
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Breast cancer recurrence
Medical expert of the article
Last reviewed: 04.07.2025
Recurrence of breast cancer often develops several months or even years after treatment. In recurrences, the tumor appears in the same place where the first tumor was or in a distant place. If a cancerous tumor develops in the second breast or in another area of the mammary gland, then oncologists consider such a tumor a new formation.
Causes breast cancer recurrence
The recurrence of a cancerous tumor frightens a woman, many assume that there was an incorrect diagnosis or that the treatment was insufficiently complete. But in reality, everything is different, in the vast majority of cases, the recurrence of a tumor is provoked not by incorrect therapy, but by the inability to detect and kill all cancer cells that have penetrated into adjacent tissues with the blood or lymph flow.
Oncologists note that if more than six months have passed since the main treatment and no metastases were detected during follow-up examinations, then the development of a second tumor is considered a relapse.
Also, a relapse of cancer is considered to be the growth of a tumor in the same breast as the first neoplasm, as well as if the tumor appeared in another organ. When a distant cancerous tumor develops (in another organ), specialists talk about metastasis of the primary tumor.
Typically, cancer recurrence indicates that some cancer cells have become resistant to treatment.
Usually, the tumor re-develops not only in the nearest tissues of the mammary gland, chest, and lymph nodes. Often, relapses involve damage to the bones of the skeleton, brain, lungs, abdominal cavity, and liver.
Recurrence of breast cancer often occurs under certain circumstances, and oncologists identify several factors that suggest the recurrence of the tumor:
- the stage at which the cancer process was detected - the later the disease is detected, the greater the likelihood of relapse
- form of cancer - with aggressive cancer processes, the risk of relapse increases
- the size of the detected cancerous tumor - with a large tumor, the risk of tumor recurrence is higher
- damage to nearby lymph nodes
- high degree of malignancy of cells
- hormonal imbalance
- a certain type of oncogenes in a tumor becomes a frequent cause of relapses
- malignant cell growth rate
After the treatment is completed, the specialist will assess the possible risks of tumor recurrence and prescribe observation.
The development of a recurrent tumor can occur at any time, but as practice shows, most often the recurrence of cancer occurs 3-5 years after the end of the course of treatment.
Symptoms breast cancer recurrence
Recurrence of breast cancer can be determined independently by regular self-examination (palpation of the mammary glands). In addition, some changes may indicate the recurrence of a cancerous tumor:
- itching, burning, changes in the nipple
- change in contour, structure, size, temperature of the breast, red spot on the skin, dimpled surface
- marble-like color on a particular area of the chest
- nipple discharge
After breast cancer treatment, it is important to regularly visit a mammologist, have an ultrasound, mammogram, and take tests if necessary. After the end of treatment of the primary tumor, the doctor prescribes quarterly examinations; over time, you can visit a mammologist less often.
Where does it hurt?
What's bothering you?
Forms
In oncological practice, it is customary to divide relapses of breast cancer as follows:
- local - the tumor develops at the operated site
- regional metastases - cancer is detected in nearby lymph nodes
- metastatic cancer – the growth of cancer cells in organs and tissues distant from the primary site (bones, liver, brain, lymph nodes).
If a patient is suspected of having a relapse of breast cancer, the specialist will prescribe a repeat examination (MRI, biopsy, positron emission tomography).
Diagnostics breast cancer recurrence
Regular mammograms and self-examinations can help diagnose cancer at an early stage.
If a recurrence of breast cancer is suspected, the patient is prescribed an ultrasound, mammography, biopsy, and analysis to determine the level of tumor markers to confirm the diagnosis.
After this, a study is carried out to determine the stage of the cancer and identify metastases.
The laboratory conducts a study on the level of tumor markers (proteins, the amount of which increases in the body during the development of cancer). However, an increased level of such proteins can be observed not only in the cancer process, so this diagnostic method is auxiliary.
Ultrasound examination complements the results obtained by mammography (X-ray images). Mammography allows to identify the tumor, its location, size.
A biopsy (examination of a small piece of tissue taken from a tumor using a puncture) allows for a more accurate diagnosis of the tumor and determination of the stage of the oncological process.
In addition, magnetic resonance imaging or computed tomography can be used to diagnose cancer.
Once recurrence of cancer is confirmed, the doctor may order a chest X-ray, a mammogram of the second breast, and a densitometry (bone density test) if metastasis to bone tissue is suspected.
[ 10 ], [ 11 ], [ 12 ], [ 13 ], [ 14 ], [ 15 ], [ 16 ], [ 17 ], [ 18 ], [ 19 ]
What do need to examine?
What tests are needed?
Who to contact?
Treatment breast cancer recurrence
Recurrent breast cancer is treated with some basic therapeutic methods, including local treatment (tumor removal surgery, radiation therapy) and systemic treatment (hormonal, chemotherapy, targeted drugs).
The recurrence of a cancerous tumor is assessed by specialists as a more aggressive form of the disease, therefore, in most cases, complex treatment is carried out (local and systemic therapy), which is aimed at destroying all pathological cells that could penetrate into other organs or tissues, but were not detected during the examination.
The exact treatment your doctor chooses depends on how you are treating the underlying cancer.
If during the first case of cancer development the tumor was removed surgically (with preservation of the breast), then when the tumor develops again, an operation to remove the mammary gland is prescribed.
If the mammary gland was initially removed, then radiation therapy is used if the cancer develops again. Hormonal treatment and chemotherapy are prescribed in both cases.
If a tumor is detected in the second breast, then a new cancerous formation is usually diagnosed that is unrelated to the original one. In this case, the doctor may prescribe a complete removal of the mammary gland or only removal of the tumor.
Systemic treatment is prescribed when cancer reoccurs in bone tissue, brain or lungs. Radiation therapy and surgery are prescribed to reduce some severe symptoms of the disease.
Some patients who have abnormal cells with increased levels of the HER2/neu protein are prescribed hormone therapy in combination with immunostimulants (this type of treatment is also used in case of negative dynamics after chemotherapy).
Targeted drugs are used primarily during clinical trials. The new technology is aimed at destroying only pathological cells, while healthy cells remain untouched.
More information of the treatment
Prevention
To prevent recurrence of breast cancer, it is necessary to begin prevention immediately after the end of the course of treatment. With breast cancer, the probability of cancer cells getting into the lymph and blood is quite high. After treatment, a specialist will determine the possible risks of recurrence of the tumor. If the probability of recurrence is high, the doctor may recommend a course of chemotherapy, which will help destroy cancer cells not detected during the examination, or prescribe tamoxifen (a drug that suppresses the action of estrogen).
Forecast
If recurrent breast cancer is diagnosed, the prognosis for a favorable cure depends on several factors:
- involvement of lymph nodes in the cancer process
- tumor size (the smaller the tumor, the more favorable the prognosis)
- the number and nature of pathological cells
- the ability of cancer cells to grow rapidly
If cancer is detected at a late stage, life expectancy is about three years.
Early detection of the tumor allows for successful treatment in the vast majority of cases.
If distant metastases are detected during examination, the treatment prognosis is significantly worsened.
Recurrence of breast cancer usually occurs several years after successful treatment of the primary tumor. Women who have had breast cancer in the past are advised to strictly follow the doctor's recommendations after treatment: regular check-ups, mammograms, and self-examination of the mammary glands.