Recurrent Breast Cancer: When Breast Cancer Comes Back

When breast cancer reappears after a period of initial treatment and apparent remission, it is referred to as recurrent breast cancer. Discovering that cancer has reappeared can trigger emotions of surprise, frustration, sorrow, and apprehension. It is entirely normal to feel this way. Coming to terms with the fact that you must once again battle the cancer you previously fought so hard to seemingly defeat may be devastating.

However, there is hope. Since your initial diagnosis, there may have been new medical advances, such as new drugs or techniques that may aid your treatment process and better alleviate side effects. Furthermore, you are now armed with experience from your initial diagnosis. With this experience and knowledge, you may find yourself better equipped to navigate the path ahead. Regardless, be assured that your healthcare team will be there for you every step of the way to help you through this journey. Take as much time as you need to process this devastating information to prepare your mind and body for the ensuing battle ahead.

Breast cancer may recur if there are breast cancer cells that were not removed during the initial treatment. These cancer cells may have evaded detection and continued to grow into a tumor over time.

However, if it is found that you have a new type of cancer or if cancer is found in the opposite breast, it would be considered different from the original cancer. If so, a new treatment strategy will have to be used on this new cancer, depending on its type and stage.

When there are initial suspicions of recurrent breast cancer, the cancer will first be assessed to determine its type and stage. This will involve tests such as lab tests and imaging procedures. These tests will be similar to the ones you may have had during your initial cancer diagnosis. According to the test results, recurrent cancer will be classified as one of the following types:

• Loco-regional recurrence

A recurrent breast cancer is considered local if it is found in the same breast or very close to it, and regional if breast cancer cells are found in nearby lymph nodes or in tissues near the original cancer.

• Distant recurrence

A breast cancer recurrence is distant if breast cancer cells are found in organs or tissues far from the original cancer. This type of cancer is said to have metastasized and is known as metastatic breast cancer.

The treatment for recurrent breast cancer will depend on various factors. The intent of treatment recommended, whether to cure the cancer or provide palliative care, will mainly depend on whether surgery is possible. The sequence or type of treatment offered will be dependent on the type of breast cancer, considering the extent and site(s) of the breast cancer and the biomarkers associated with it.

• Loco-regional recurrence

A loco-regional recurrence will usually be treated with surgery first, if possible, depending on the initial treatment. Those who had breast-conserving surgery during their initial treatment will likely have to undergo a mastectomy. Those who already had a mastectomy during their initial treatment may still undergo surgery to remove as much of the tumor as possible, followed by radiation therapy.

Breast cancer that has spread to nearby lymph nodes will usually be removed through lymph node surgery, if possible. Other treatment methods, such as radiation therapy, hormone therapy, chemotherapy, targeted therapy, immunotherapy, or a combination of these may also be used to treat the regional recurrent breast cancer.

• Distant recurrence

Distant recurrent breast cancer will be treated the same way as treating metastatic, or stage IV, breast cancer.

It's important to note that every case of recurrent breast cancer is unique, and treatment approaches vary based on individual circumstances. Open communication with healthcare providers and adherence to recommended treatments is vital as it enables you to receive the best possible chance for a positive outcome. Do not underestimate the power of emotional support from loved ones and support groups, as they are also integral to managing recurrent breast cancer effectively. Sharing your experiences, concerns and feelings with those who care about you can provide additional comfort and strength. You are not alone in this, and the stronger your support network is, the better you can effectively cope with the complexities of recurrent breast cancer.