Materiały źródłowe

• #1 Recurrent breast cancer – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/recurrent-breast-cancer/symptoms-causes/syc-20377135

  Recurrent breast cancer is breast cancer that comes back after initial treatment. Although the initial treatment is aimed at eliminating all cancer cells, a few may have evaded treatment and survived. These undetected cancer cells multiply, becoming recurrent breast cancer. […] Recurrent breast cancer may occur months or years after your initial treatment. The cancer may come back in the same place as the original cancer (local recurrence), or it may spread to other areas of your body (distant recurrence). […] After your breast cancer treatment ends, your doctor will likely create a schedule of follow-up exams for you. During follow-up exams, your doctor checks for any symptoms or signs of cancer recurrence. […] Recurrent breast cancer occurs when cells that were part of your original breast cancer break away from the original tumor and hide nearby in the breast or in another part of your body. Later, these cells begin growing again.

• #2 Recurrent breast cancer | Altru Health System

  https://www.altru.org/health-library/conditions/recurrent-breast-cancer

  Recurrent breast cancer is breast cancer that comes back after initial treatment. Although the initial treatment is aimed at eliminating all cancer cells, a few may have evaded treatment and survived. These undetected cancer cells multiply, becoming recurrent breast cancer. […] Recurrent breast cancer may occur months or years after your initial treatment. The cancer may come back in the same place as the original cancer (local recurrence), or it may spread to other areas of your body (distant recurrence). […] If your doctor suspects you may have recurrent breast cancer based on results of a mammogram or physical exam, or because of signs and symptoms, he or she may recommend additional tests to confirm the diagnosis. […] Tests and procedures may include: Imaging tests. What imaging tests you’ll undergo will depend on your specific situation. Imaging tests may include magnetic resonance imaging (MRI), computerized tomography (CT), X-ray, bone scan or positron emission tomography (PET).

• #3 Breast cancer recurrence | Breast Cancer Now

  https://breastcancernow.org/about-breast-cancer/diagnosis/breast-cancer-recurrence/

  After treatment, most breast cancers dont come back. But sometimes breast cancer can return. Find out more about the different types of breast cancer recurrence. […] Recurrence is the term used when breast cancer has come back. […] Tests, including a biopsy, will help to confirm the type of recurrence. […] Diagnosing a local or regional recurrence usually involves similar tests to those used to diagnose primary breast cancer. […] If you are diagnosed with a local or regional recurrence, your doctors may use tests to check if there is cancer in any other parts of your body before starting treatment. […] Diagnosing secondary breast cancer involves different tests depending on what symptoms you have and where they are in the body. […] If breast cancer has spread to another part of the body, it can be treated but it cannot be cured. […] If cancer has spread from the breast to another part of the body, it can be treated but it cannot be cured.

• #4 Breast Cancer Recurrence: Types, Symptoms and Risk

  https://www.cancercenter.com/cancer-types/breast-cancer/types/rare-breast-cancer-types/recurrent-breast-cancer

  There are three types of recurrent breast cancer: Local recurrence: When cancer returns to the same part of the breast as the initial diagnosis, the disease is classified as a local recurrence. Regional recurrence: This type is diagnosed when the breast cancer is found in nearby lymph nodes and/or the chest wall. Distant recurrence: Also called metastatic breast cancer, this occurs when breast cancer cells travel away from the original tumor in the breast to other parts of the body through the lymphatic system or bloodstream. Common areas for metastasis include the bones, liver and lungs. Even when a metastatic breast tumor spreads to a different part of the body, it contains the same cancerous cells that developed in the breast. […] The signs of cancer recurrence depend on where the cancer resurfaces. The patient might not see or feel any signs of a local recurrence, and, if she does, it’ll probably be a slight change in or around the breast or underarm area. More often than not, the patient’s provider finds evidence of a local recurrence during a physical exam or mammogram.

