When and where do recurrences occur?
Breast cancer can recur at any time, but most recurrences occur in the first
three to five years after initial treatment. Breast cancer can come back as a
local recurrence (in the treated breast or near the mastectomy scar) or as a
distant recurrence somewhere else in the body. The most common sites of
recurrence include the lymph nodes, the bones, liver, or lungs.
How do I know there is a recurrence?
Women who have been treated for breast cancer should continue to practice
breast self-examination, checking both the
treated area and the other breast each month. A woman should report any changes
to her doctor right away. Breast changes that might indicate a recurrence
include:
- An area that is distinctly different from any other area on either
breast
- A lump or thickening, in or near the breast or in the underarm, that
persists through the menstrual cycle
- A change in the size, shape, or contour of the breast
- A mass or lump, which may feel as small as a pea
- A marble-like area under the skin
- A change in the feel or appearance of the skin on the breast or nipple
[dimpled, puckered, scaly, or inflamed (red, warm, or swollen)]
- Bloody or clear fluid discharge from the nipples
- Redness of the skin on the breast or nipple
In addition to performing monthly breast self-exams, keep your scheduled
follow-up appointments with your health care provider. During these
appointments, your health care provider will perform a breast exam, order lab or
imaging tests as needed, and ask you about any symptoms you might have.
Initially, these follow-up appointments may be scheduled every three to four months.
The longer you are cancer-free, the less often you will need to see your health
care provider. Continue to follow your health care provider’s recommendations
on screening mammograms (usually recommended once a year).
Prognostic indicators
Prognostic indicators are characteristics of a patient and her tumor that may
help a physician predict a cancer recurrence. These are some common indicators:
Lymph node involvement — Women who have lymph node involvement are
more likely to have a recurrence.
Tumor size — In general, the larger the tumor, the greater the chance
of recurrence.
Hormone receptors — About two-thirds of all breast cancers contain
significant levels of estrogen receptors, which means the tumors are estrogen
receptor positive (ER+). ER+ tumors tend to grow less aggressively and may
respond favorably to treatment with hormones.