By Fran SmithWhy even smart doctors miss breast cancer - and how to make sure you're
getting the best care.
No matter what you know about other diseases, breast cancer is probably the
one that scares you most. It is frightening, striking nearly 182,000
women this year and plunging them into a world of complicated, arduous
treatment. So it's heartening to know that more women are being diagnosed
early, when the odds of beating the cancer are as high as 98 percent.
Prevention and treatment...
Breast cancer can recur or come back in three ways:
The cancer can return at the original site. This is called a local recurrence.
The cancer can recur nearby, such as in the chest. This is called a regional recurrence.
The cancer can spread to a distant location in the body, such as lymph nodes, bone marrow, or lungs. This is called a distant recurrence, or a metastasis.
Your doctor will order more tests to see if the breast cancer has spread, beginning with a physical exam and often a biopsy. The doctor is checking to see if cancer is present and, if so, if it is a recurrence of the same type of cancer or a completely new cancer (which is called a second primary cancer.)
If it is a recurrence, additional tests may include a bone scan, X-rays including CT scan, an MRI, blood tests, and PET scan.
Treatment will depend on whether the recurrence is local, regional, or distant.
Local recurrence can be treated with a mastectomy if a lumpectomy was originally performed or radiation if a mastectomy has been performed.
Regional breast recurrence is rare. Treatment may include a combination of surgery, medication, and radiation.
Treating a distant recurrence of breast cancer that has spread (called metastastic) can include:
Before treatment begins for metastatic breast cancer, the patient should be well-informed of all her options, including the risks and benefits of treatment. The focus of treatment for metastatic cancer is on extending life and having a good quality of life rather than cure.
Women are encouraged to continually reevaluate their breast cancer treatment plan and talk with their health care providers about whether treatment is helping their quality of life. During this time, women should take the best possible care of themselves by:
Getting enough rest.
Seeking out emotional support when needed.
Possibly making plans in the event their condition worsens.
At some point, the doctor may recommend a hospice program. Hospice care can either be delivered in a patient's home or in a separate facility. The focus of hospice care is to make the woman comfortable and help with arrangements for the future.