Recurrent breast cancer is breast cancer that comes back after initial treatment. Although the initial treatment is aimed at eliminating all cancer cells, a few may have evaded treatment and survived. These undetected cancer cells multiply, becoming recurrent breast cancer.

Symptoms

Signs and symptoms of recurrent breast cancer vary depending on where the cancer comes back.

Local recurrence: the cancer reappears in the same area as the original cancer.

In case of lumpectomy, the cancer could recur in the remaining breast tissue. In case of mastectomy, the cancer could recur in the tissue that lines the chest wall or in the skin.

Symptoms of local recurrence within the same breast may be:

• A new lump in the breast or irregular area of firmness
• Changes to the skin of the breast
• Skin inflammation or area of redness
• Nipple discharge

A regional breast cancer recurrence means the cancer has come back in the nearby lymph nodes.

Signs and symptoms of regional recurrence may include a lump or swelling in the lymph nodes located:

• Under the arm
• Near the collarbone
• In the groove above the collarbone
• In the neck

Distant recurrence (metastatic) recurrence means the cancer has traveled to distant parts of the body, most commonly the bones, liver and lungs.

Signs and symptoms include:

• Persistent and worsening pain, such as chest or bone pain
• Persistent cough
• Difficulty breathing
• Loss of appetite
• Weight loss
• Severe headaches
• Seizures

Causes

Recurrent breast cancer occurs when cells that were part of the original breast cancer break away from the original tumor and hide nearby in the breast or in another part of the body. Later, these cells begin growing again.

Sometimes cancer cells may be dormant for years without causing harm. Then something happens that activates the cells, so they grow and spread to other parts of the body. It's not clear why this occurs.

Risk Factors

For breast cancer patients, factors that increase the risk of a recurrence include:

• Lymph node involvement. Finding cancer in nearby lymph nodes at the time of the original diagnosis increases the risk of the cancer coming back.
• Larger tumor size. Women with larger tumors have a greater risk of recurrent breast cancer.
• Positive or close tumor margins. During breast cancer surgery, the surgeon tries to remove the cancer along with a small amount of the normal tissue that surrounds it.
• Lack of radiation treatment following lumpectomy. Women who don't undergo the radiation therapy have an increased risk of local breast cancer recurrence.
• Younger age. Younger women, particularly those under age 35 at the time of their original breast cancer diagnosis, face a higher risk of recurrent breast cancer.
• Inflammatory breast cancer. Women with inflammatory breast cancer have a higher risk of local recurrence.

Complications

Minor complications include:

• Slight swelling of the breast during radiotherapy.
• The skin becomes darker during the course of radiotherapy, similar to tanning from the sun.
• Most women will have aches or pains from time to time in the treated breast or the muscles surrounding the breast, even years after treatment.
• Rarely, patients may develop a rib fracture years following treatment.

Prevention

Try incorporating these healthy tips:

• Take care of yourself emotionally
• Take care of yourself physically
• Eat healthy
• Reduce stress
• Limit alcohol
• Exercise regularly
• Continue with regular health screenings
• Maintain a healthy weight
• Have your vitamin D levels checked
• Take endocrine therapies as prescribed