When breast cancer returns after successful treatment, it is called recurrent breast cancer. It occurs when lingering cancer cells start to grow again, following a remission period. While it doesn’t recur in every breast cancer survivor, it’s something most survivors think about. Thankfully many new treatments are available through Willamette Valley Cancer Institute, including access to clinical trials with the most advanced treatment options available to our patients. 

Even if recurrent breast cancer cannot be put into remission, it can often be managed using long-term therapies such as hormone or targeted therapies.

Where Does Breast Cancer Recur?

Breast cancer can redevelop in various areas throughout the body ranging from the same breast it was found in originally to distant areas such as the brain or bones. 

Based on where it’s located, recurrent breast cancer is categorized into three categories: local, regional, or distant.

  • Local recurrence means that the cancer has returned to the same breast, which includes the chest wall, skin, remaining breast tissue, or within the surgical scar.
  • Regional recurrence refers to breast cancer that resurfaces in the lymph nodes near the breast but has not spread to distant parts of the body.
  • Distant recurrence means the cancer has metastasized and now affects other parts of the body, such as the brain, liver, bones, and lungs. 

Can You Prevent Breast Cancer Recurrence?

There is nothing specific you can do to avoid breast cancer from recurring. Some factors outside of your control make it more likely to recur including the type and stage of breast cancer identified at the initial diagnosis as well as the size of the tumor and lymph node involvement at diagnosis. 

Some lifestyle choices can have an impact on the likelihood of cancer recurring. Try to do the following to keep your body as healthy as possible:

  • Maintain a healthy weight by eating healthy and exercising
  • Stop smoking, if you are a smoker
  • Stop drinking alcohol or limit to no more than 1 drink a day

We recommend you talk with your oncologist before taking any vitamins or herbal supplements. There is no specific proof that taking vitamins or other supplements reduces the risk of breast cancer recurrence. However, they could interact with medications you’re taking, such as hormone therapy, reducing their effectiveness. 

Symptoms of Recurrent Breast Cancer

Typically, local recurrence is less likely to show symptoms than regional or distant recurrence. The signs and symptoms of recurrent breast cancer vary depending on the location of the cancer’s growth. Common symptoms may include:

  • Nipple changes
  • Persistent chest pain
  • Fatigue
  • Swollen lymph nodes in the breast region
  • New lumps, swollen areas, or unusual firmness
  • Numbness or weakness
  • Nausea or loss of appetite
  • Unexplained weight loss
  • Seizures
  • Bone pain
  • Severe headaches
  • Jaundice (yellowing of the skin or white of the eyes)
  • Difficulty swallowing

Diagnosing Breast Cancer Recurrence

Local breast cancer recurrence is typically discovered during a routine mammogram. Local and more advanced recurrence may be found as a result of a follow up oncology appointment. Be sure to go to your periodic appointment for a breast physical exam, imaging such as a PET scan, and blood tests. Any areas of concern will be biopsied.

If test results indicate a recurrence, further tests are performed, including bone scans or additional imaging scans to determine if the cancer has grown outside of the breast. 

Treatment for Recurrent Breast Cancer at WVCI

When breast cancer has recurred, our oncologists will work with our team to develop a personalized treatment plan based on the location and size of the recurrence. Biomarker test results will also indicate whether a targeted therapy will be effective. Clinical trials may also be available to patients whose breast cancer recurs.

Local Recurrence Breast Cancer Treatment

Surgery is typically the first step in treating local recurrence. This would involve a mastectomy for women who initially had a lumpectomy. If a mastectomy was performed previously, the new tumor—along with some nearby lymph nodes and a margin of healthy tissue—will be surgically removed. Following surgery, radiation therapy might be administered if it wasn't part of the initial treatment plan. Other possible treatments for local breast cancer recurrence include:

  • Hormone Therapy: Medications that block estrogen and progesterone may be effective in preventing cancer cell growth for hormone-receptor-positive cancer.
  • Targeted Therapy: This involves using drugs that block the overproduction of the HER2 protein, with the medication circulating in the bloodstream to target cancer in various body areas.
  • Immunotherapy: Some immunotherapy drugs may not be recommended for first-line treatment but can be suitable for breast cancer recurrence, using the body’s immune system to attack cancer cells.

Regional Recurrence Breast Cancer Treatment

Regional recurrence indicates a tumor has developed and spread to nearby lymph nodes. In this case, surgery will involve removing the affected lymph nodes along with the cancer. After surgery, some patients may receive radiation therapy to eliminate any residual cancer cells.

Related reading: How is Radiation Therapy Used to Treat Breast Cancer?

Systemic therapies, such as hormone therapy, chemotherapy, or targeted therapy, may also be administered to destroy any remaining cancer cells after surgery.

Distant Recurrence Breast Cancer Treatment

Distant recurrence occurs when breast cancer spreads beyond the original site to areas such as the bones, lungs, or brain, making treatment more challenging. Surgery is rarely an option for treating distant recurrent breast cancer. However, several systemic therapies can be used, including:

  • Hormone Therapy: This treatment blocks hormone receptors fueling cancer growth and can be used before or alongside chemotherapy.
  • Chemotherapy: Different chemotherapy drugs may be administered based on their effectiveness at various stages. If one type is no longer effective, several alternative combinations are available.
  • Immunotherapy: This approach boosts the body's immune response against cancer cells.
  • Targeted Therapy: These drugs target cancers with specific genetic markers, such as HER2-positive cancers. Based on biomarker test results, additional targeted therapies can be used for recurrent and late-stage breast cancers that indicate genetic changes within the cancer cells.
  • Palliative Care: Focuses on managing breast cancer symptoms and improving quality of life, which may include bone-building medications and radiation therapy.

Related Reading: 

What is Metastatic Breast Cancer?

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woman discussing breast scan with oncologist after metastatic breast cancer diagnosis

Comprehensive Breast Cancer Treatment in the Willamette Valley

The breast cancer doctors at Willamette Valley Cancer Institute offer the latest breast cancer treatment, including clinical trials, and are here to develop a treatment plan tailored to your needs. If you have been diagnosed with recurrent breast cancer, make an appointment with one of our oncologists at a location convenient to you in Albany, Corvallis, Eugene, Florence, Lincoln City, or Newport, Oregon.

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