Recurrent breast cancer is defined as breast cancer that reoccurs in the same spot as the original breast cancer. In other words, the cancer must come back in exactly the same spot, or very near, to the site of the original cancer in order for the cancer to be recurrent. If breast cancer forms in a different part of the same breast where the cancer originally formed, or in the other breast, it is not considered recurrent breast cancer but a new instance of primary breast cancer. Recurrent breast cancer comes in several different forms--local, regional and distant recurrence. The treatment varies depending on the form.
Types of Recurrence
Recurrent breast cancer is defined as a local recurrence if the cancer only comes back in the spot where the original cancer was found. Normally, local recurrence is found during physicals, breast self exams or mammograms.
Regional recurrent breast cancer refers to breast cancer that comes back in the original spot, but that has also spread to include either the lymph nodes (between the ribs and breastbone, in the neck or by the collarbone) or the muscles in the chest wall.
Distant recurrence occurs when the cancer reappears in the breast, but also in an unrelated part of the body. In other words, distant recurrence means that when the cancer comes back, it is metastatic. Metastatic breast cancer is no longer curable, so treatments are designed to improve and lengthen life.
Treatment for Recurrence
The type of treatment depends on the recurrence. Local recurrence is the easiest to treat, and involves the use of surgery, chemotherapy, radiation and hormonal therapy. In other words, it is treated very similar to primary breast cancer. Regional recurrence is a bit more difficult to treat, but is still curable. Metastatic cancer is not curable and treatment is centered on relieving symptoms and slowing cancer growth.
Local Recurrence
The appropriate treatment for local recurrence varies depending on the patient's situation. A patient who previously had a lumpectomy or breast-conserving surgery who experiences local recurrence usually will need to have a mastectomy. If the patient originally had a mastectomy, local recurrence can still occur and appears near the mastectomy site or the skin where the breast originally was. If surgery is possible to treat local recurrence after mastectomy, it is performed to remove the tumor.
In either case, if the affected area was not given radiation during the first course of treatments, the patient is administered radiation. If the patient already received radiation, this treatment method is no longer an option and either hormone therapy or chemotherapy must be used to try to control or cure the recurrence.
Regional Recurrence
Regional recurrence is usually treated by removal of the lymph nodes (if possible) along with radiation and chemotherapy designed to shrink or kill the cancer cells in the lymph nodes. A 2001 study by the Cochrane Breast Cancer Collaborative Review Group revealed that combining chemotherapy with radiation did not dramatically increase the survival rate.
Distant Recurrence
Distant recurrence means the cancer is metastatic and incurable. The most common sites of metastases for rest cancer include the liver, lungs, bone and brain. Treatment depends on the site of metastases. Chemotherapy and radiation may be used to attempt to kill cancer cells. If the cancer is hormone receptive, hormone blockers may be administered to block the estrogen that cancer cells need to grow. Pain medication may be prescribed to deal with the symptoms of the metastases.
Tags: breast cancer, cancer cells, comes back, local recurrence, lymph nodes, other words, breast cancer
