Has breast cancer come back? (Breast Cancer Recurrence) Let's talk about this!

When you think you've been treated for breast cancer and are feeling better, do you have a nagging fear that the disease will come back? In fact, sometimes it can. Today we're talking about breast cancer recurrence . Don't be afraid to hear this, because it's very important to be aware of it.

What is breast cancer recurrence?

Simply put, when you have finished treatment for breast cancer, the cancer comes back to your body again, which is what we call 'breast cancer recurrence' . This can happen within a few months of treatment, or it can happen years later. Our doctors can treat this recurring cancer, but sometimes it can come back.

What are the ways this cancer comes back?

The type of cancer is determined by where it comes back from. There are three main types:

• Local Recurrence: This means that the cancer has returned to the same breast (or area of ​​the breast) where it was first found. For example, if you had cancer in your right breast and it was removed, it would be like cancer cells growing back in that right breast.

• Regional Recurrence: This is when the cancer recurs near the original tumor, such as in the axillary lymph nodes or in the lymph nodes around the neck.

• Distant Recurrence: This is the most serious type. This is when breast cancer cells have spread far from where the original tumor was, to your lungs, bones, brain, or other parts of your body. This is also called (Metastatic Breast Cancer) . It is often called (Stage 4 Breast Cancer) .

There's something else you should know. Imagine you had cancer in one of your breasts, and it was treated and cured. Then, if a new cancer develops in your other breast, that is, the breast on the other side where there was no cancer before, it is not considered a 'recurrence'. Doctors call it a 'second cancer'.

What types of breast cancer are most likely to come back?

According to the American Cancer Society, inflammatory breast cancer (IBC) and triple-negative breast cancer (TNBC) are more likely to come back than other types of breast cancer. These types are more aggressive, which is why they are so common.

How common is it for breast cancer to come back?

In fact, this is not something that happens to everyone, which means it is not very common. However, the exact percentage of times this happens depends on many factors, such as the stage of your original cancer and the treatment you received.

How long does it usually take for cancer to come back?

In most cases, if the cancer comes back in the same place after a lumpectomy , which is a surgery that removes only part of the breast, it is most likely to happen within the first five years. However, if you have radiation therapy after the lumpectomy , this risk can be greatly reduced. When these two treatments are combined, the chance of the cancer coming back within 10 years is reduced to between 3% and 15%. Sometimes, based on things like your genetic testing, your doctor may recommend additional treatments to further reduce this risk.

The rate of cancer recurrence is slightly different for those who have had a mastectomy , which involves removing the entire breast:

• If there were no cancer cells in the axillary lymph nodes when you had your initial surgery, the chance of the cancer coming back within five years is about 6%.
• However, if there are cancer cells in the lymph nodes in the armpit, the chance of recurrence is about 25%. However, if you have radiation therapy after mastectomy , this risk can be reduced to 6%.

What are the symptoms of cancer recurrence?

Symptoms vary depending on where the cancer comes back. For example, symptoms are not the same when the cancer comes back in the same place it was (local recurrence), but when it has spread to nearby lymph nodes (regional recurrence).

Local recurrence may present with symptoms such as:

• Feeling a new lump or tumor in the breast or under the skin of the chest.
• Nipple changes: The nipple may appear to be inverted, or there may be some discharge from the nipple.
• (Lumpectomy) The skin around the surgery site swells and appears to be pulled inward.
• Thickening of the skin over or around the surgical scar.
• Breast tissue feels firmer than usual.

Regional recurrence may present with the following symptoms:

• Persistent chest pain .
• Difficulty swallowing .
• Feeling pain, swelling, or numbness in one arm or shoulder.
• Swollen lymph nodes in the armpit or around the neck.

In distant recurrence (Distant / Metastatic / Stage 4 Recurrence), these symptoms can affect any organ. That is, places like bones, lungs, brain, liver. Symptoms vary depending on where the cancer has spread. They can include:

• Pain where the cancer has spread, especially in the bones .
• A persistent dry cough .
• Conditions like dizziness, loss of balance, and seizures.
• Feeling unimaginably tired (Extreme Fatigue) .
• Loss of appetite, nausea, weight loss.
• Severe headache .
• Feeling numbness or weakness in some parts of the body.

Why does this breast cancer keep coming back?

