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Symptoms

By Mayo Clinic staff

Signs and symptoms of recurrent breast cancer vary depending on where the cancer comes back. It may show up as a lump in the breast, thickening of the surgical scar or lump on the chest wall near where your original cancer was. It may be detected in an abnormal finding on a mammogram of the breast where you had a lump removed (lumpectomy), or show up in a distant place in your body such as a bone, your liver or your lungs.

Local recurrence
In a local recurrence, cancer reappears in the same area as your original, or "primary," tumor. This could be in the remaining breast in women who have had a lumpectomy, or it may be in the chest wall or skin in women who have had a mastectomy.

Signs and symptoms of local recurrence within the same breast may include:

  • A new lump in your breast or irregular area of firmness
  • A new thickening in your breast area
  • A new pulling back of the skin at the lumpectomy site
  • Skin inflammation or area of redness
  • Flattening or indentation of your nipple or other nipple changes

Signs and symptoms of local recurrence on the chest wall after a mastectomy may include:

  • One or more painless nodules on or under the skin of your chest wall
  • A new area of thickening along or near the mastectomy scar

Regional recurrence
A regional breast cancer recurrence means the cancer has come back in the lymph nodes in your armpit or collarbone area. Signs and symptoms of regional recurrence may include:

  • A lump or swelling in the lymph nodes under your arm, in the groove above your collarbone or around your breastbone
  • Swelling of your arm
  • Persistent pain in your arm and shoulder
  • Increasing loss of sensation in your arm and hand
  • Persistent chest pain
  • Difficulty swallowing

Distant (metastatic) recurrence
A distant or metastatic recurrence means the cancer has traveled to distant parts of the body, most commonly the bones, liver and lungs. The signs and symptoms may include:

  • Bone pain
  • Persistent, dry cough
  • Difficulty breathing
  • Shortness of breath
  • Chest pain
  • Loss of appetite
  • Abdominal tenderness or discomfort
  • Persistent nausea, vomiting or weight loss
  • Jaundice
  • Severe headaches
  • Visual disturbances
  • Seizures, numbness or imbalance

When to see a doctor
After you've been treated for breast cancer, you should continue to see your doctor regularly for follow-up exams. Your doctor will check for any signs of cancer recurrence. You'll also have an annual mammogram if you had a lumpectomy. Still, many women discover recurrent breast cancer on their own. You know your body best — what feels normal and what doesn't. Check your breasts monthly to look for changes.

It's important to be aware of the signs and symptoms of recurrent breast cancer, such as new pain, changes or new lumps in your breast or surgical scar, weight loss, and shortness of breath. If you experience any signs and symptoms that might suggest a recurrence, talk to your doctor.

Causes Definition

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References
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  2. Hayes DF. Overview of Treatment for Locally Advanced, Recurrent, and Metastatic Breast Cancer. http://uptodateonline.com/index. Accessed Nov. 12, 2008.
  3. American Cancer Society, Living With Uncertainty: The Fear of Cancer Recurrence. http://www.cancer.org/docroot/MLT/content/MLT_4_1x_Living_With_Uncertainty_-_The_Fear_of_Cancer_Recurrence.asp. Accessed May 19, 2009.
  4. Punglia RS et al. Local therapy and survival in breast cancer. N Engl J Med. 2007; 356:2399-2405.
  5. UpToDate, Hirsch A, Management of Locoregional Recurrence of Breast Cancer after Breast-Conserving Therapy, July 31, 2007, accessed November 12, 2007, http://uptodateonline.com/utd/content/topic.do?topicKey=breastcn/23524&view=print.
  6. UpToDate, Hirsch A, Management of Locoregional Recurrence of Breast Cancer after Mastectomy, May 10, 2007, accessed November 12, 2007, http://uptodateonline.com/utd/content/topic.do?topicKey=breastcn/28927&view=print.
  7. Debled M et al. Prognostic factors of early distant recurrence in hormone receptor-positive, postmenopausal breast cancer patients receiving adjuvant tamoxifen therapy: Results of a retrospective analysis. Cancer. 2007; 109:2197-2204. Accessed May 19, 2009.  http://www3.interscience.wiley.com/cgi-bin/fulltext/114214630/PDFSTART
  8. Geiger AM et al. Recurrences and second primary breast cancers in older women with initial early-stage disease. Cancer. 2007; 109:966-974. http://www3.interscience.wiley.com/cgi-bin/fulltext/114082491/PDFSTART Accessed May 19, 2009.
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  11. National Breast Cancer Coalition, Gene-Expression Profile Testing, March 2007, accessed October 30, 2007, http://www.stopbreastcancer.org//index.php?option=com_content&task=view&id=161&Itemid=178.
  12. American Cancer Society, Breast Cancer Recurrence Test Gets FDA Nod, February 7, 2007, accessed May 8, 2008, http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Breast_Cancer_Recurrence_Test_Gets_FDA_Nod.asp.
  13. U.S. Food and Drug Administration, FDA Clears Breast Cancer Specific Molecular Prognostic Test, February 6, 2007, accessed October 5, 2007, http://www.fda.gov/bbs/topics/NEWS/2007/NEW01555.html.
  14. Buchanan CL, Locoregional Recurrence after Mastectomy: Incidence and Outcomes, Journal of the American College of Surgeons, October 2006, 469-474.
  15. Coombes RC, Survival and Safety of Exemestane versus Tamoxifen after 2-3 Years' Tamoxifen (Intergroup Exemestane Study): A Randomised Controlled Trial, The Lancet, February 17, 2007, 559-570.
  16. Thiebaut ACM, Dietary Fat and Breast Cancer: Contributions From a Survival Trial, Journal of the National Cancer Institute, December 20, 2006, 1753-1755.
  17. Pierce JP, Influence of a Diet Very High in Vegetables, Fruit, and Fiber and Low in Fat on Prognosis Following Treatment for Breast Cancer: The Women's Healthy Eating and Living (WHEL) Randomized Trial, JAMA, July 18, 2007, 289-298.

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May 27, 2009

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