Can Breast Cancer Recur? How Will I Know?

A cancer diagnosis can be devastating for not only the patient but also her loved ones. The treatment for breast cancer is multimodality and can be long drawn. To be cancer free and remain that way is what every patient aspires to be, but, unfortunately, some patients will come back with a recurrence- local or distant.

Dr. Geeta Kadayaprath, Associate Director & Head - Breast Surgical Oncology, Max Super Speciality Hospital, Patparganj, says, Breast cancer is one of the most common cancers in women, and the cases are only rising every year. Despite having undergone the best of treatments available, most women who have fought breast cancer worry about its recurrence. However, worrying is normal, and the fear and anxiety usually subside with time.

Staying Aware and Looking for Changes after Treatment

After a successful breast cancer treatment, it is important to be aware of the changes that may happen, in the breast after a conservation surgery or on the chest wall after a mastectomy It is important to undergo a clinical examination and annual mammogram as part of the follow-up schedule.

Here are changes you should look for in the breast –

• Change in skin texture such as dimpling or puckering
• Constant pain in breast or in the surrounding areas
• Changes in shape or size
• Swelling in the upper arm
• Swelling of the chest or armpit
• Redness or rash on the skin
• Unusual discharge from the nipple
• Inverted nipple

If you notice any other changes apart from these, let your doctor know as soon as possible.

Locoregional Recurrence and Distant Metastases

Breast cancer that returns to its original site or in the armpit or neck after a successful treatment is called a locoregional recurrence. When breast cancer returns and spreads to other part(s) of the body, it is known as metastasis or distant recurrence.

Locoregional Recurrence

Breast cancer may return to its original site or in the area near it or in the armpit or neck. When such an event occurs, it is important to look for disease elsewhere in the body with the help of imaging. This could mean a PET CT or a CECT chest and abdomen and bone scan. If there is no evidence of distant relapse, then it is treated in the same way, when you had the first incidence of breast cancer. The recurrence in the breast or armpit or neck will be biopsied and sent for examination to a pathologist and tested for hormone receptor, Her-2-neu and other characteristics. This will be followed by either surgery or systemic treatment in the form of chemotherapy or hormonal treatment and radiotherapy.

The following symptoms are associated with local recurrence:

• Thickened skin near the mastectomy scar
• Swelling of skin near the lumpectomy scar
• New lump in the breast
• Swelling or redness of the skin around the breast area
• Unnatural firm spot or area on the breasts which has recently developed
• Flattened nipple

Distant Metastases 

Also known as distant recurrence, it happens when the breast cancer spreads to the remote parts of the body. Bones, lungs, liver and brain are the most common sites to which where breast cancer spreads. The metastatic breast cancer symptoms depend on the location of cancer; however, the most common ones are listed below:

• Shortness of breath
• Constant pain in the joints or bones
• Unexplained dry cough
• Difficulty breathing
• Loss of appetite
• Vision problems
• Seizures
• Difficulty in urinating
• Loss of balance
• Nausea, weight loss or vomiting

If you are a breast cancer survivor and suspect any of the symptoms mentioned above, consult an oncologist immediately. The tests to diagnose metastatic breast cancer are again–

• PET scan
• CT scan of the area where signs are seen
• CT chest and abdomen
• Bone Scan
• Biopsy of the suspected area
• MRI, blood tests, bronchoscopy etc may be required on a case to case basis in confounding situations

For a breast cancer survivor, the most important thing is to be aware of the symptoms. Recurrent disease is tough to deal with and can deal a severe blow to someone who has been through the rigours of treatment and has to now deal with this new situation. Keeping a close watch on the symptoms and careful self-examination can help diagnose cancer recurrence early. It can then aid in a better and more effective treatment. If you suspect that you have a recurrence, it is best to book an appointment with our oncologist in Delhi for effective options. Cancer treatment in India has advanced over the years and we at Max Healthcare are equipped with the best to deal with the most challenging situations in breast cancer.

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