Recurrent breast cancer can occur months or years after the initial treatment, in the same place as the original cancer or in another area.
Although initial treatment aims to eliminate all cancer cells, a small number of cells may evade treatment and survive, multiplying and becoming recurrent breast cancer.
According to Master, Doctor Nguyen Do Thuy Giang (Head of Breast Surgery Department, Tam Anh General Hospital, Ho Chi Minh City), cancer can recur in the same location as the original cancer (local recurrence) or can spread to other areas (distant metastasis). Treatment can eliminate locally recurrent breast cancer, in the lymph nodes or distant metastasis. Even if it cannot be cured, treatment can control the disease for a long time.
Signs and symptoms of recurrent breast cancer vary depending on the location and extent of the recurrent lesion.
Local recurrence: Local recurrence is when cancer comes back in the same area as the original cancer. If you have had a wide lumpectomy, cancer can come back in the remaining breast tissue. If you have had a mastectomy, cancer can come back in the tissue on your chest wall or in your skin.
Signs and symptoms of recurrence after a wide mastectomy include: a new lump in the breast or an area of uneven firmness, changes in the skin of the breast, dermatitis or redness, and nipple discharge. According to Dr. Giang, signs and symptoms of recurrence of the chest wall after mastectomy include: one or more painless nodules on or under the skin of the chest wall and a new area of thickening along or near the mastectomy scar.
Breast cancer recurs in the same location as the original tumor or spreads to other areas. Photo: Freepik
Regional recurrence: Regional recurrence is cancer that comes back in the lymph nodes on the same side as the original breast cancer, including: the axillary lymph nodes, the lymph nodes above and below the collarbone, or the internal mammary lymph nodes (within the chest). Signs and symptoms of recurrence include lumps or swelling in these lymph nodes: under the arm, in the armpit, near the collarbone, in the groove above the collarbone, in the neck.
Distant recurrences - distant metastases: The most common distant recurrences - distant metastases are to the bones, liver and lungs, and to the contralateral lymph nodes (such as the axillary or supraclavicular or subclavian nodes, mediastinal or intrathoracic nodes). Signs and symptoms include: persistent and worsening pain such as chest, back or flank pain; persistent cough; shortness of breath; loss of appetite; short-term weight loss; severe headache; seizures; contralateral lymph node sites such as the axillary or supraclavicular or subclavian nodes.
Recurrent breast cancer occurs when cells that were part of your original breast cancer break away from the original tumor and hide nearby in the breast or in another part of the body. These cells then start to grow again.
The chemotherapy, biological therapy, radiation therapy, endocrine therapy, or other treatments you received after your initial breast cancer diagnosis were designed to kill any cancer cells that remained after surgery. But sometimes these treatments cannot kill all of the cancer cells.
Dr. Thuy Giang added that cancer cells can lie dormant for years without causing harm. Then something happens to activate these cells, they grow and spread to other parts of the body. Currently, research is unclear why this happens.
Risk factors for breast cancer recurrence include: age (younger than 35 at the time of initial breast cancer diagnosis); obesity (having a higher body mass index) increases the risk of recurrence; cancer stage; triple-negative breast cancer (no receptors for estrogen or progesterone and Her2); inflammatory breast cancer.
There are also other risk factors such as: cancer detected in lymph nodes with lymph node metastasis at the time of initial diagnosis; large tumor size; positive margins (wide surgical margins of tumor excision with very little malignant cells or healthy tissue margin, unsafe); lack of radiotherapy after wide surgical excision; no endocrine therapy for hormone receptor-positive breast cancer.
After completing breast cancer treatment, patients are re-examined and monitored periodically according to the severity of the disease and endocrine treatment. The doctor will check for any symptoms or signs of recurrence, if any, diagnose and treat side effects of endocrine treatment, screen for remaining breast cancer...
You can share any new signs or symptoms with your doctor before your scheduled check-up. If you notice any persistent signs or symptoms that worry you, you should see your doctor.
Duc Nguyen
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