One of the tools a woman can use against breast cancer recurrence
is compliance with her doctor’s follow-up guidelines.
These will certainly include continuation of monthly breast
self-examinations, screening mammograms (usually once per
year), and scheduled appointments with the physician, which
may be as often as every three months at first. At these appointments,
he will perform a breast exam, discuss possible symptoms and
order lab work or imaging tests he may feel are indicated.
Most breast cancer tends to recur in the first two to five
years after initial treatment. Breast cancer recurrence can
occur in the same breast previously treated or it can recur
in the other breast or in another part of the body, most often
the lymph nodes, lungs, liver or bones (still called breast
There are several factors related to the first breast tumor
that can influence the probability of recurrence: tumor size,
prior involvement of lymph nodes, histologic grade (high number
of abnormal cells in cancerous tissue), hormone receptors
(presence of estrogen receptors in cancer cells; can be favorable),
nuclear grade (refers to rate of division of cancer cells;
faster growing not favorable), oncogene presence (promotes
abnormal changes in cells; may increase recurrence). During
monthly breast self-exams, women should use the recommended
guidelines for technique and report any changes in the previously
treated breast or other breast.
If a new area of concern becomes apparent in the previously
treated breast and it turns out to be a breast cancer recurrence,
treatment will depend on how the prior involvement was handled.
If there was a lumpectomy and radiation, the surgeon may want
to perform a mastectomy since radiation was most likely used
on that same tissue. If there was a mastectomy done, the tumor
will be removed and followed with radiation. In both instances,
chemotherapy and/or hormonal therapy will be prescribed.
When cancer is found in the other breast, the new breast
cancer recurrence may be of a type entirely different from
the first. After tests and staging are complete, the patient’s
doctors will recommend a treatment plan, with probably a lumpectomy
or mastectomy and chemotherapy and/or hormonal therapy.
If the cancer is a metastasis into a distant area of the
body, such as bones, lungs, brain or other organs, the treatment
will involve chemotherapy or hormonal therapy or both together.
In order to relieve other unfavorable symptoms of the patient,
radiation may be performed; or the need for more surgery may
be recommended at the new site. Immunotherapy may be used
alone or with chemotherapy for certain patients and can generally
be started after chemotherapy or hormonal therapy is no longer
Janet Brown is a medical writer
and graduate of Loyola University New Orleans. Her personal
experiences with breast cancer have drawn her to her current
work developing breast cancer patient education and awareness
materials. She currently lives in Georgia.