A doctor helps a patient get into position for a mammogram.
A doctor helps a patient get into position for a mammogram.
A doctor helps a patient get into position for a mammogram.

Breast Cancer Recurrence

Featured Expert:

The recurrence of breast cancer can be frightening. Most patients diagnosed with breast cancer will not experience a recurrence, but if it does return, there is reason for hope: In most cases, a breast cancer recurrence can be managed.

Julie Lange, M.D., a breast cancer specialist at Johns Hopkins, helps you understand your risk and suggests health tips that can improve your chances of avoiding recurring breast cancer.

What is the risk for breast cancer recurrence?

The risk of recurrence depends on the type of breast cancer and its stage. Timing matters, too: The highest risk of recurrence for breast cancer patients is during the first few years after treatment.

“At the Johns Hopkins Breast Center, our team of breast cancer specialists monitors patients who are at risk of recurrence,” Lange explains. “The follow-up schedule depends on the stage of cancer, what kind of treatment has been received and prognostic factors. The risk of recurrence decreases as time goes on, but never gets down to zero.” 

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What is the treatment for breast cancer recurrence?

Depending on the type of cancer and where it appears, management of recurring breast cancer could include surgery, medical treatments, radiation or a combination of these therapies. Palliative and supportive care and clinical trials may also be part of the treatment plan.

Local Breast Cancer Recurrence

“Breast cancer can return to the same area (or close to) where it first appeared,” Lange says. In this case, your doctor will base a treatment approach on how the first cancer was addressed.

“If the original tumor was treated with lumpectomy and radiation, many patients may then need a bigger surgery, such as mastectomy, for the purpose of local control,” she explains. “If the original tumor was treated with mastectomy, then local resection of the recurrence should be considered. This is often followed by radiation therapy to the resection site.”

Lange says an oncologist (a doctor who treats cancer with medicines) will evaluate a patient with recurrent breast cancer. Based on characteristics of the cancer cells and how they are behaving, the oncologist might recommend chemotherapy, hormonal therapy or a combination of treatments. For some patients, clinical trials of new therapies may be available.

Metastatic Breast Cancer

Sometimes breast cancer recurs and shows up in another organ within the body. “Metastatic breast cancer is usually approached as a chronic disease with a goal of controlling the cancer and slowing its progression,” Lange says.

Your doctor may recommend one or more therapies to prolong and improve quality of life, including:

  • Chemotherapy
  • Radiation
  • Hormone therapy
  • Biologic targeted therapy
  • Small molecule inhibitors (such as everolimus or palbociclib) that can enter cancer cells and inhibit tumor growth

New treatment approaches being tested in clinical trials

woman meditating

Lifestyle changes can reduce the risk of breast cancer returning 

Surviving breast cancer diagnosis, treatment and recovery can cause uncertainty and concern that the cancer will come back or that a new cancer will occur. Addressing self-care after breast cancer and tending to your overall well-being can help restore a more positive outlook, and might even reduce your chances of facing cancer again.Does using deodorant increase your breast cancer risk? Learn about breast cancer myths and facts

“We are experts in managing local breast cancer recurrence and metastatic disease,” Lange says. “As a comprehensive breast center, our patients range from the newly diagnosed to those with advanced metastatic disease.

“Our goal is to find treatment and management options for all patients, using all the healing modalities that evidence-based medicine has proven to be beneficial in the treatment of breast cancer.”

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Lifestyle Changes After Breast Cancer

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