About breast cancer: checking for cancer recurrence

What is breast cancer: checking for cancer recurrence?

Introduction to Breast Cancer Recurrence

Breast cancer can recur at any time, but most recurrences occur in the first three to five years after initial treatment. Breast cancer can come back as a local recurrence (in the treated breast or near the mastectomy scar) or as a distant recurrence somewhere else in the body. The most common sites of recurrence include the lymph nodes, the bones, liver, or lungs.

How Do I Know There Is A Recurrence?

If you've been treated for breast cancer, you should continue to practice breast self-examination, checking both the treated area and your other breast each month. You should report any changes to your doctor right away. Breast changes that might indicate a recurrence include:

  • An area that is distinctly different from any other area on either breast
  • Lump or thickening in or near the breast or in the underarm that persists through the menstrual cycle
  • A change in the size, shape, or contour of the breast
  • A mass or lump, which may feel as small as a pea
  • A marble-like area under the skin
  • A change in the feel or appearance of the skin on the breast or nipple, including skin that is dimpled, puckered, scaly, or inflamed (red, warm or swollen)
  • Bloody or clear fluid discharge from the nipples
  • Redness of the skin on the breast or nipple

In addition to performing monthly breast self-exams, keep your scheduled follow-up appointments with your healthcare provider. During these appointments, your healthcare provider will perform a breast exam, order lab or imaging tests as needed, and ask you about any symptoms you might have. Initially, these follow-up appointments may be scheduled every three to four months. The longer you are cancer-free, the less often you will need to see your healthcare provider. Continue to follow your healthcare provider's recommendations on screening mammograms (usually recommended once a year).

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What Factors Determine The Likelihood Of A Recurrence?

Prognostic indicators are characteristics of a patient and her tumor that may help a physician predict a cancer recurrence. These are some common indicators:

  • Lymph node involvement. Women who have lymph node involvement are more likely to have a recurrence.
  • Tumor size. In general, the larger the tumor, the greater the chance of recurrence.
  • Hormone receptors. About two-thirds of all breast cancers contain significant levels of estrogen receptors, which means the tumors are estrogen receptor positive (ER+). ER-positive tumors tend to grow less aggressively and may respond favorably to treatment with hormones.
  • Histologic grade. This term refers to how much the tumor cells resemble normal cells when viewed under the microscope; the grading scale is 1 to 4. Grade 4 tumors contain very abnormal and rapidly growing cancer cells. The higher the histologic grade, the greater chance of recurrence.
  • Nuclear grade. This is the rate at which cancer cells in the tumor divide to form more cells. Cancer cells with a high nuclear grade (also called proliferative capacity) are usually more aggressive (faster growing).
  • Oncogene expression. An oncogene is a gene that causes or promotes cancerous changes within the cell. Tumors that contain certain oncogenes may increase a patient's chance of recurrence.

How Will My Prognosis Affect My Treatment?

Following surgery or radiation, your treatment team will determine the likelihood that the cancer will recur outside the breast. This team usually includes a medical oncologist, a specialist trained in using medicines to treat breast cancer. The medical oncologist, who works with your surgeon, may advise the use of tamoxifen (tamoxifen citrate, Nolvadex) or possibly chemotherapy. These treatments are used in addition to, but not in place of, local breast cancer treatment with surgery and/or radiation therapy.

What are the symptoms for breast cancer: checking for cancer recurrence?

A newly inverted nipple symptom was found in the breast cancer: checking for cancer recurrence condition

In a local recurrence, cancer reappears in the same area as your original cancer.

If you've undergone a lumpectomy, the cancer could recur in the remaining breast tissue. If you've undergone a mastectomy, the cancer could recur in the tissue that lines the chest wall or in the skin.

Signs and symptoms of local recurrence within the same breast may include:

Signs and symptoms of local recurrence on the chest wall after a mastectomy may include:

  • One or more painless nodules on or under the skin of your chest wall
  • A new area of thickening along or near the mastectomy scar

Regional recurrence

A regional breast cancer recurrence means the cancer has come back in the nearby lymph nodes.

Signs and symptoms of regional recurrence may include a lump or Swelling in the lymph nodes located:

  • Under your arm
  • Near your collarbone
  • In the groove above your collarbone
  • In your neck

Distant recurrence

A distant (metastatic) recurrence means the cancer has traveled to distant parts of the body, most commonly the bones, liver and lungs.

Signs and symptoms include:

  • Persistent and worsening pain, such as chest, back or hip pain
  • Persistent cough
  • Difficulty breathing
  • Loss of appetite
  • Weight loss without trying
  • Severe headaches
  • Seizures

What are the causes for breast cancer: checking for cancer recurrence?

Recurrent breast cancer occurs when cells that were part of your original breast cancer break away from the original tumor and hide nearby in the breast or in another part of your body. Later, these cells begin growing again.

The chemotherapy, radiation, hormone therapy or other treatment you may have received after your first breast cancer diagnosis was intended to kill any cancer cells that may have remained after surgery. But sometimes these treatments aren't able to kill all of the cancer cells.