• #5 Recurrent breast cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/recurrent-breast-cancer/diagnosis-treatment/drc-20377141

  If your doctor suspects you may have recurrent breast cancer based on results of a mammogram or physical exam, or because of signs and symptoms, he or she may recommend additional tests to confirm the diagnosis. […] Your doctor may recommend a biopsy procedure to collect suspicious cells for testing, as this is the only way to confirm whether your cancer has returned. […] A pathologist can determine if the cancer is a recurrence of cancer or a new type of cancer. […] Your treatment options will depend on several factors, including the extent of the disease, its hormone receptor status, the type of treatment you received for your first breast cancer and your overall health. […] Treatment for a local recurrence typically starts with an operation and may include radiation if you haven’t had it before.

• #6 Treatment if your breast cancer comes back | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/breast-cancer/treatment/if-your-cancer-comes-back

  Many women have no more problems after their original treatment for breast cancer. But sometimes breast cancer comes back after treatment to try to cure it. This is called recurrent or relapsed breast cancer. […] Symptoms of recurrent breast cancer include: a lump called a nodule in the breast or scar, change in shape or size of the breast, swelling in the lymph nodes above and below the collarbone, the neck, and around the breastbone, changes in the shape or position of the nipple, redness or a skin rash around the breast. […] You have tests to check if the cancer has come back. These include: a mammogram, an ultrasound scan, having a sample of tissue taken (biopsy). […] The treatment you have for recurrent breast cancer depends on the treatment you had before. It also depends on where the cancer has come back.

• #7 How Can You Tell if Breast Cancer is Recurring?

  https://georgiaradiationtherapy.com/blog/how-can-you-tell-if-breast-cancer-is-recurring

  A regional recurrence has spread beyond the initial location but is still nearby, usually in a lymph node in the armpit or collarbone area. Signs and symptoms of a regional recurrence include a lump or swelling in the armpit, collarbone, or neck. […] When a distant recurrence occurs, the cancer has spread far beyond the initial location to the lungs, bones, brain, or other body areas. This is also referred to as stage 4 breast cancer. Signs and symptoms of a distant recurrence include persistent pain in the chest, back, or hip, persistent cough, difficulty breathing, loss of appetite, unexplained weight loss, severe headache, and seizure. […] Symptoms of breast cancer recurrence will vary depending on the type of recurrence. Some common signs and symptoms of breast cancer recurrence include: A lump on the breast or chest area, Flattening of the nipples or abnormal discharge, Swollen skin near a lumpectomy site, Thickening of the skin near the surgical scar, Firm breast tissue, Chest pain, Difficulty swallowing, Pain or swelling in one arm or shoulder, Swollen lymph nodes in the underarms or collarbone area, Dry cough, Dizziness, Fatigue, Loss of appetite.

• #8 Examining Breast Cancer Recurrence Detection Methods in a Community Oncology Setting

  https://www.targetedonc.com/view/examining-breast-cancer-recurrence-detection-methods-in-a-community-oncology-setting

  Data from a large study showed that the majority of breast cancer recurrences were self-detected, with only 6.8% found by physician exams, suggesting the need for better screening methods to detect metastatic recurrences earlier. […] The study found that routine survivorship clinical breast exams had a low detection rate for recurrences, with only 6.8% of recurrences being detected this way. […] The study revealed that patient-reported symptoms were the most common modality for detecting recurrence, accounting for 69.4% of cases. Routine mammograms detected 8.1% of recurrences, diagnostic testing identified 10.9%, and physician exams were only 6.8%. […] The study also found that most recurrences were distant, so most recurrences were metastatic, emphasizing the need for alternative screening modalities to detect metastatic recurrences earlier since the current surveillance strategies do not recommend any sort of surveillance to detect metastatic cancer.

• #9 Recurrent breast cancer | Altru Health System

  https://www.altru.org/health-library/conditions/recurrent-breast-cancer

  Recurrent breast cancer is breast cancer that comes back after initial treatment. Although the initial treatment is aimed at eliminating all cancer cells, a few may have evaded treatment and survived. These undetected cancer cells multiply, becoming recurrent breast cancer. […] Recurrent breast cancer may occur months or years after your initial treatment. The cancer may come back in the same place as the original cancer (local recurrence), or it may spread to other areas of your body (distant recurrence). […] If your doctor suspects you may have recurrent breast cancer based on results of a mammogram or physical exam, or because of signs and symptoms, he or she may recommend additional tests to confirm the diagnosis. […] Tests and procedures may include: Imaging tests. What imaging tests you’ll undergo will depend on your specific situation. Imaging tests may include magnetic resonance imaging (MRI), computerized tomography (CT), X-ray, bone scan or positron emission tomography (PET).