The main reason breast cancer comes back is that some of the cancer cells in your breast were not completely destroyed by the treatments you received. Breast cancer treatments are very effective, but did you know that these cancer cells are very cunning?

• Sometimes, treatments can shrink tumors and weaken the cancer cells to the point where they can't be detected by tests. But those cells are still there. Over time, those cells can get stronger again, start growing again, and form new tumors.
• Surgery to remove a cancerous tumor is not always 100% successful. Before surgery, cancer cells may have spread to nearby lymph nodes, tissues, or blood.

Who is at higher risk of this cancer coming back?

Anyone who has had breast cancer can have it come back. However, your risk of the cancer coming back depends on several factors:

• Age: Women who develop breast cancer before the age of 35 are more likely to have the cancer come back.
• Cancer Stage: When you are first diagnosed with breast cancer, doctors will use the stage of the cancer to plan treatment and predict the future. There is a relationship between the stage at which the cancer was first diagnosed and the risk of the cancer coming back. For example, someone with Stage III cancer is more likely to have the cancer come back than someone with Stage I or Stage II cancer.
• Cancer Type: Cancers that are more aggressive and spread quickly, such as Inflammatory Breast Cancer or Triple-Negative Breast Cancer, are more difficult to treat. Therefore, such cancers are more likely to recur and spread.

What are the possible complications if the cancer comes back?

Treating breast cancer can be challenging when it recurs or spreads:

• Treatments that worked in the past may not be as effective this time. Your doctor may try other treatments. They may also recommend that you take part in clinical trials , which are research studies on new treatments.
• (Metastatic Breast Cancer) , which means the cancer has spread to more than one place in the body, making it really difficult to treat. (But remember, no matter where breast cancer spreads, it's still considered breast cancer. Because breast cells are different from lung cells, bone cells, or cells in other places where cancer can spread.)

How do doctors detect that the cancer has come back?

Some of the tests that were used to initially detect breast cancer are now being done:

• Mammogram test
• Ultrasound examination
• Scans such as (MRI) , (CT Scan) or (PET Scan - Positron Emission Tomography Scan)
• Blood tests to look for tumor markers
• A biopsy means taking a small piece of tissue and examining it.

What are the treatments for recurrent breast cancer?

Treatment options vary depending on where the cancer has recurred and what previous treatments have been given. For example:

• If you have previously had a lumpectomy for local or regional cancer, this time your doctor may recommend a mastectomy to remove one or both breasts, as well as nearby lymph nodes.
• If you have had a lumpectomy before, you may be able to have another lumpectomy along with radiation therapy. You should discuss this with your doctor.
• If cancer recurs in a reconstructed breast, the surgeon may need to remove either the breast implant or the skin flap.
• If you have had a mastectomy before, this time the treatment may include surgery to remove the new tumor, followed by radiation therapy .

In addition to this, there are other treatment methods:

• Hormone Therapy
• (Chemotherapy) (We call it chemo)
• Immunotherapy
• Targeted Therapy

What is the treatment for metastatic cancer?

The main treatment for metastatic breast cancer is systemic therapy, which affects the entire body. This includes chemotherapy , hormonal therapy , immunotherapy , and targeted therapy .

If the cancer comes back, will it be worse than before?

Treating breast cancer that comes back can be challenging. But it doesn't always mean it's worse than the original cancer. If you have breast cancer that comes back, you may be given a different treatment than you were given before, or a more aggressive treatment like surgery, or more powerful anticancer drugs. A lot depends on your situation. So the best person to ask what you can expect is your doctor.

Can recurrent cancer be completely cured?

It really depends on your situation. Ask your doctor if the goal of the treatment this time is to completely cure the cancer, or to control its growth and spread. That way, you can get a clear idea.

What is the chance of survival if the cancer comes back?

This is a bit of a sensitive subject. In general, the five-year survival rate after cancer diagnosis is as follows:

• Localized breast cancer is about 99% of breast cancer cases.
• Regional breast cancer is about 86%.
• About 27% of cases have spread distantly, that is , metastatic breast cancer .

But this is very important : These cancer survival rates are just estimates based on the experiences of a large group of people with the same condition. Also, these estimates are based on information that may have been available years ago. Think about the difference between a selfie you took five years ago and one you took yesterday. Just like your appearance, these survival rates change over time, as new treatments come out and medical science advances.

