Symptoms and treatments of recurrent breast cancer

Symptoms and treatments of recurrent breast cancer.  Breast cancer recurrence is a common occurrence in clinical practice. What are the symptoms when it recurs?

Breast cancer recurrence or “recurrent breast cancer” refers to cancer that recurs to the same or opposite breast or chest wall after a period of time after the cancer cannot be detected.

During surgery to remove breast cancer (lumpectomy or mastectomy) for the original diagnosis, the surgeon will remove all cancer that can be seen and felt. But the detection of cancer is not sensitive enough to detect the tiny group of cancer cells that may be left after surgery. Isolated cell populations may survive radiation therapy and chemotherapy, aiming to reduce the risk of recurrence. Even single cells that escape treatment can multiply and grow into tumors.

Breast cancer can return to three general areas:

·The area of ​​the breast where cancer was first diagnosed, this is called local recurrence

· Lymph nodes in the armpit or clavicle area where cancer was first diagnosed. This is called regional recurrence

· Another part of the body, such as lungs, bones or brain, rarely, the opposite breast, this is called metastasis or distant recurrence

Some doctors believe that local and regional breast cancer recurrences have many of the same characteristics, so they may use the term “localized” recurrence.

Studies have shown that when breast cancer recurs, the nature of the cancer may change. For example, the hormone receptor status may change from hormone receptor positive to hormone receptor negative. The HER2 status may also be different from the original breast cancer. If you have already received breast cancer treatment and now have a new diagnosis of breast cancer recurrence, your doctor may want to perform a biopsy of the metastatic area to determine if there are any changes in hormone receptor or HER2 status.

▌Local recurrence

Local breast cancer recurrence means that the breast cancer is in or near the same place where it was originally found in the breast.

◆ Symptoms of local recurrence

Local breast cancer recurrence may cause any of the following symptoms:

• A new lump on the breast
• Unnaturally firm new breast areas
• Redness or swelling of the skin in or around the breast area
• Flattening of nipples or other changes
• Collision on or under the skin of the chest wall
• New skin or swelling at the site of breast tumor removal
• Mastectomy scar

After breast cancer surgery and radiation, the entire breast area can be swollen and reddened for several months. But if you are worried about any changes in your breasts, please consult your doctor. Redness can also be a sign of infection, so it’s a good idea to have a doctor see it.

If you had a mastectomy and reconstructed the breast, you may develop a harmless lump due to the accumulation of scar tissue or dead fat cells in the reconstructed breast. These types of lumps are not cancer. Despite this, your doctor still needs to know about any bumps you feel in your breasts in order to monitor changes in size or tenderness. Since mastectomy and reconstruction usually remove all breast tissue and replace it with other tissue or implants, mammograms are generally not recommended for breast reconstruction. Your doctor can monitor any new masses on the reconstructed breast by performing a clinical breast exam, such as an MRI.

◆ Test to diagnose local recurrence

If you have a lumpectomy and a new lump will appear later, your doctor may order you to have a mammogram. If the results of the mammogram are unclear or suspicious, the doctor may ask you to have an ultrasound, MRI or PET scan. If these tests indicate a recurrence, the doctor will perform a biopsy of the lump.

◆ Treatment of local recurrence

If you have a local breast cancer recurrence (the cancer was first diagnosed in the same area) and your original treatment was lumpectomy and radiation therapy, your doctor may recommend mastectomy. Doctors rarely recommend a second lumpectomy to treat local recurrence. If you have never received radiotherapy before, it is usually only an option, and the risk of cancer spreading is very, very low.

If breast cancer recovers in the reconstructed breast, the doctor may recommend removing the implant or flap used to reconstruct the breast. It is possible that the breast can be completely reconstructed again in the future. You can discuss your options with your physician and plastic surgeon.

If breast cancer recurs locally, your doctor may recommend some or all of the following treatments, depending on the characteristics of the cancer:

·Surgery to remove the affected lymph nodes

·Chemotherapy

·Radiation Therapy

·If the cancer is hormone receptor-positive hormone therapy

·Targeted therapy

If you are diagnosed with locally recurring breast cancer, you and your doctor will decide on the treatment plan based on the characteristics of the cancer.

▌Regional recurrence

Regional breast cancer recurrence means that the breast cancer has returned to the lymph nodes of the armpit or collarbone near the area where the cancer was first detected.

◆ Symptoms of regional recurrence

Regional recurrence of breast cancer may cause any of the following symptoms:

Lumps or swelling of lymph nodes under the arm, above the collarbone, or near the breastbone

Swelling in the arm on the same side where breast cancer was first discovered

Constant pain in arms and shoulders

· Loss of sensation in arms and shoulders

·Continuous chest pain

·Problems with swallowing

◆ Test diagnosis area recurrence

For people who have had a lumpectomy in the past and have any of the above symptoms, doctors usually recommend mammograms. Mammograms can sometimes detect enlarged lymph nodes. If your lymph nodes are enlarged or any other symptoms of local recurrence, your doctor will perform a biopsy of the lymph nodes to determine if the cancer has recurred. Your doctor may also want you to have an ultrasound, MRI, CT or PET scan.

For people who have had a mastectomy in the past and have any of the above symptoms, the doctor will most likely recommend a PET scan or a CT scan.

◆ Treatment of local recurrence

If breast cancer returns to the lymph nodes in the armpit or collarbone, your doctor may recommend some or all of the following treatments based on the characteristics of the cancer:

·Surgery to remove the affected lymph nodes

·Chemotherapy

·Radiation therapy if the area has never received radiotherapy

·If the cancer is hormone receptor-positive hormone therapy

·Targeted therapy

If you are diagnosed with a regional recurrence of breast cancer, you and your doctor will decide a treatment plan based on the characteristics of the cancer.

▌Metastasis or distant recurrence

When breast cancer returns in other parts of the body, it is called “metastatic”. Metastatic breast cancer is stage IV breast cancer.

The most common sites of breast cancer metastasis are bones, lungs, brain and liver. Symptoms may vary by location and may include bone pain, numbness or weakness in any part of the body, persistent dry cough, loss of appetite, severe headache, vision problems, persistent nausea, weight loss, and seizures.

Tests to diagnose the recurrence of metastatic breast cancer include blood tests, X-rays, MRI, CT scans, PET scans, bone scans, and biopsies.

(source:internet, reference only)

Disclaimer of medicaltrend.org