• #10 Current Approaches and Challenges in Early Detection of Breast Cancer Recurrence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3982041/

  Mammography is the mainstay of surveillance imaging following curative treatment of breast cancer with 8%-50% of ipsilateral recurrence and 18%-80% of contralateral metachronous cancer detected by mammography alone. […] The ACR practice guidelines for breast MR state that MRI is useful in women with a history of breast cancer and suspicion for disease recurrence when clinical, mammographic, or sonographic findings are inconclusive. […] Breast cancer relapses are rarely curable with estimates of only 1-1.5% of women who present each year with recurrent breast cancer having potentially curable disease. However, current data shows a survival benefit from early detection of asymptomatic loco-regional or contra-lateral breast cancer recurrences.

• #11 Breast Cancer Diagnosis – National Breast Cancer Foundation

  https://www.nationalbreastcancer.org/breast-cancer-diagnosis/

  Breast cancer can be diagnosed through multiple tests, including a mammogram, ultrasound, MRI, and biopsy. […] Regular screenings, including breast self-exams, mammograms, and clinical breast exams, can help detect cancer before signs or symptoms develop. […] A diagnostic mammogram is used if signs of breast cancer are present or after suspicious results are found on a screening mammogram. […] An ultrasound (or sonogram) may be used to help determine if a breast lump is a benign cyst or a solid mass that may indicate breast cancer. […] A breast MRI uses magnetic energy and radio waves to assess the size and specific location of an abnormal finding in the breast tissue. […] A biopsy removes tissue or fluid from a suspicious area in the breast tissue that is then examined to check for the presence of breast cancer. […] Lab tests, such as a hormone receptor test and HER2/neu test, are used to determine prognosis and treatment options after a breast cancer diagnosis. […] Waiting for the results of breast cancer screening or tests can be stressful, but there are ways to cope and help calm your mind and nerves.

• #12 Diagnostic Challenges of Postsurgical Breast Cancer Recurrence

  https://www.asrt.org/promotions/insidejournals/inside-asrt-journals-mammo

  ASCO 2012 guidelines recommend routine clinical examination and follow-up with mammography for surveillance in the adjuvant setting. However, for lesions presenting deep in the muscle layer or in proximity to a surgical scar or the axilla, physical examination and mammography are limited in diagnosing recurrence effectively. In the presence of a recurring cancer, magnetic resonance (MR) imaging is useful to differentiate benign vs malignant disease presentation because of a higher tissue sensitivity (99%) when compared to mammography (33%). Nevertheless, MR imaging is not without drawbacks, including inhomogeneous fat suppression or altogether failure of fat suppression. In addition, in a study of 969 women, MR imaging results provided false diagnosis of recurring breast cancer in 91 women when compared with pathology results of their benign lesions; therefore, routine breast MR surveillance might expose patients to additional biopsies for benign lesions.

• #12 Diagnostic Challenges of Postsurgical Breast Cancer Recurrence

  https://www.asrt.org/promotions/insidejournals/inside-asrt-journals-mammo

  Mammography remains a staple of detection and diagnosis of breast cancer but with cosmetic surgical reconstruction techniques, detection challenges have increased. Surgical options for treatment of breast cancer include breast conservation with local excision of tumor, transverse rectus abdominis myocutaneous (TRAM) flap reconstruction, latissimus dorsi flap, and deep inferior epigastric perforator (DIEP) flap techniques. These methods intend to conserve the cosmetic appearance of the breast for the patient, but mammography’s effectiveness in detection and diagnosis of recurrent cancer often is dependent upon the location of the lesion. In addition, there is little consistency in the standard of follow-up care for symptomatic patients. Mammography does increase survivability as documented in Joensuu et al: Cancerous tumors detected by mammography screening are associated with a better prognosis than tumors of similar size found outside of screening. Hanagiri et al notes that in 5% to 10% of patients undergoing mastectomy for breast cancer, recurrence occurred in the thoracic wall. This typically makes mammography less effective in discovering recurrence, as the chest wall is not imaged adequately with mammography. A posterior location beneath scar tissue from reconstruction also makes tumors less likely to be palpated on self-examination or clinical examination.

