Breast Cancer Recurrence

The goal of treating early and locally advanced breast cancer is to remove the cancer and keep it from coming back (breast cancer recurrence).

Most people diagnosed with breast cancer will never have a breast cancer recurrence. However, everyone who has had breast cancer is at risk of recurrence.

The risk of recurrence varies greatly from person to person. Talk with your health care provider about your risk of recurrence and things you can do that may lower your risk.

How is a local recurrence or metastasis found?

Breast cancer can recur at the original site (called local recurrence). It can also return and spread to other parts of the body (called metastasis or distant recurrence).

Local recurrence is usually found on a mammogram, during a physical exam by a health care provider or when you notice a change in or around the breast or underarm.

Metastasis is usually found when symptoms are reported to a provider.

If you have a local recurrence or metastasis, it’s not your fault. You did nothing to cause it.

Learn about follow-up care after breast cancer treatment.

Local recurrence

When a local recurrence is found, it’s treated in much the same way as the first breast cancer.

The tumor is removed by the surgeon, examined by the pathologist and tested for hormone receptor status, HER2 status and other characteristics.

Tests are also done to be sure there’s no sign of metastasis.

Local recurrence after lumpectomy

Local recurrence after lumpectomy (breast conserving surgery) can most often be treated successfully.

Treatment generally includes surgery, usually a mastectomy. Radiation therapy may be given if it wasn’t part of the initial breast cancer treatment.

Treatment may also include chemotherapy, hormone therapy and/or HER2-targeted therapy.

Local recurrence after mastectomy

Even though the entire breast is removed in a mastectomy, breast cancer can still return to the chest area. If you notice any changes around the mastectomy scar, tell your health care provider.

The more lymph nodes with cancer at the time of the mastectomy, the higher the chances of breast cancer recurrence.

Local recurrence after a mastectomy is usually treated with surgery followed by radiation therapy (if radiation therapy wasn’t part of the initial treatment).

Treatment may also include chemotherapy, hormone therapy and/or HER2-targeted therapy.

Metastasis

Signs and symptoms

Metastasis (distant recurrence) is most often found when people report symptoms.

These may include:

  • Fatigue
  • Shortness of breath
  • Weight loss
  • Bone pain
  • Seizures
  • Yellowing of the skin or whites of the eyes (jaundice)

Don’t panic if you have signs or symptoms like fatigue, weight change or bone pain. These are common problems for many people. Most often, they don’t mean the breast cancer has spread. For example, bone pain may be a sign of arthritis or muscle strain. And, lots of people have fatigue for a number of reasons.

However, discuss any signs or symptoms you have (especially if they last more than 2 weeks) with your health care provider to find out the cause. It’s always OK to get a second opinion, especially if you feel your provider isn’t listening to your concerns.

Follow-up tests

You should see your oncologist and other health team providers regularly, usually about every 6 months for the first few years after breast cancer treatment. After that, you will see them every year for many years.

Your providers will examine you and pay close attention to the breast/chest wall, underarm and neck. You will also need a mammogram every year (unless you had bilateral mastectomy).

If you don’t have any symptoms that could be related to breast cancer recurrence, and if there are no concerning findings on your physical exam, you don’t need extra tests. There is no role for lab tests, X-rays, CT scans, bone scans or PET scans if you are not having any symptoms and there are no findings on your physical exam.

If you have signs and symptoms that might be due to breast cancer recurrence, your health care team will order follow-up tests to see if the breast cancer has returned and spread to other organs (metastasized).

Depending on your signs and symptoms, follow-up tests may include:

  • Blood tests (including tumor marker tests)
  • Imaging tests (such as bone scans, CT scans, PET scans and chest X-rays)
  • A tissue biopsy (to check if a suspicious finding is a recurrence of breast cancer)

Other tests may also be done.

For people with no signs or symptoms of metastases, using blood or imaging tests (other than mammography) does not increase survival [185]. They are not a standard part of follow-up care.

Learn about routine follow-up after breast cancer treatment (not related to signs of recurrence).

Treatment

If follow-up tests show metastatic breast cancer, this means the cancer has spread to other parts of the body, most often the bones, lungs, liver or brain.

Although it’s spread to another part of the body, it’s still considered and treated as breast cancer.

For example, breast cancer that has spread to the bones is still breast cancer (not bone cancer). It’s treated with breast cancer drugs rather than treatments for a cancer that began in the bones.

When metastases are present, tests are done to determine which organs are involved and the hormone receptor status and HER2 status of the tumor. Then, you and your provider can discuss your treatment options.

Learn more about treatment of metastatic breast cancer.

Learn about clinical trials.

Pain management

Metastatic breast cancer can cause pain in the areas where the cancer has spread.

It’s important to control any pain related to metastatic breast cancer. Even mild pain can interfere with daily life and make other side effects, such as fatigue, seem worse.

Learn more about management of pain related to metastatic breast cancer.

Support

Treatment for breast cancer is stressful and can be difficult. If you have a recurrence, it’s common to have a strong emotional response.

You are not alone

If you have a breast cancer recurrence, remember there are many people who have been where you are today. They had the same fears and faced the same tough choices.

It may be helpful to talk with others going through treatment for local recurrence or metastasis. A cancer support group may help.

Your health care provider may be able to help you find a local support group. Our Support section offers a list of resources to help find local and online support groups.

Learn more about social support and find a list of support resources.

SUSAN G. KOMEN® SUPPORT RESOURCES

  • If you or a loved one needs more information about breast health or breast cancer, call the Komen Breast Care Helpline at 1-877 GO KOMEN (1-877-465-6636). All calls are answered by a trained specialist or oncology social worker in English and Spanish, Monday through Friday from 9:00 a.m. to 10:00 p.m. ET. You can also email the helpline at helpline@komen.org
  • We offer an online support community through our closed Facebook Group – Komen Breast Cancer group. The Facebook group provides a place where those with a connection to breast cancer can discuss each other’s experiences and build strong relationships to provide support to each other. Visit Facebook and search for “Komen Breast Cancer group” to request to join the closed group.
  • Komen Affiliates offer breast health education and some fund breast cancer programs through local community organizations. Your local Affiliate may also help you find breast cancer resources in your area. Find your local Affiliate.
  • Our Family and Friends section has detailed information and resources for loved ones.
  • Our fact sheets, booklets and other education materials offer additional information. 

 

Clinical trials

Research is ongoing to improve all areas of treatment for breast cancer.

New therapies are being studied in clinical trials. The results of these studies will decide whether these therapies will become part of standard care.

After discussing the benefits and risks with your health care provider, we encourage you to consider joining a clinical trial.

Susan G. Komen® Breast Cancer Clinical Trial Information Helpline

If you or a loved one needs information or resources about clinical trials, call our Clinical Trial Information Helpline at 1-877 GO KOMEN (1-877- 465- 6636) or email clinicaltrialinfo@komen.org.

BreastCancerTrials.org in collaboration with Susan G. Komen® offers a custom matching service to help find clinical trials that fit your needs. 

When to consider joining a clinical trial

If you have a breast cancer recurrence, consider joining a clinical trial before treatment begins or when your health care provider is considering changing treatments.

Learn more about clinical trials