Recurrent Breast Cancer

Diagnosis

Diagnosis of recurrent breast cancer begins when a doctor suspects a return of cancer based on a physical exam, mammogram findings or new symptoms. To confirm the diagnosis, imaging tests may be recommended. These tests vary depending on individual needs and may include MRI, CT scan, X-ray, bone scan or PET scan. Not everyone requires every imaging test, and your doctor selects the most appropriate options for your situation.

A biopsy is often needed to confirm whether cancer has returned. During this procedure, a sample of suspicious tissue is removed and examined in a laboratory. A pathologist determines whether the cancer is a recurrence or a new type of cancer. Lab tests also help reveal whether the cancer is sensitive to hormone therapy or targeted treatments, as these characteristics can change over time. This information guides the development of a personalized treatment plan.

Treatment

Treatment for recurrent breast cancer depends on several factors, including the extent of the disease, hormone receptor status, treatments used previously and overall health. Your doctor also considers your goals and preferences.

Treating a local recurrence usually begins with surgery. If a lumpectomy was performed the first time, a mastectomy is often recommended for recurrence in the breast. If a mastectomy was previously performed and cancer returns in the chest wall, surgery is used to remove the cancer along with some nearby normal tissue. Lymph nodes that weren’t removed during the original treatment may also be taken out. Radiation therapy may be recommended if you didn’t receive it during initial treatment. Chemotherapy and hormone therapy may also be used depending on tumor characteristics.

A regional recurrence may be managed with surgery if the cancer can be removed. Radiation therapy may follow surgery or be used as the main treatment when surgery isn’t possible. Drug treatments such as chemotherapy, hormone therapy or targeted therapy may also be part of the plan.

Metastatic recurrence requires a different approach. Treatment aims to control the cancer, relieve symptoms and help you live as well as possible for as long as possible. Hormone therapy is often the first treatment for hormone receptor–positive metastatic breast cancer because it usually has fewer side effects than chemotherapy. Chemotherapy may be used if the cancer is hormone receptor negative or if hormone therapy is no longer effective. Targeted therapy may be an option if cancer cells show features that respond to these medications. Immunotherapy may be used for certain types of advanced breast cancer, including some triple-negative cancers. If cancer has spread to the bones, bone-building drugs can help reduce the risk of fractures and relieve bone pain. Radiation therapy or surgery may also be used to control specific symptoms and improve quality of life.