What happens if breast cancer returns?

pink ribbon, symbol of breast cancer awareness

The shocking news of singer Olivia Newton-John’s announcement of back pain caused by breast cancer that has metastasized to her sacrum, serves as a reminder of the possibility of a recurrence of this disease.  Newton-John was diagnosed with breast cancer originally in 1992 and underwent chemotherapy after a modified radical mastectomy with reconstruction.  She followed up with other alternative forms of treatment which included acupuncture, yoga, meditation, and massage.

Any woman who has had breast cancer is aware that a recurrence can and does occur.  Just how likely is it for this disease to recur?  It depends on several factors:

  • The size of the original tumor
  • The number of lymph nodes involved, if any
  • How aggressive the cancer was
  • How well a woman responded to her first course of treatment

Discovering a local recurrence of metastasis

When breast cancer recurs at the original site it is referred to as a local recurrence.  But it can also return and spread to other parts of the body in which case it will then be called metastasis or distant recurrence.

Local recurrence is usually found on a mammogram, during a physical exam by a healthcare provider or when a woman notices a change.  Metastasis is usually found when a women notices certain symptoms and reports them to her healthcare provider.

Local recurrence

If a woman has had a lumpectomy (breast conserving surgery) and has a local recurrence, the cancer can most often be treated successfully.  The treatment generally includes surgery or radiation therapy may be given if it was not used as part of the first breast cancer treatment.

Other forms of treatment may include chemotherapy, hormone therapy and/or targeted therapy.

Metastasis

A distant recurrence in another area of the body or metastasis is when a woman may notice changes or other symptoms that get her attention.  These can include the following:

  • Shortness of breath
  • Weight loss
  • Bone pain

Women should not automatically panic if any of these symptoms do occur as they can be common and usually do not mean a return of breast cancer or that it has spread.  But it is advisable for any women who has had breast cancer in the past and notices these symptoms, to discuss them with her doctor.

What is done to check for a breast cancer return?

Depending on the symptoms a woman is experiencing, will determine what tests are done to check on a return of breast cancer and if it has spread.

Follow-up tests that may be conducted could include the following:

  • 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

Treatment of a recurrence or metastasis

Metastatic breast cancer means the cancer has spread to other parts of the body which likely occurs in the bones, lungs, liver, or brain.  Tests will be done to determine which organs are involved and the hormone receptor status and the HER2 status of the tumor.

Even though the cancer has spread to a different part of the body, it is still considered breast cancer. For example, if breast cancer has spread to the bones it is still breast cancer and not bone cancer. The treatment for it will be with breast cancer drugs instead of treatment for cancer that starts originally in the bones.

Getting support

The news of a recurrence or metastasis of breast cancer can be devastating and stressful to say the least.  Now, more than ever, a woman will need a strong support system to help her get through this difficult time giving her both emotional and moral support.  One answer for some women may be to join a cancer support group.  If a woman wants to take advantage of this, she can ask her healthcare team to help her find a local support group.

In the meantime, we wish Olivia Newton-John a complete recovery and remission of her next battle against cancer.

What happens if breast cancer returns?
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Dr. David Samadi, MD.

Dr. David Samadi, MD. is Chairman of Urology and the Chief of Robotic Surgery at Lenox Hill Hospital and named to the prestigious Castle Connoly America’s Top Doctors and New York Magazine’s Best Doctor’s List.

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Dr. David Samadi, MD.

Dr. David Samadi, MD. is Chairman of Urology and the Chief of Robotic Surgery at Lenox Hill Hospital and named to the prestigious Castle Connoly America’s Top Doctors and New York Magazine’s Best Doctor’s List.