Recurrence of breast cancer

Recurrence of breast cancer often develops in a few months or even years after treatment. When relapsed, the tumor appears in the same place where the first tumor was located, or in a remote place. If a cancer develops in the second breast or in another area of the breast, then oncologists consider such a tumor a new formation.

[1], [2],

Causes of the recurrence of breast cancer

Re-emergence of a cancerous tumor frightens a woman, many suggest that there was initially an incorrect diagnosis or treatment was not complete enough. But in fact, everything is different, in most cases, the re-development of the tumor provokes not the wrong therapy, but the inability to detect and kill all the cancer cells that have penetrated into the adjacent tissues with the blood or lymph flow.

Oncologists note that if more than half a year has passed after the main treatment and no metastases have been detected in the control examinations, then the development of a repeat tumor is considered a relapse.

Also, cancer recurrence is considered to be a tumor growth in the same breast as the first tumor, and also if the tumor appeared in another organ. When developing a distant cancerous tumor (in another organ), experts talk about metastasizing the primary tumor.

As a rule, the re-development of cancer indicates that some cancer cells showed insensitivity to treatment.

Usually re-development of the tumor occurs not only in the nearest tissues of the breast, thorax, lymph nodes. Often, in cases of recurrence, the bones of the skeleton, brain, lungs, abdominal cavity, and liver are affected.

Recurrence of breast cancer often occurs in certain circumstances and oncologists identify several factors that suggest a re-development of the tumor:

• the stage at which the cancer process was found - the later the disease is revealed, the greater the probability of relapses
• form of cancer - in aggressive cancer processes, the risk of recurrence increases
• the size of the detected cancer tumor - with a large neoplasm higher risk of recurrent tumor development
• affection of nearby lymph nodes
• high degree of malignancy of cells
• hormonal imbalance
• a certain type of oncogenes in the tumor becomes a frequent cause of relapse
• malignant cell growth level

After the treatment is completed, the specialist will assess the possible risks of re-development of the tumor and prescribe an observation.

The development of a repeat tumor can occur at any time, but as practice shows, most often the repeated development of cancer occurs 3-5 years after the course of treatment is completed.

[3], [4], [5]

Symptoms of the recurrence of breast cancer

Recurrence of breast cancer can be determined independently through regular self-examination (palpation of the mammary glands). In addition, some changes may indicate the re-development of a cancerous tumor:

• itching, burning, changes in the nipple
• change of contour, structure, size, breast temperature, red spot on skin, pit surface
• marble-like color on a separate section of the breast
• discharge from the nipple

After the treatment of breast cancer it is important to visit the mammologist regularly, do ultrasound, mammography, and take tests if necessary. After the termination of treatment of a primary tumor the doctor appoints quarterly examinations, in due course the mammologist can be visited less often.

Forms

In cancer practice, it is common to share a relapse of breast cancer as follows:

• local - the tumor develops in the operated place
• regional metastases - cancer is detected in the nearest lymph nodes
• metastatic cancer - the growth of cancer cells in organs and tissues far away from the primary focus (bones, liver, brain, lymph nodes).

If the patient is suspected of recurrence of breast cancer, then the specialist appoints a second examination (MRI, biopsy, positron emission tomography).

[6], [7], [8], [9]

Diagnostics of the recurrence of breast cancer

Regular mammography and self-examination will help to diagnose the development of cancer in the early stages.

If there is a suspicion of recurrence of breast cancer, the patient is to be diagnosed with ultrasound, mammography, biopsy, and an analysis of the level of cancer markers.

After this, a study is conducted to determine the stage of cancer and detect metastases.

In the laboratory, a study is conducted on the level of tumor markers or tumor markers (proteins, the number of which increases with the development of cancer in the body). However, an elevated level of such proteins can be observed not only in the cancer process, so this diagnostic method is ancillary.

The ultrasound study complements the results obtained with mammography (X-ray images). Mammography can detect a tumor, its location, size.

Biopsy (examination of a small piece of tissue taken from the tumor with puncture) allows more accurately diagnose the tumor and determine the stage of the oncological process.

In addition, magnetic resonance imaging or computed tomography can be used to diagnose cancer.

After the repeated development of cancer is confirmed, the doctor can prescribe a chest X-ray, a mammogram of the second breast, densitometry (determination of bone density) with suspicion of metastasis in bone tissue.

[10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20]

Treatment of the recurrence of breast cancer

Recurrence of breast cancer is subject to some basic therapeutic methods, including local treatment (tumor removal surgery, radiation therapy) and systemic treatment (hormonal, chemotherapy, targeted drugs).

Repeated development of a cancerous tumor is estimated by specialists as a more aggressive form of the disease, therefore in most cases complex treatment (local and systemic therapy) is conducted, which is aimed at the destruction of all pathological cells that could penetrate into other organs or tissues, but not detected during examination.

Which treatment the doctor chooses will depend on the treatment of the initial cancer process.

If during the first case of cancer development the tumor was surgically removed (with preservation of the breast), then with the re-development of the tumor, an operation for the removal of the breast is prescribed.

If the mammary gland was initially removed, then with repeated development of the cancer, radiotherapy is used. Hormonal treatment and chemotherapy are prescribed in both cases.

If the tumor is detected in the second breast, then a new cancers formation is usually diagnosed, which has nothing to do with the original one. In this case, the doctor can prescribe a complete removal of the breast or only the removal of the tumor.

Systemic treatment is prescribed for the re-development of cancer in bone tissue, brain or lung. Radiation therapy and surgical intervention is prescribed to reduce some of the severe symptoms of the disease.

Some patients with pathological cells with an increased level of HER2 / neu protein are prescribed hormone therapy in combination with immunostimulants (this type of treatment is also used for negative dynamics after chemotherapy).

Targeting drugs are used primarily during clinical trials. The new technology is aimed at destroying only pathological cells, while healthy cells remain untouched.

Prevention

To prevent recurrence of breast cancer, it is necessary to start prevention immediately after the end of treatment. In breast cancer, the likelihood of cancer cells entering the lymph and blood is quite high. After treatment, the specialist will determine the possible risks of repeated development of the tumor. If there is a high likelihood of a relapse, the doctor may advise you to undergo a course of chemotherapy that will help to destroy the cancer cells not detected on the examination or prescribe tamoxifen (a drug that suppresses estrogen).

[21], [22], [23],

Forecast

If the recurrence of breast cancer is diagnosed, the prognosis of a favorable cure depends on several factors:

• involvement in the cancerous process of the lymph nodes
• size of the tumor (the smaller the tumor is detected, the better the prognosis)
• number and nature of pathological cells
• the ability of cancer cells to grow rapidly

When the cancer process is detected in the late stages, the life expectancy is about three years.

Early detection of the tumor allows successful treatment in the overwhelming majority of cases.

If the examination reveals distant metastases, the prognosis of treatment is significantly worsened.

Recurrence of breast cancer usually develops a few years after the successful cure of the primary tumor. Women who have had breast cancer in the past are advised to strictly follow the doctor's recommendations after treatment: regularly come to inspections, do mammograms, and perform self-examination of the mammary glands.

[24], [25], [26], [27], [28], [29]