• #13 Recurrent Breast Cancer | Queens NY Medical Imaging | Main Street

  https://www.mainstreetradiology.com/procedures/petct/recurrent-breast-cancer/

  Accurately diagnosing breast cancer. […] Accurately diagnosing breast cancer – and determining its stage in patients who have already had it brings its own set of challenges. […] Traditional CT scans often have trouble distinguishing between new cancers and anatomical changes brought about by the first battle with the disease. […] Whole-body positron emission tomography (PET) has been shown to be both more sensitive and specific than CT for the diagnosis of recurrent breast cancer. […] In addition, PET is less sensitive than surgical axillary node staging. PET is reserved for patients with clinical suspicion of metastatic disease or local recurrence, where PET has been shown to be superior to CT. […] Accurate staging of breast cancer recurrence is critical for therapeutic planning. […] Limitations of CT include the difficulty in distinguishing post-operative and post-radiation changes from recurrence, and inability to identify and characterize small lesions. […] Bone scan, although a sensitive study for skeletal metastases, results frequently in false positive diagnoses.

• #14 Disease Restaging and Diagnosis of Recurrent and Metastatic Disease Following Primary Therapy with FDG-PET Imaging

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2794199/

  Breast cancer is the most common non-skin cancer and the second leading cause of cancer death in women. There are 40,000 women per year dying of breast cancer in the US, and most breast cancer victims die of progressive metastatic disease. The optimal treatment of patients with recurrent breast cancer depends on knowing the true extent of disease. Conventional imaging (CI) for restaging breast cancer which includes mammography, ultrasound and MR for locoregional recurrence and contrast-enhanced CT and bone scintigraphy for distant metastasis covers likely sites of breast cancer recurrence and spread, but may miss sites of recurrence and particularly sites of disease spread. The addition of FDG PET to CI for detection of recurrent neoplasm after primary treatment of breast cancer has proven to be a complementary imaging technique, overcoming many of the limitations CI for re-staging. The additional metabolic information provided by FDG PET increases the accuracy of detecting recurrent or metastatic lesions. This is particularly true in the evaluation of extra-axillary regional lymph nodes and for some bone metastases that are osteolytic. Integrated PET/CT systems, with their ability to accurately map foci of elevated FDG uptake to anatomic structures, have provided additional diagnostic confidence and a modest level accuracy in the evaluation of breast cancer recurrences compared to FDG PET alone.

• #15 Disease Restaging and Diagnosis of Recurrent and Metastatic Disease Following Primary Therapy with FDG-PET Imaging

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2794199/

  Bone is the most frequent site of recurrence after treatment for primary breast cancer; nearly 70% of patients with advanced disease have skeletal metastases. Metastases from breast cancer can produce a varied physiologic response in bone; lesions can be osteolytic, osteoblastic or a mixture of the two. Bone scintigraphy has been the standard initial imaging method for the detection of skeletal metastases in oncologic patients because of its ability to survey the entire skeleton with high sensitivity for detection of metastatic lesions. Retrospective studies comparing the sensitivity of bone scintigraphy to FDG PET for the detection of skeletal metastases in patients with advanced breast cancer have shown conflicting results. Some studies have shown FDG PET to be equal or superior to planar bone scintigraphy in the detection of skeletal metastases while others have shown FDG PET to be less sensitive on a lesion-based analysis. Their findings suggest that the physiologic basis of tracer uptake in skeletal metastases with FDG PET and bone scintigraphy is different; FDG uptake is a more direct reflection of metabolically active tumor cells in bone while bone scintigraphy reflects a reparative process occurring in bone tissues adjacent to tumor cells. These results also suggest that FDG PET and bone scan should not be considered substitutes for each other for skeletal metastasis staging in breast cancer. In our center, bone scintigraphy remains one of the routine studies in breast cancer metastatic staging, with FDG PET to help clarify staging in the case of difficult or equivocal conventional staging.

