Breast Cancer Recurrence: What Patients Need to Know & How to Cope

Facing breast cancer is a journey filled with ups and downs. Just when you think the road is getting smoother, the fear of recurrence can cast a shadow. The fundamental truth, however, is this – you are never traversing this path in isolation. We are here to stand with you, offering our support by sharing the valuable insights contained in this blog.

In this blog, we want to embark on this journey together and explore the world of breast cancer recurrence, demystify what it entails, discuss what you might expect and most importantly, uncover ways to find strength and hope in the midst of it all. Our goal is simple and heartfelt – to equip you with knowledge, envelop you with support and wrap you in a comforting embrace of encouragement. You’re not just a patient; you’re a brave soul on a profound journey, and we’re here to stand with you, every step of the way.

LET’S GET INTO THE ROOT OF BREAST CANCER RECURRENCE

Although treatments like – chemotherapy, radiation, hormone therapy or other treatments administered following the initial breast cancer diagnosis are designed with the intention of eradicating any cancer cells that could have persisted after surgery, yet, in some cases, these treatments may not be fully effective in eliminating all of the cancer cells. Recurrent breast cancer occurs when cells, once part of the original tumor, quietly break away and hide, either within the breast or elsewhere in the body. Over time, these dormant cells can unexpectedly regain their vitality.

The most common type of recurrent breast cancer in men and women are as follows:

• Local Recurrence: Cancer reappears in or near the same breast or the chest wall.

Suggested Treatment: The preferred approach for local recurrence is surgical intervention. This may involve performing a mastectomy if the patient has not undergone one previously or surgically removing the tumor. Subsequent to the surgical procedure, a combination of breast cancer chemotherapy and radiation is often employed.

Hormone therapy or targeted therapy may also be considered, depending on whether the specific cancer type is receptive to either or both of these treatments.

• Regional Recurrence: Cancer returns in the lymph nodes near the original tumor.

Suggested Treatment: In cases of regional recurrence, the initial course of action typically involves surgical intervention to eliminate affected lymph nodes. Following the surgical procedure, the patient is often recommended to undergo radiation therapy, with the potential addition of chemotherapy, hormone therapy and/or targeted therapy as part of the treatment plan.

• Distant Recurrence: Cancer metastasizes, spreading to other parts of the body, such as the bones, liver or lungs.

Suggested Treatment: When cancer reappears at a distant site, the primary mode of treatment is drug therapy, which may include chemotherapy, hormone therapy, targeted therapy for breast cancer or a combination of these. Breast cancer surgery and/or radiation might be considered, but primarily to alleviate symptoms in specific cases.

Please note: When cancer in one breast responds to treatment, but another tumor develops in the untreated breast, healthcare providers categorize it as a new cancer rather than recurrent breast cancer. They may refer to this as a second cancer.

9 FACTORS THAT INCREASES THE CHANCES OF RECURRENT BREAST CANCER

Breast cancer survivors are resilient individuals who have triumphed over a challenging journey. However, their battle continues in the form of vigilance against the potential recurrence of this formidable adversary. Understanding the factors that may heighten the risk of breast cancer recurrence is a crucial step in this ongoing fight. 

Below, we have mentioned several risk factors that survivors should be aware of and discuss with their oncologist on how they can influence the course of this disease. 

• Lymph Node Involvement: Discovering cancer in nearby lymph nodes during your initial diagnosis raises the risk of cancer returning.
• Larger Tumor Size: Individuals with larger tumors have a heightened risk of recurrent breast cancer.
• Positive/Close Tumor Margins: Tumor margins are critically examined during breast cancer surgery. If any part of the border contains cancer cells (positive margin) or if the margin between the tumor and normal tissue is narrow, the risk of recurrence increases.
• Absence of Radiation Treatment After Lumpectomy: While most individuals opting for a lumpectomy undergo breast radiation therapy to lower the risk of recurrence, those who skip this treatment have an increased risk of local breast cancer recurrence.
• Younger Age: Those under 35 at the time of their initial breast cancer diagnosis, particularly, face a higher risk of recurring breast cancer.
• Inflammatory Breast Cancer: People with inflammatory breast cancer are at a greater risk of local recurrence.
• Lack of Endocrine Therapy: For individuals with Hormone Receptor-Positive Breast Cancer, failing to undergo endocrine therapy can elevate their risk of recurrence.
• Cancer Cells with Specific Traits If you had triple-negative breast cancer, there’s an increased risk of recurrent breast cancer. Triple-negative breast cancer lacks estrogen or progesterone receptors and does not overproduce the HER2 protein.
• Obesity: We all are aware of the severe health risks associated with obesity, such as cardiovascular diseases, high blood sugar and more. However, it’s important to note that a higher body mass index is also connected to an increased risk of cancer recurrence, especially in the breast area.

