Recurrence in the breast

Recurrence in the breast

Careful imaging, or pictures of areas inside the body, is critical in determining treatment options. Even if you have already had several imaging tests in order for your doctor to make a diagnosis, you may have more mammography, MRIs, CAT or PET scans, ultrasound, and if necessary, chest X-rays.

If the cancer has come back in the area of the original lumpectomy, but you have no signs of disease elsewhere, then your outlook is probably quite good.

If the cancer came back just as a small lump in your breast, you may need only local treatment. Local treatment is successful in 8 out of 10 women who have a breast cancer recurrence that is limited to the breast.

If your initial treatment was lumpectomy and radiation therapy, then the standard of care for a recurrence is complete removal of the breast (mastectomy). Another lumpectomy followed by radiation therapy is usually only an option if you haven't had radiation therapy before and your risk of cancer spread is very low. Here are some signs that your situation would be considered encouraging:

• The breast cancer came back only at the place where it first appeared.
• The cancer lump is at most four centimeters wide and can be completely removed.
• The recurrent cancer is not invasive (DCIS [ductal carcinoma in situ]).
• It's been a long time between when you were last treated and when the cancer came back.
• The cancer does not appear to be very aggressive and has not spread to nearby lymph nodes.

If you already had lumpectomy and radiation therapy, you may be able to get into a study or clinical trial using partial breast radiation as an alternative to mastectomy.

If the cancer has some features that are less encouraging, your doctor may recommend some sort of systemic (whole-body) treatment. The purpose of this treatment is to get rid of any cancer cells that might be outside the breast but can't be seen on tests. Find out about systemic (whole-body) treatments here.

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