These are probably the questions you had when you first learned you had breast cancer. Your doctor was your best source of information back then, and he still is. So don't be alarmed by these statistics. It's best to talk to your doctor to get the most accurate information about your condition.

Can breast cancer be prevented from coming back?

Research has shown that some treatments can reduce the risk of some breast cancer subtypes coming back. For example, hormone therapy , such as tamoxifen or aromatase inhibitors, can reduce the risk of breast cancer coming back in people with early-stage estrogen-receptive breast cancer (ER-positive or ER+) . Chemotherapy after surgery (called adjuvant therapy ) can also reduce the risk.

But, in general, experts still don't fully understand why some people get breast cancer again and others don't. If you do get breast cancer again, don't assume it's because of something you did or didn't do. It's not your fault.

Although you can't prevent breast cancer from recurring, it's important to do regular breast self-examinations and follow-up screenings as recommended by your doctor. This can help your doctor detect metastatic breast cancer at a relatively early stage, when it's easier to treat.

How should I take care of myself? (both mentally and physically)

If you've had breast cancer again, you're probably living with a lot of different emotions. That's very normal.

• You may be angry about having to deal with this cancer treatment again.
• It can be frustrating to have to deal with this condition again, which makes you feel like you have lost control over your health.
• Anxiety and fear about the future may come to mind.
• Since there is no guarantee that the cancer will not come back, it can be frustrating.

It's normal and natural to feel these feelings. But if you feel stuck in a cycle of negative emotions, talk to your doctor. He or she can help you reason with your fears. They may also refer you to a mental health professional to help you understand and manage your feelings.

Here are some other things you can do to reduce the stress of living with recurrent breast cancer:

• Continue to eat a healthy diet: Focus on filling your plate with a variety of vegetables, fruits, lean proteins, and whole grains. Eating well will help you maintain your energy during treatment.
• Get some exercise: Regular exercise reduces stress and can also help you cope with some of the mental challenges that come with breast cancer recurrence.
• Consider palliative care: Palliative care providers help you manage symptoms and side effects of treatment.
• Participate in Cancer Survivorship Programs: You've been a survivor since the day you were diagnosed with breast cancer. Ask your doctor about programs and services specifically designed for people with recurrent breast cancer.

When should I see my doctor?

If you notice any changes in your breasts, or if you have symptoms like a cough, headache, or swollen lymph nodes that persist and don't go away, you should definitely see your doctor.

What questions should I ask my doctor?

If tests confirm that your breast cancer has returned, you may want to ask your doctor questions like these:

• What type of breast cancer recurrence do I have?
• If it has spread, where has it spread?
• What is the stage of this cancer?
• What are the treatments?
• What are the risks and side effects of the treatment?
• What signs of complications should I look out for?

Can I ever be sure that the cancer will never come back?

Unfortunately, no one can give you that guarantee. Even if tests don’t find any signs of breast cancer, there may still be some small, undetectable cancer cells that have escaped treatment for the cancer that has returned. Also, cancer cells can travel from your breast to other parts of your body. If they do, they can grow there and form tumors.

Finding out that your breast cancer has come back can be a difficult thing to do. It's understandable to feel disappointed, angry, and scared. However, you may have been overjoyed when you received treatment and found that the cancer was gone. Now, it's back. It can feel like a nightmare all over again. But knowing this can give you some peace of mind: Treatment for breast cancer that has come back can often get rid of the cancer that has come back. You may also be able to take part in clinical trials that are evaluating new treatments. If your breast cancer has come back, your doctor will recommend the best treatment options for you, including clinical trials .

Finally, the most important things you need to remember

Breast cancer recurrence is a scary thing. But it's important to be aware of it, pay attention to the symptoms, and talk openly with your doctor.

• Don't worry: not all cancers come back, and even if they do, there are treatments.
• Listen to your body: Tell your doctor if you notice any new lumps, pain, or changes.
• Don't miss the proper tests: Get follow-up tests as directed by your doctor.
• You are not alone: ​​your family, friends, and medical team will support you. Psychological support is also very important.
• Try to stay positive: Treatment can be successful, and new treatments are emerging all the time.

Remember, your doctor is the best person to advise you, so don't hesitate to ask them if you have any questions or concerns.

` Breast Cancer, Cancer Recurrence, Breast Cancer Recurrence, Cancer Symptoms, Cancer Treatment, Metastatic Breast Cancer, Women's Health