• #16 Disease Restaging and Diagnosis of Recurrent and Metastatic Disease Following Primary Therapy with FDG-PET Imaging

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2794199/

  FDG PET and PET/CT are useful tools for restaging breast cancer patients who have undergone primary therapy, particularly in those with advanced stages, equivocal findings at conventional staging studies or asymptomatic with elevated tumor markers. In the clinical setting, they should be used to answer specific clinical questions and to complement conventional staging studies, not as a replacement. Evaluation of locoregional recurrences involving the skin, breast and chest wall with FDG PET and PET/CT can be problematic due to poor accuracy and diagnosis is usually made by histologic confirmation. For evaluation of distant metastases, FDG PET and PET/CT perform significantly better than conventional staging studies, particularly for the detection of nodal disease and osteolytic skeletal metastases, and therefore a more accurate method of determining the true extent of disease. One exception is the detection of sclerotic bone metastases; these lesions are not metabolically active enough for FDG PET detection but readily are detected by bone scan. PET/CT enhances diagnostic confidence (with marginal improvement in accuracy) compared to FDG PET alone for the evaluation of metastatic disease. FDG PET and PET/CT can also help in the assessing the treatment response of metastases earlier than conventional imaging. Serial FDG PET or PET/CT more accurately reflects disease status in patients with bone-dominant disease undergoing systemic treatment compared to conventional methods. Preliminary investigations show that FDG PET has the greatest impact on the choice of treatment in patients with suspected or proven locoregional recurrence who are being considered for aggressive curative treatment and in the evaluation of treatment response in patients with metastatic disease.

• #17 Recurrent breast cancer | Altru Health System

  https://www.altru.org/health-library/conditions/recurrent-breast-cancer

  Removing a sample of tissue for lab testing (biopsy). Your doctor may recommend a biopsy procedure to collect suspicious cells for testing, as this is the only way to confirm whether your cancer has returned. Working in a laboratory, a pathologist examines the cells and determines the types of cells involved. […] A pathologist can determine if the cancer is a recurrence of cancer or a new type of cancer. Tests also show whether the cancer is sensitive to hormone treatment or targeted therapy, since these may have changed since your original cancer diagnosis.

• #18 Breast Cancer Workup: Approach Considerations, Breast Cancer Screening, Ultrasonography

  https://emedicine.medscape.com/article/1947145-workup

  Advances in mammography include the development of digital mammography and the increased use of computer-aided diagnosis (CAD) systems. […] The US Preventive Services Task Force (USPSTF) reports that reduction in breast cancer mortality due to screening mammography varies with patient age. […] The different techniques used in breast imaging vary with respect to sensitivity, specificity, and positive predictive value. […] Percutaneous vacuum-assisted large-gauge core-needle biopsy (VACNB) with image guidance is the recommended diagnostic approach for newly diagnosed breast tumors. […] Testing for human epidermal growth factor receptor 2 (HER2) gene amplification or protein overexpression is essential in breast cancer, to identify tumors that may benefit from HER2-targeted therapies.

• #19 Recurrent breast cancer | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/recurrent-breast-cancer

  Recurrent breast cancer is breast cancer that comes back after initial treatment. Although the initial treatment is aimed at eliminating all cancer cells, a few may have evaded treatment and survived. These undetected cancer cells multiply, becoming recurrent breast cancer. […] If your doctor suspects you may have recurrent breast cancer based on results of a mammogram or physical exam, or because of signs and symptoms, he or she may recommend additional tests to confirm the diagnosis. […] Tests and procedures may include: Imaging tests. What imaging tests you’ll undergo will depend on your specific situation. Imaging tests may include magnetic resonance imaging (MRI), computerized tomography (CT), X-ray, bone scan or positron emission tomography (PET). […] Removing a sample of tissue for lab testing (biopsy). Your doctor may recommend a biopsy procedure to collect suspicious cells for testing, as this is the only way to confirm whether your cancer has returned. Working in a laboratory, a pathologist examines the cells and determines the types of cells involved. […] A pathologist can determine if the cancer is a recurrence of cancer or a new type of cancer. Tests also show whether the cancer is sensitive to hormone treatment or targeted therapy, since these may have changed since your original cancer diagnosis.

