Breast cancer health centre

Checking for breast cancer recurrence

Breast cancer recurrence means the cancer has come back some time after treatment.

The outlook after recurrence will usually depend on the location of the recurrence and how far it has spread.

Breast cancer recurrence may be detected during routine follow-up appointments after treatment, or it may be identified between appointments if something doesn't seem right with a breast.

Breast awareness and breast cancer recurrence

The same breast awareness that's important for detecting the first breast cancer is just as vital when checking for a recurrence - knowing what your breasts and surrounding area are like and examining them regularly to look for changes or anything unusual.

This might be:

• Areas of a breast seeming different from other areas
• Lumps or small masses
• Thickening of skin near the breast or under arms
• Changes in the size, shape or contours of the breasts
• Marble-like areas under skin
• Skin feeling different on the breast or around the nipple, including dimples, puckering, scaly appearance, redness, inflammation, swelling or warmness
• Discharge from the nipples.

Types of breast cancer recurrence

Types of breast cancer recurrence are:

Local recurrence

This means the cancer has come back in the area where the original tumour had been removed.

The success of treatment for local recurrence may be better if there's been a longer time between the original treatment and the new cancer being discovered.

It isn't clear whether having a local breast cancer recurrence means that there's a greater chance or not of the cancer spreading elsewhere in the body in future.

Local recurrence may be treated with a mastectomy if a lumpectomy was originally performed.

Locally advanced breast cancer (regional recurrence)

This means the cancer has returned and spread to tissue and lymph nodes in the area around the chest, neck and beneath the breastbone. As there is a risk of cancer spreading to other parts of the body, treatment affecting the entire body may be recommended, such as chemotherapy, hormone therapy and some targeted treatments.

Treatment may include a combination of surgery, drugs and radiotherapy.

Secondary breast cancer

This means the cancer has returned and has spread elsewhere in the body - called metastatic - which may affect bones, lungs, liver or brain.

Secondary breast cancer cannot be cured but it can be treated to slow its spread and relieve symptoms.

The goal of treatment for a recurrence of metastatic breast cancer is to extend and improve quality of life, and may include:

• Hormone therapy with or without chemotherapy, or with or without trastuzumab. This depends if the cancer is oestrogen receptor (ER) positive or you are positive for the HER2 gene
• Radiotherapy to shrink tumours
• Surgery to remove tumours.

In some cases, participation in clinical trials for new treatments may be offered.

Like the original breast cancer treatment, the options will be explained so that their risks and benefits can be understood before going ahead.