Sometimes cancer cells may be dormant for years without causing harm. Then something happens that activates the cells, so they grow and spread to other parts of the body. It's not clear why this occurs.

What are the treatments for breast cancer: checking for cancer recurrence?

Prognostic indicators are characteristics of a patient and her tumor that may help a physician predict a cancer recurrence. These are some common indicators:

  • Lymph node involvement. Women who have lymph node involvement are more likely to have a recurrence.
  • Tumor size. In general, the larger the tumor, the greater the chance of recurrence.
  • Hormone receptors. About two-thirds of all breast cancers contain significant levels of estrogen receptors, which means the tumors are estrogen receptor positive (ER+). ER-positive tumors tend to grow less aggressively and may respond favorably to treatment with hormones.
  • Histologic grade. This term refers to how much the tumor cells resemble normal cells when viewed under the microscope; the grading scale is 1 to 4. Grade 4 tumors contain very abnormal and rapidly growing cancer cells. The higher the histologic grade, the greater chance of recurrence.
  • Nuclear grade. This is the rate at which cancer cells in the tumor divide to form more cells. Cancer cells with a high nuclear grade (also called proliferative capacity) are usually more aggressive (faster growing).
  • Oncogene expression. An oncogene is a gene that causes or promotes cancerous changes within the cell. Tumors that contain certain oncogenes may increase a patient's chance of recurrence.

What are the risk factors for breast cancer: checking for cancer recurrence?

For breast cancer survivors, factors that increase the risk of a recurrence include:

  • Lymph node involvement. Finding cancer in nearby lymph nodes at the time of your original diagnosis increases your risk of the cancer coming back.
  • Larger tumor size. People with larger tumors have a greater risk of recurrent breast cancer.
  • Positive or close tumor margins. During breast cancer surgery, the surgeon tries to remove the cancer along with a small amount of the normal tissue that surrounds it. A pathologist examines the edges of the tissue to look for cancer cells.

    If the borders are free of cancer when examined under a microscope, that's considered a negative margin. If any part of the border has cancer cells (positive margin), or the margin between the tumor and normal tissue is close, the risk of breast cancer recurrence is increased.

  • Lack of radiation treatment following a lumpectomy. Most people who choose a lumpectomy (wide local excision) for breast cancer undergo breast radiation therapy to reduce the risk of recurrence. Those who don't undergo the radiation therapy have an increased risk of local breast cancer recurrence.
  • Younger age. Younger people, particularly those under age 35 at the time of their original breast cancer diagnosis, face a higher risk of recurrent breast cancer.
  • Inflammatory breast cancer. People with inflammatory breast cancer have a higher risk of local recurrence.
  • Lack of endocrine therapy for hormone receptor-positive breast cancer. In people who have a certain type of breast cancer, not receiving endocrine therapy can raise their risk of recurrence.
  • Cancer cells with certain characteristics. If your breast cancer wasn't responsive to hormone therapy or treatments directed at the HER2 gene (triple negative breast cancer), you may have an increased risk of breast cancer recurrence.
  • Obesity. Having a higher body mass index increases your risk of recurrence.

Is there a cure/medications for breast cancer: checking for cancer recurrence?

Cure/medications for breast cancer:

1. Breast cancer cells can remain after a mastectomy or chemotherapy. They can recur at any time, but in general, recurrences occur in the first three to five years after initial treatment. Breast cancer can come back as a local recurrence or a distant recurrence that is somewhere else in the body.
There is a need for self-examination after treatments for cancer, and if one finds some changes, doctors' advice must be needed at that time.

2. In local recurrence, if undergone a lumpectomy, it can recur at the remaining area, and under a mastectomy, cancer could recur in the tissue that lines the chest wall or in the skin. A new lump in your breast, Changes to the skin, Skin inflammation, and Nipple discharge are the symptoms of local recurrence.

3. In distant recurrence, it travels to distant parts of the body, most commonly the bones, liver and lungs. In which pain, such as chest, back or hip pain, cough, breathing, weight loss, seizure, etc.. are the symptoms.

4. Cancer recurrence occurs when the original cells of cancer break and hide in other parts or in other areas of tissues and then they grow up again. chemotherapy, radiation, and hormone therapy are the treatments that are given after breast cancer surgery but sometimes these treatments aren't able to kill all of the cancer cells.

Treatment for breast cancer recurrence depends on type of recurrence and treatment of initial cancer surgery. Sometimes it needed to remove the breast implant or skin flap.
These are the treatments for breast cancer recurrence:
1. Mastectomy
2. Chemotherapy
3. Hormone therapy
4. Immunotherapy
5. Radiation therapy
6. Targeted therapy

Symptoms
A breast lump or thickening that feels different from the surrounding tissue,Change in the size, shape or appearance of a breast,Changes to the skin over the breast, such as dimpling,A newly inverted nipple,Peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin,Redness or pitting of the skin over your breast, like the skin of an orange
Conditions
Tumor
Drugs
Surgery,Chemotherapy,Radiation therapy,Targeted therapy,Hormonal therapy,Immunotherapy

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