Recurrence of breast can occur at any time; however, the majority of the recurrences happen during the initial first three to five years following therapy. Recurrent breast cancer lesion can occur either locally (in the breast that was treated or around the scar of mastectomy) or at some other site in the body, most common sites being lymph nodes, liver, bones, lungs or brain. How can you know the breast cancer is coming back? How to deal with it?

What Are the Signs of Breast Cancer Recurrence?

If you have a personal history of breast cancer, then it is recommended that you should practice regular breast self-exams. It should include checking both the area that has been treated and the other disease free breast every month. If you notice any abnormal changes, consult your physician immediately.

1. Signs

• You notice an area that is different in appearance from the rest of the breast.
• You feel an abnormal lump or thickening of the tissue in the breast or in the underarms, especially if they persist even after the menstrual cycle.
• You notice a change in the shape, size or contour of the breast.
• You feel a marble-like area under the skin of the breast.
• You notice or feel abnormal appearing skin on the breast or nipple, for instance, the skin becomes dimpled, scaly, puckered or inflamed.
• You notice discharge from the nipples, which may be clear or bloody.
• The skin on the breast or nipple becomes red.

2. Warnings

Apart from doing regular breast self-exams, you should also schedule regular appointments with your physician. During these follow-up appointments your physician will perform breast exam, do appropriate imaging or lab tests as required and enquire about any abnormal symptoms that you may be experiencing. The frequency of these follow-up appointments should be every 3-4 months initially. Gradually as you remain cancer-free, the frequency of follow-up appointments can be decreased. You should go for regular screening mammograms, which are usually recommended to be done once a year.

3. When to See a Doctor

You should also see your doctor immediately in case you develop any of the following symptoms: new onset of pain, changes or occurrence of new lumps or thickening in the breast or scar of mastectomy or chest wall, unintentional weight loss, shortness of breath etc. You should also visit and talk to your physician if you notice any of the symptoms of recurrence mentioned above.

What Are the Risk Factors of Breast Cancer Recurrence?

Various factors that increase your risk of breast cancer recurrence are:

1. Lymph Node Involvement

If your cancer has spread to the nearby lymph nodes when you were diagnosed initially, then your chances of having a recurrence are increased. Females who have multiple affected lymph nodes are at a higher risk.

2. Large Size of Tumor

If the size of your tumor was larger at the time of initial diagnosis, then also your chances of recurrence are high. Females who have tumors with size greater than 5 centimeters or 2 inches have the highest chance of recurrence. Such females should consider radiation therapy even if they have had mastectomy to remove the tumor.

3. Tumor Margins Are Close or Positive

Your chances of recurrence are increased if you have a positive tumor margin. Some healthy margin of normal tissue is also removed during the removal of breast lump. If these borders are free of cancer, then the margins are negative; however, if there are cancerous cells present, then the margins are positive.

4. No Radiation Therapy is Given after Lumpectomy

Females who choose to undergo lumpectomy so as to preserve the breast tissue are recommended to undergo radiation therapy to the remaining breast so as to avoid a recurrence.

5. Age

The risk of recurrence is increased if the age of the female is less than 35 years at the time of the initial diagnosis.

6. Presence of Inflammatory Breast Cancer

Females who suffer from inflammatory breast cancer are also a higher risk of recurrence.

How to Treat Breast Cancer Recurrence

• A local breast cancer recurrence is treated according to the initial treatment you received. If your initial treatment was lumpectomy then recurrence is treated with mastectomy. Similarly, if initially you had a mastectomy, then the recurrence is treated by removing the tumor followed by radiation therapy. Chemotherapy, hormone therapy and/or radiation therapy may be used following surgery.
• If the recurrence is in the other breast, treatment is done by doing a lumpectomy or mastectomy followed by radiation and/or systemic therapy.
• Females who have recurrence in distant organs such as lungs, bones, brain etc, treatment is done using systemic therapy.

Home Remedies for Breast Cancer Recurrence

1. Eat Well

You should eat a nutritious diet to maintain stamina so as to cope with the side effects of treatment and prevent recurrence.

• Eat foods rich in protein. Protein rich foods help in the repair of body tissues. Recommended foods include chickpeas, kidney beans, eggs, cottage cheese, yoghurt, poultry, fish, peanut butter etc in your diet.
• Eat foods with an open mind. You should keep trying different nutritious and beneficial foods even if you have a dislike for any particular variety.
• Eat small quantities of foods at regular intervals. Eat several small meals throughout the day. Snack on fresh fruits and vegetables which you should keep handy.

2. Manage Stress

Practice stress managing strategies such as meditation, yoga and stretching exercises. One technique of meditation is to simply close your eyes and paying attention your inhalation and exhalation.

3. Stay Active

Get involved in regular physical activity as it helps to relieve depression and anxiety, improves mood and decrease the side effects of medications. You can go for a walk or do swimming, or biking.

How to Prevent Breast Cancer Recurrence

There are various factors that are associated with reduced risk of breast cancer recurrence. Some of these are:

• Tamoxifen or Aromatase Inhibitor Therapy. Breast cancer recurrence risk is reduced by taking tamoxifen for five years after the initial treatment. According to research, some patients may benefit from aromatase inhibitor therapy either 2-3 years post tamoxifen therapy or post initial treatment.
• Chemotherapy. Chemotherapy is associated with a reduced risk of cancer recurrence.
• Radiation therapy. Radiation therapy should be given to females who had breast sparing surgery or with a large tumor or inflammatory breast cancer to reduce the risk of recurrence.
• Herceptin. Herceptin is shown to reduce the cancer risk for females whose cancer releases extra HER2 protein.
• Maintaining healthy weight also reduces the risk of cancer recurrence.