Breast Cancer Recurrence

Breast cancer recurrence is when breast cancer comes back (recurs) after successful treatment. This can happen in the first few years after you complete treatment. Rarely, some types of breast cancer come back many years later. Recurrent breast cancer may be:

• Local: Cancer returns in the same breast (chest) area as the original tumor.
• Regional: Tests show cancer near the original tumor, in lymph nodes in your armpit (axillary lymph nodes) or in or around your collarbone area.
• Distant: Cancer that started in your breast comes back in your bones, brain, liver or lungs. This is metastatic breast cancer.

Breast cancer that develops in places like your bones or lungs is still breast cancer. That’s because breast cells are different from the cells in the other areas where it can spread.

Newer treatments are reducing the risk that breast cancer will come back. And there are several ways to treat it.

What type of breast cancer has the higher recurrence rate?

There are many types of breast cancer, which makes it hard to estimate a single recurrence rate that applies to every situation. According to the American Cancer Society, inflammatory breast cancer (IBC) and triple-negative breast cancer (TNBC) are more likely to come back than other breast cancer types.

How long can it take for breast cancer to come back?

Research suggests that in some cases, breast cancer can return 10 to 30 years after diagnosis and treatment. But different breast cancer types have different rates of recurrence. And factors like the cancer stage and cancer treatment may play a role.

It’s normal to wonder whether breast cancer will come back. Share your concerns with your cancer care team. They’ll explain how your specific diagnosis and treatment may affect your risk. They’ll also discuss ways to reduce the potential risk.

Symptoms of recurrent breast cancer

Your symptoms will depend on where the recurrent cancer develops. For example, local recurrent cancer symptoms are very different from the symptoms that develop when cancer spreads.

Local recurrent cancer

This is when cancer comes back in the same area as the original cancer. You may have:

• Breast lumps or bumps on or under your chest
• Nipple changes, such as flattening or nipple discharge
• Swollen skin or skin that pulls near the lumpectomy site
• Thickening on or near the surgical scar
• Unusually firm breast tissue

Regional recurrent breast cancer symptoms

In this case, there’s cancer in areas close to the breast affected by cancer. There may be breast cancer cells in your armpit lymph nodes or around your collarbone. You may have:

• Chronic chest pain
• Difficulty swallowing
• Pain, swelling or numbness in one arm or shoulder
• Swollen lymph nodes in your armpit or in or around your collarbone area

Distant recurrent breast cancer symptoms

This is breast cancer in your bones, brain, liver or lungs. Your symptoms may be:

• Pain where breast cancer has spread, including bone pain
• Chronic dry cough
• Dizziness, balance problems or seizures
• Extreme fatigue
• Loss of appetite, nausea and weight loss
• Severe headaches
• Numbness or weakness

Recurrent breast cancer causes

This condition often happens when treatment doesn’t kill all the cancer cells in your breast. Breast cancer treatments are effective. But eliminating breast cancer cells can be tricky.

For example, cancer treatment may shrink breast cancer tumors but leave behind weakened microscopic cancer cells. Tests may not spot these cells. Over time, some cells can start to grow and make new tumors in your breast or another area of your body.

Or you may develop recurrent breast cancer if cancer cells in your breast move into your bloodstream or lymph nodes before you start treatment. In that case, the cells may travel to another area of your body. They may multiply to make new tumors.

Anyone with a breast cancer diagnosis can have a recurrence. But certain issues increase the chance that breast cancer will come back, including:

• Age: Females who develop breast cancer before age 35 are more likely to get breast cancer again.
• Cancer stage: Cancer that was only in your breast is less likely to come back. But cancer in your lymph nodes increases the chance of recurrent breast cancer.
• Cancer treatment: Procedures like mastectomy and lumpectomy may increase the risk. So can treatments like chemotherapy or radiation therapy.
• Hormone receptor status: Some breast cancer tumors use estrogen or progesterone to grow. Hormone receptor-positive cancer (HR+) and HER2-positive cancer (HER2+) are more likely to come back.

Complications of recurrent breast cancer

The new tumor may be more challenging to treat. You may need different or more aggressive cancer medication or treatment, especially if you have metastatic breast cancer.

How doctors diagnose recurrent breast cancer

Your healthcare provider will do some of the same tests you had when you first received your breast cancer diagnosis, including:

• Mammograms
• Ultrasounds
• CT, MRI or PET scans
• Blood tests for tumor markers
• Biopsy

How is recurrent breast cancer treated?

Your cancer care team will look at factors like where cancer has spread and the type of cancer treatment you’ve already had. The next set of treatments may combine surgery and medication. Some potential procedures include:

• Lumpectomy: If you had this procedure before, your provider may do another lumpectomy to remove the new tumor. You may also have radiation therapy.
• Mastectomy: Your provider may recommend a mastectomy if you had a lumpectomy to remove a tumor in or near your breast. They may suggest removing one or both of your breasts and nearby lymph nodes.

Other potential treatments include:

• Chemotherapy
• Hormone therapy
• Immunotherapy
• Targeted therapy

Your new diagnosis may trigger waves of emotions. You may feel angry or sad about your situation or fearful about the future. You may simply feel overwhelmed by all the ways that cancer affects you and your family.

Ask your cancer care team for help. They may recommend palliative care for breast cancer. This care focuses on supporting you through recurrent breast cancer treatment and beyond.

When should I see my healthcare provider?

If you had a lumpectomy, tell your provider about any breast lumps, bumps or nipple discharge. If you had a mastectomy, contact your provider if you have swelling near your surgical scar or thickening skin.

​What can I expect if I have recurrent breast cancer?

In general, your odds of living five years or more are good after treatment for local or regional recurrent breast cancer. The odds aren’t as favorable when recurrent cancer develops in more distant areas of your body.

It’s understandable that you’d like to know what could happen after treatment. You probably had similar questions when you were first diagnosed with breast cancer. Your healthcare provider was your best resource for information then, and they’re your best source now.

Can breast cancer recurrence be prevented?

Experts don’t fully understand why breast cancer comes back in some people and not in others. That makes it hard to prevent. Some cancer medications may reduce the risk. For example, having chemotherapy after surgery may help to keep some types of breast cancer from coming back.

While you may not be able to prevent recurrent breast cancer, there are things you can do to lower your risk, including:

• Eat well: Meals that balance protein, whole grains, fruit and vegetables support your immune system and give you energy. Cancer symptoms and treatment can take away your appetite. Try eating several small meals during the day.
• Stay physically active: Having obesity is a cancer risk factor. Regular physical activity can help you manage your weight.
• Avoid alcohol and tobacco: Alcohol and tobacco are known carcinogens (substances that may increase your cancer risk).

Checking your breasts monthly and getting regular follow-up screenings may help you and your provider spot recurrent breast cancer before it spreads or creates large tumors.

Is cancer in my untreated breast recurrent breast cancer?

No. Healthcare providers would consider it a new breast cancer.