• #20 All About Blood Tests for Breast Cancer | BCRF

  https://www.bcrf.org/about-breast-cancer/blood-tests-for-breast-cancer/

  Doctors are also currently using blood tests for breast cancer diagnosis, treatment, and recurrence surveillance. […] For instance, a test for carcinoembryonic antigen (CEA), a protein detectable in the blood, can indicate the presence of several forms of cancer, including breast cancer. The only blood test specific to breast cancer looks for the cancer antigen 27.29 (CA 27.29). These tests are only used as aids in making a diagnosis, monitoring treatment progress, or determining if the cancer has spread. […] Researchers are studying ways to expand the use of blood tests for breast cancer detection, and/or to determine if a patients breast cancer has recurred, progressed, or metastasized. […] Liquid biopsy is thus gaining traction as a highly sensitive and specific test for ctDNA and may serve as a useful tool in breast cancer diagnosis and early detection.

• #21 ASCO 2024: New ultra-sensitive blood test predicts recurrence of breast cancer, months or even years before relapse

  https://www.icr.ac.uk/about-us/icr-news/detail/asco-2024-new-ultra-sensitive-blood-test-predicts-recurrence-of-breast-cancer-months-or-even-years-before-relapse

  A new type of blood test can predict the recurrence of breast cancer in high-risk patients, months or even years before they relapse, research has shown. […] The findings, presented at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago on Sunday 2 June, involved analysing blood samples from the ChemoNEAR sample collection study for circulating tumour DNA (ctDNA) that is released into the bloodstream by cancer cells. […] By helping to spot the patients most likely to relapse, the ICR scientists hope the results will pave the way for a new strategy for treating recurrent breast cancer where treatment can be started much earlier, without waiting for incurable, advanced disease to develop and show up on a scan. […] The results showed that detection of ctDNA at any point after surgery or during the follow up period was associated with a high risk of future relapse and poorer overall survival.

• #22 ASCO 2024: New ultra-sensitive blood test predicts recurrence of breast cancer, months or even years before relapse

  https://www.icr.ac.uk/about-us/icr-news/detail/asco-2024-new-ultra-sensitive-blood-test-predicts-recurrence-of-breast-cancer-months-or-even-years-before-relapse

  Molecular residual disease was detected in all 11 patients who relapsed. […] The median lead time to clinical relapse in this group of patients was 15 months, an increase of over three months, compared with current tests in all types of breast cancer. […] Testing a patients blood for ctDNA will allow clinicians to diagnose the return of cancer at the very earliest stage. […] It is very exciting to see advances in technology that can detect cancer cells and DNA with greater sensitivity to pick up residual disease or detect the early signs of breast cancer recurrence while a cure is still possible. […] Early detection is one of our greatest weapons against breast cancer and these initial findings, which suggests new tests could be able to detect signs of breast cancer recurrence over a year before symptoms emerge, are incredibly exciting. […] The study shows the importance and promise of using an ultra-sensitive MRD test like NeXT Personal to detect the earliest traces of breast cancer recurrence, and more optimally guide management of breast cancer patients.

• #23 Testing Process – Breast Recurrence Score® Test | Precision Oncology

  https://precisiononcology.exactsciences.com/patients-and-caregivers/understanding-your-diagnosis/breast-cancer/breast-recurrence-score/testing-process

  As with all genomic tests, the Breast Recurrence Score test is performed on the tumor tissue thats already been removed from your breast during your surgery or biopsy. […] The activity of these genes can provide important information about how your specific tumor might behave in the future, including: How likely your tumor is to return […] Am I a candidate for the Breast Recurrence Score test? […] If I am a candidate for the Breast Recurrence Score test, how could we use the test results to develop my treatment plan?

