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Checking for Breast Cancer Recurrence
Breast cancer can recur at any time, but most recurrences occur in the first three to five years after initial treatment. Breast cancer can come back as a local recurrence (in the treated breast or near the mastectomy scar) or as a distant recurrence somewhere else in the body. The most common sites of recurrence outside the breast include the lymph nodes, the bones, liver, lungs, or brain.
How Do I Know There Is A Recurrence of Breast Cancer?
If you've been treated for breast cancer, you should continue to practice breast self-exam, checking both the treated area and your other breast each month. You should report any changes to your doctor right away. Breast changes that might indicate a recurrence include:
- An area that is distinctly different from any other area on either breast.
- Lump or thickening in or near the breast or in the underarm that persists through the menstrual cycle.
- A change in the size, shape, or contour of the breast.
- A mass or lump, which may feel as small as a pea.
- A marble-like area under the skin.
- A change in the feel or appearance of the skin on the breast or nipple, including skin that is dimpled, puckered, scaly, or inflamed (red, warm, or swollen)
- Bloody or clear fluid discharge from the nipples
- Redness of the skin on the breast or nipple
In addition to performing monthly breast self-exams, keep your scheduled follow-up appointments with your doctor. During these appointments, your health care provider will perform a breast exam, order lab or imaging tests as needed, and ask you about any symptoms you might have. Initially, these follow-up appointments may be scheduled every three to four months. The longer you are cancer-free, the less often you will need to see your doctor. Continue to follow recommendations on screening mammograms (usually recommended once a year).
What Are the Risk Factors for a Breast Cancer Recurrence?
Prognostic indicators are characteristics of a patient and her tumor that may help a doctor predict a recurrence of breast cancer. These are some common indicators:
- Lymph node involvement. Women who have lymph node involvement are more likely to have a recurrence.
- Involvement of the microscopic lymphatic system or blood vessels within the breast increases the risk of recurrence.
- Tumor size. In general, the larger the tumor, the greater the chance of recurrence.
- Hormone receptors. About two-thirds of all breast cancers contain significant levels of estrogen receptors, which means the tumors are estrogen receptor positive (ER+). ER-positive tumors tend to grow less aggressively and may respond favorably to treatment with hormones.
- 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 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 (also called proliferative capacity) are usually more aggressive (faster growing).
- Oncogene expression. An oncogene is a gene that causes or promotes cancerous changes within the cell. For example, tumors that contain the HER2 oncogene may increase a patient's chance of recurrence.
WebMD Medical Reference
Breast Cancer Guide
VIVELLE-DOT (estradiol transdermal system) IS AVAILABLE BY PRESCRPTION ONLY.
INDICATION
Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman's ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.
IMPORTANT SAFETY INFORMATION
Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).
Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).
Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.
The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.
You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.
Please see Full Prescribing Information for Vivelle-Dot.
October is National Breast Cancer Awareness Month, and a new study reveals why a high number of women with the disease still prefer to have the entire breast surgically removed instead of just the tumor. It's not always because doctors recommend it.
