically discovered using similar methods to those used for the initial cancer diagnosis. However, patients with a history of cancer are often recommended to undergo screenings and tests more frequently than those who have never experienced the disease. Here are some common screening and diagnostic methods.
Performing a self-breast exam to feel and look for changes can be helpful in detecting tumors and other symptoms. Some patients may also receive a breast exam as part of their routine annual check-up with their doctor.
The most common breast cancer screening is through mammograms, but other types of imaging can be helpful too. Often, cancer patients receive these scans more frequently than those who have never had cancer. Some of the common methods for this include:
Tumor markers refer to substances created by cells as a reaction to cancer. These substances are typically present in low quantities in most people, but a significant increase may suggest the presence of certain cancers. However, not all cancers produce tumor markers, and high levels do not always indicate cancer. Tumor markers are primarily a starting point, after which further testing is needed to confirm or rule out the presence of the disease.
The standard method for an official breast cancer diagnosis is typically a biopsy. This procedure involves using a thin needle to remove a small tissue sample for analysis. In some cases, an MRI or other imaging technique is used to guide the needle to the exact location being tested. There are variations of the biopsy procedure depending on the location of the tumor and the size of the sample needed.
If breast cancer recurrence is confirmed, treatment will depend on factors such as:
Specific treatment will depend on factors mentioned above. Here are some general methods to be aware of:
A 2D screening mammogram
Turnaround times for breast imaging results can vary widely depending on the facility and your doctor’s availability. Often, patients wait a week or more and receive their results during a follow-up appointment. With PocketHealth, you don’t have to wait as long—your results are available securely as soon as they’re uploaded, allowing you to review them often before your follow-up visit.
When you do gain access to your results, it’s common to find medical terminology somewhat confusing, but Report Reader helps you to better understand your report by offering clear, straightforward definitions for medical terms—simply tap or click on any underlined words to reveal their meaning.
Here are some common questions regarding breast cancer recurrence.
While treating recurrent breast cancer can sometimes be more complex, it doesn’t necessarily mean the prognosis is worse than the first time. Possible outcomes depend on several factors, which vary by individual. The patient’s medical provider will likely have the most knowledge of their specific case. Generally, the earlier the recurrence is diagnosed, the easier it is to treat. Fortunately, most medical providers regularly screen previous cancer patients, so if signs of recurrence appear, it can be addressed early.
Complications depend on factors such as the cancer’s stage, grade and whether it has metastasized. Recurrent cases may require more intensive treatments, but this doesn’t necessarily indicate a worse prognosis. It may simply mean a different or more varied approach than the initial treatment. Ultimately, much depends on the individual and their specific case.
Triple-negative breast cancer and inflammatory breast cancer are the two types most likely to recur later. These types are less common than other forms of breast cancer. Triple-negative breast cancer accounts for 10 to 15% of all cases, while inflammatory breast cancer is even rarer, making up 1 to 5% of all cases.
If a patient had a mastectomy for their initial breast cancer diagnosis, the cancer may still recur in the chest region. However, the recurrence rate is low. About 5% of patients who have had a mastectomy will experience recurrence within 12 years.
There are several recurrence risk factors related to the type and grade of the initial cancer and treatment types, such as radiation or a mastectomy. However, there are some steps that patients may consider to potentially lower their risk:
The possibility of breast cancer recurrence can feel overwhelming and stressful, but remember, you’re not alone. Often, successful treatment for recurring cancer can eliminate the disease, allowing many patients to return to a normal life. The earlier these cases are detected, the more likely this outcome will be.
Regardless of the type or severity of recurrence, reaching out to support services and connecting with other breast cancer survivors can be helpful. Here are some support organizations that may assist patients in navigating their health journey:
Given the repetitive nature of breast imaging, tracking changes over time is essential. Having secure access to all your imaging records in one place allows you to be actively involved in your health journey. You can compare breast changes, send records to other medical providers, and even print and store these reports for your own use. For Mary, accessing her breast imaging through PocketHealth helped her catch the medical recommendation for more frequent mammogram screenings, something her clinic had missed.
Another tool for your breast health is MyCare Navigator, which provides personalized insights to your health and identifies any recommended follow-up steps. This feature can also generate individualized questions to ask your doctor based on the findings in your report, ensuring you make the most of your consultation.
