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Symptoms of Breast Cancer Recurrence

All breast cancer patients, both men and women, need to be aware of the potential symptoms of recurrence no matter what kind of treatment they had.

Symptoms of Recurrence

The symptoms of breast cancer recurrence may be very similar to the symptoms you experienced with your original cancer, especially since it typically recurs in the same site. The majority of breast cancer recurrences will occur within five years of the original diagnosis, with the most critical time being between two and three years post-treatment.

Some of the changes to look for within the previously treated breast are nipple discharge, new redness of the skin near or around the scar, crusting of the nipple and of course, any new lumps or masses that you feel. It is critical that you report these changes to your doctor and have them examine you. Also, if you have new pain that is unexplained by any kind of injury and is not going away with reasonable treatment, tell your doctor. Even if you are having back pain, neck pain or joint pain and do not believe it could be related to breast cancer. Breast cancer does often metastasize to and recur in bone, so these pains should not be ignored.

Breast cancer survivors should also make sure to have routine mammograms. A mammogram can be done whether or not symptoms are present and can confirm whether or not there is anything to investigate further. They can detect calcifications that may indicate a breast cancer recurrence prior to being able to feel a mass or lump.

The doctor may request that a full body PET/CT scan or bone scan depending on what kind of symptoms are present. PET/CT is similar to a CT scan but uses a special contrast with a radioactive sugar compound, which is taken up by tissues that are highly metabolic. Simply put, cancer cells are rapidly dividing and require lots of energy to do so, in the form of sugar. Cancer cells take up this contrast and the subsequent scan picks the highly metabolic cells up on imaging. However, there are some tissues that are naturally highly metabolic and will show up on imaging even though no cancer is present. These are the brain, heart, kidneys and bladder. For this reason, PET/CT cannot be used to image for metastasis or recurrence in these tissues.

In general, the well-known risk factors for breast cancer recurrence include: 3

  • Tumor size and grade
  • Hormone receptor status
  • Axillary node status
  • Pathologic cancer stage, determined after surgery
  • Status of genetic biomarkers, specifically BRCA

Symptoms of distant recurrence may seem completely unrelated, but may include:

  • Chronic pain
  • Fatigue
  • Coughing unexplained by illness, especially coughing up blood
  • Unexplained weight loss
  • Abdominal pain, bloating and pelvic discomfort

Any unusual physical symptoms that persist for more than a few days and do not resolve with normal treatment should be evaluated further. Going to your primary care physician who should be familiar with your family history, prior breast cancer treatment and your overall health will help identify potential concerns early. The American Cancer Society states that early detection and early treatment of breast cancer recurrence is critical for survival, just as it is with the initial cancer diagnosis.

References

1 Nguyen, P. L., Taghian, A. G., Katz, M. S., & etal. (2008). Breast Cancer Subtype Approximated by Estrogen Receptor, Progesterone Receptor, and HER-2 Is Associated With Local and Distant Recurrence After Breast-Conserving Therapy. Journal of Clinical Oncology , 2373-2378.

2 Israel, O., & Kuten, A. (2007). Early Detection of Cancer Recurrence: 18F-FDG PET/CT Can Make a Difference in Diagnosis and Patient Care. Journal of Nuclear Medicine , 285-355.

3 Isaacs, C., Stearns, V., & Hayes, D. F. (2001). New prognostic factors for breast cancer recurrence. Seminars in Oncology , 53-67.

This article was originally published on July 27,2012 and last revision and update of it was 9/2/2015.