For many women, the diagnosis of breast cancer represents not only a major
physical battle, but also the ultimate emotional challenge -- one that affects
every relationship in our life.
Indeed, from friendships to romance, from being a parent to being a
daughter, the way you relate to everyone -- and the way they relate to you --
can be affected.
"I do think cancer has more impact on emotions and emotional
relationships than other catastrophic diseases, because with cancer, death is
Breast cancer can come back as a local recurrence (meaning in the treated breast or near the mastectomy scar) or somewhere else in the body. Some of the most common sites of recurrence outside the breast are the lymph nodes, bones, liver, lungs, and brain.
How Do I Know if There Is a Recurrence of Breast Cancer?
If you've been treated for breast cancer, you should keep doing breast self-exams, checking the treated area and your other breast each month. You should tell your doctor about any changes right away.
Also, keep getting regular mammograms.In some screening centers, three-dimensional mammograms are available in addition to traditional digital mammograms. If genetic tests show you have the BRCA mutations, you may also need an MRI of your breast. Talk to your doctor about the best screening tests for you.
Breast changes that might be a recurrence include:
A lump or thickening in or near the breast or in the underarm that doesn’t go away after your period
A change in the size, shape, or contour of the breast
A change in the feel or appearance of the skin on the breast or nipple, including skin that is dimpled, puckered, scaly, red, warm, or swollen
Blood or clear fluid coming out of a nipple
Along with monthly breast self-exams, you should go to follow-up appointments with your doctor. During these appointments, your doctor should examine your breasts, ask about any symptoms, and order lab or imaging tests if they are needed. Go over any new symptoms with your doctor right away, like pain, headaches, weight loss, lack of appetite, or anything else.
At first, your follow-up appointments may be every 3 to 4 months. The longer you are cancer-free, the less often you will need to see your doctor.
What Are the Risk Factors for a Breast Cancer Recurrence?
These things may affect the chance of your breast cancer coming back:
Tumor size. The larger the tumor was, the greater the chance of recurrence.
Cancer spread. If your breast cancer had spread to your lymph nodes, the more lymph nodes that had cancer cells, the higher your risk of recurrence. Your risk is also higher if cancer cells were found in the lymph vessels or blood vessels of your breast.
Hormone receptors. About two-thirds of all breast cancers have receptors for estrogen (called ER+) or progesterone (PR+) or both types.
HER2. This gene triggers the growth of cancer cells.
Histologic grade. This term refers to how much the tumor cells resemble normal cells when viewed under the microscope. The higher the histologic grade, the greater the chance of recurrence.
Nuclear grade. This is the rate at which cancer cells in the tumor divide to form more cells. Cancer cells with a high nuclear grade are usually more aggressive (faster growing).