DETECT RECURRENT BREAST CANCER SYMPTOMS & TAKE PROMPT ACTIONS

The symptoms of recurring breast cancer can vary based on the location it is reappearing. For instance, when cancer reappears in the same area as the initial cancer (local recurrence), it presents different signs compared to regional recurrence, which involves breast cancer spreading to nearby lymph nodes. Symptoms of local recurrence of breast cancer includes:

• Lumps/bumps on or under your chest.
• Changes in nipple (For instance: flattening of nipple or weird discharge).
• Swelling of the skin/skin tightening near the lumpectomy site.
• Thickening on or near the surgical scar.
• Abnormally firm breast tissue.

On the other hand, regional breast cancer recurrence can result in:

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

Distant or metastatic breast cancer (Stage 4) can affect various organs including the bones, lungs, brain or even liver. Distant recurrent breast cancer symptoms will depend on the site of cancer spread and may include:

• Pain in areas where breast cancer has spread, particularly bone pain.
• Persistent dry cough.
• Dizziness, balance issues or seizures.
• Profound fatigue.
• Decreased appetite, nausea and weight loss.
• Severe headaches.
• Numbness or weakness.

BREAST CANCER RECURRENCE: COPING STRATEGIES FOR PATIENTS

Dealing with the idea of breast cancer coming back can stir up a whirlwind of emotions. But you know what? We’re in this together. Here are some coping strategies that can make this journey a little easier for patients suffering from breast cancer that reappeared after years of disappearing. Read on!

1. Open Communication: Maintain open and honest communication with your Oncologist. Discuss your concerns, fears, and ask questions about your risk factors and breast cancer recurrence treatment.

2. Regular Follow-Ups: Attend your follow-up appointments as scheduled  to monitor your health and address any early signs promptly for breast cancer recurrence prevention.

3. Healthy Lifestyle: Focus on maintaining a balanced diet, engaging in regular physical activity and avoiding tobacco and excessive alcohol consumption. A healthy lifestyle can positively impact your overall well-being!

4. Stress Management: Find stress-reduction techniques that work for you, such as mindfulness, meditation or yoga. Managing stress can improve your emotional and physical health.

5. Support Network: Lean on your support network that includes your friends and family members. You can also choose to enroll yourself in a patient community as connecting with others who have experienced similar challenges can provide immense emotional support.

6. Genetic Counseling: 15% of women diagnosed with breast cancer have a family history of the disease. If you have a first-degree relative like a mother, or sister, who has had breast cancer, your risk of developing it yourself is nearly doubled. This is when you need to go for genetic counseling, in order to better understand your genetic risk factors and potential breast cancer recurrence prevention measures.

Conclusion:

Breast cancer recurrence is tough. But knowing what to expect and how to handle it is empowering. Taking steps to reduce the risk and seeking support from your healthcare team, loved ones & patient communities can help you face it with strength.

If you are a patient who has or is still battling breast cancer, open up and share your thoughts. You have the potential to make a big difference by sharing your experiences through MDForLives’ paid surveys and get rewarded for it! This helps improve breast cancer recurrence treatment. Together, we can give hope to others facing the same challenges.

References: 

• Recurrent Breast Cancer
  Source: mayoclinic.org
• Breast Cancer Recurrence
  Source: clevelandclinic.org
• Breast cancer recurrence
  Source: cancercenter.com