Approximately two-thirds of all recurrences or returns of breast cancer occur within the breast originally affected by the cancer. The majority of times, breast cancer returns very close to the spot where the original cancer was diagnosed. If cancer does not occur at or close to the original spot, it may be considered a new cancer as opposed to a recurrence. This new cancer might occur in a different spot in the same breast or in the other breast.
Returning Breast Cancer
Approximately one-third of local returning breast cancers (cancers that reoccur in the same spot as the original cancer only, with no spread to lymph nodes or other body parts) are identified during a mammogram. One-third are identified during a physical exam, either by a doctor or the patient herself. The final third are found using both mammograms and physical exams.
In 80 percent of returning breast cancer cases, the breast cancer returns only to the spot where the original cancer was (a localized recurrence or local return), and there is no cancer anywhere else in the body.
Local Recurrence
Signs of local recurrence include the formation of a lump at the spot of the cancer, which grows and persists. Thickening of the breast skin near the original site of the cancer, swelling or redness may also be signs of a local return (although they may also be caused by the cancer treatment or a breast infection called mastitis). However, the appearance of a lump does not always signify a return of breast cancer. Lumps can also be caused by the breakdown of fatty tissue from the original cancer treatments, or scar tissue from the original treatment. Local recurrence or return is still possible in women who have had mastectomies. In that case, the lump or skin changes typically occur in the skin or tissue that remains where the breast originally was.
Regional Recurrence
Regional return of breast cancer involves the return of cancer to the original location, accompanied by the presence of cancer cells in the lymph nodes of the arm, collarbone or neck, or in the breastbone, ribs or chest muscles. This is more serious and more difficult to treat than a local return or recurrence. Signs and symptoms of a regional recurrence include swollen lymph nodes under the armpit closest to the breast that was affected by the cancer, and/or swollen lymph nodes in the neck or collarbone.
Distant Recurrence
A distant recurrence or return means that the cancer appears somewhere else in the body besides the breast. This is very dangerous because it means the cancer has metastasized and is no longer curable. Symptoms of distant recurrence include pain in the bones (if bone metastases are present), weight loss (usually associated with liver metastases) or difficulty breathing (a symptom of lung metastases). Common areas of metastases for breast cancer include the chest wall, the bones, the lungs, the liver and the brain.
Reducing the Risk of Recurrence
Treatments such as chemotherapy or radiation following an initial breast surgery may help to prevent a recurrence or return of breast cancer. Continued therapy for several years following a breast cancer diagnosis may help to minimize the chances of breast cancer returning. Hormone receptive cancer may be treated with a continued dosage of hormone control therapy and estrogen blockers for a period of 5 years or greater following the remission of the original cancer.
Tags: breast cancer, original cancer, lymph nodes, local return, recurrence include, recurrence return
