Breast Cancer Recurrence
The goal of treating early breast cancer is to remove the cancer and keep it from coming back. A return of breast cancer is called a breast cancer recurrence.
Most people diagnosed with breast cancer will never have a breast cancer recurrence. However, everyone who’s had breast cancer is at risk of recurrence.
The risk of breast cancer recurrence varies greatly from person to person. Your health care provider cannot tell you whether or not you will have a recurrence, but they can give you some information about your risk. Talk with your provider about your risk of recurrence and things you can do that may be linked to a lower risk of recurrence.
How is a local breast cancer recurrence or metastasis found?
Breast cancer that recurs at the original site is called a local recurrence. A local recurrence is usually found on a mammogram, during a clinical breast exam by a health care provider or when you notice a change in or around your breast or underarm.
Breast cancer that returns and spreads to other parts of the body is called a distant recurrence (metastasis). This is metastatic breast cancer and may also be called stage IV or advanced breast cancer.
Metastasis is usually found when new and persistent symptoms are reported to a health care provider and follow-up tests are done.
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 breast cancer 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 a surgeon, examined by a pathologist and tested for hormone receptor status, HER2 status and other tumor characteristics.
If needed, tests may be done to check for signs of metastasis.
Local recurrence after a lumpectomy
Local recurrence after a lumpectomy (breast-conserving surgery) can most often be treated successfully.
Treatment generally includes surgery, most often 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, HER2-targeted therapy and/or other drug therapies.
Learn about types of treatment for a local recurrence.
Local recurrence after a 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 a breast cancer recurrence tend to be.
Local recurrence after a mastectomy is usually treated with surgery, and radiation therapy if radiation therapy wasn’t part of the initial treatment.
Treatment may also include chemotherapy, hormone therapy, HER2-targeted therapy and/or other drug therapies.
Learn about types of treatment for a local recurrence.
Metastasis
Signs and symptoms
Metastasis (distant recurrence) is most often found when people report new and persistent symptoms.
These may include:
- Fatigue
- Shortness of breath
- Weight loss
- Bone pain
- Seizures
- Jaundice (yellowing of the skin or whites of the eyes)
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 many people have fatigue for a number of reasons.
Discuss any signs or symptoms you have (especially if they last more than 2 weeks) with your health care provider to find the cause.
It’s always OK to get a second opinion, especially if you feel your health care provider isn’t listening to your concerns.
Follow-up tests
You’ll see your oncologist and other health care providers regularly for the first 5 years after breast cancer treatment. After that, you’ll see them or you may see your primary care physician regularly for many years of follow-up care.
Your health care team will examine you and pay close attention to your breast/chest wall, underarms and neck. You’ll also need a mammogram every year unless you had a bilateral mastectomy.
If you don’t have any signs or symptoms of metastasis and there are no concerning findings on your physical exam, you don’t need extra tests.
For people with no signs or symptoms of metastasis, using blood or imaging tests (other than mammography) does not increase survival [226]. These tests are not a standard part of follow-up care.
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 metastasized (spread to other parts of the body).
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.
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’s 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 metastasis is present, tests are done to find out which organs are involved and to check the hormone receptor status and HER2 status of the tumor. Then, you and your oncologist can discuss your treatment options.
Metastatic breast cancer can cause pain in the areas where the cancer has spread.
Controlling pain is a standard part of metastatic breast cancer care. Even mild pain can interfere with daily life and make other side effects, such as fatigue, seem worse.
Learn more about treatment of metastatic breast cancer.
Learn more about management of pain related to metastatic breast cancer.
Learn about clinical trials.
Support
Treatment for breast cancer is stressful and difficult. If you have a recurrence, it’s common to have a strong emotional response.
You’re not alone
If you have a breast cancer recurrence, it’s normal to feel afraid, sad or worried. Remember there are many people who have been where you are today. They had the same fears and worries, and they faced the same tough choices.
It may help to talk with others going through treatment for local breast cancer recurrence or metastasis. You can do this in a support group or by connecting one-on-one with another breast cancer survivor.
You can also talk with your health care providers about how you’re coping. They care about your overall well-being and can help you find ways to improve it. In addition to suggesting a support group, they may connect you to another member of your health care team, such as a social worker or patient navigator, for support. They may also refer you to a counselor.
Our Support section offers a list of resources to help find local and online support groups and other resources.
Learn more about social support and support groups.
Learn about healthy ways to cope with stress.
Susan G. Komen® Support Resources |
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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 the standard of care.
After discussing the benefits and risks with your health care provider, we encourage you to consider joining a clinical trial.
Susan G. Komen® Patient Care Center |
If you or a loved one needs information or resources about clinical trials, the Patient Care Center can help. Contact the Komen Breast Care Helpline at 1-877-465-6636 or email clinicaltrialinfo@komen.org. Se habla español. |
BreastCancerTrials.org in collaboration with 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.
Updated 04/10/24