• #24 The Oncotype® DX Breast Recurrence Score | OncoLink

  https://www.oncolink.org/cancers/breast/screening-diagnosis/the-oncotype-R-dx-breast-recurrence-score

  Oncotype Dx is a genomic lab test that helps guide treatment choices for people with early-stage invasive breast cancers. This test helps decide if using chemotherapy along with hormone (endocrine) therapy after surgery will lower your risk of your cancer coming back (recurring). […] Higher scores mean there is a greater risk of recurrence (cancer coming back). A higher score also means that getting chemotherapy would likely reduce the risk of your cancer coming back. Your recurrence score, along with your age and the size and grade of your tumor, will be used to pick the best treatment for you to help prevent a recurrence. […] A score of 26-100 means a high risk of recurrence. The benefits of chemotherapy in preventing recurrence outweigh the risks. […] A score of 26-100 means a high risk of cancer recurrence. The benefits of chemotherapy are greater than the risks.

• #25 Risks, Symptoms, and Treatments for Breast Cancer Recurrence – Ezra

  https://ezra.com/blog/breast-cancer-recurrence

  While late relapse is not common, cancer survivors are not guaranteed a clean-bill of health. […] A bilateral mastectomy, or surgical removal of both breasts, significantly reduces your chances of breast cancer relapse. […] However, there is still a minimal chance that residual breast tissue or cancer cells could recur on the chest wall. […] If you’ve had a lateral mastectomy, in which only one breast is removed, you can still develop breast cancer in the opposite breast. […] You’ll likely recognize the symptoms if you have a breast cancer relapse. […] If symptoms arise, your clinician can monitor you by performing a clinical breast exam. […] Local breast cancer recurrence is when cancer comes back in the same area that the first tumor was found. […] Research has shown that the characteristics of breast cancer may be different if it comes back.

• #26 Breast Cancer Recurrence: Rate, Symptoms, & Survival Rates

  https://www.medicinenet.com/breast_cancer_recurrence/article.htm

  If your doctor believes you have recurrent breast cancer based on the findings of mammography or physical exam or on signs and symptoms, you may be subjected to further tests to confirm the diagnosis: Imaging tests, such as MRI, CT, X-ray, bone scan, or positron emission tomography, may be done to look for abnormal cells. Your doctor will decide which tests will be most beneficial in your case. […] A biopsy involves tissue extraction for detailed evaluation in a lab. Your doctor may advise you to get a biopsy done to collect suspicious cells for testing as this is the only method to determine whether your cancer has returned. A pathologist analyzes cells in a laboratory to identify the types of cells involved. […] Recurrent breast cancer is not always as life-threatening as initial breast cancer. If diagnosed early, it can be treated and with better results. It is best to have yourself screened on a regular basis after completing your initial breast cancer treatment.

• #27 Diagnostic Challenges of Postsurgical Breast Cancer Recurrence

  https://www.asrt.org/promotions/insidejournals/inside-asrt-journals-mammo

  TRAM and DIEP flap reconstruction methods create additional difficulties. In a retrospective study of patients with recurring breast cancer who had undergone TRAM flap reconstruction after initial diagnosis as part of their treatment course, findings were consistent with similar studies in which TRAM flap breast reconstruction was shown to be a safe surgical method that does not raise the statistical recurrence of breast cancer significantly. It remained within the average recurrence rate of 2% to 4%. The challenge is that half of all recurring cancers mimicked the imaging findings of benign lesions presenting a differential diagnosis. In the other half, imaging findings showed malignancies. Little information is available on the recurrence rate of breast cancer in patients using the less invasive method of DIEP flap reconstruction, possibly because of its more recent introduction. Findings demonstrate similarities in the appearance of recurring breast cancer. The locations of recurring tumors more often are superficial below the dermis and in the posterior area along the chest wall. This presentation is common to TRAM and DIEP flap reconstruction techniques. Despite challenges, alternative diagnostic tools can be used for detecting postsurgical recurring breast cancer.

• #28 Diagnostic Challenges of Postsurgical Breast Cancer Recurrence

  https://www.asrt.org/promotions/insidejournals/inside-asrt-journals-mammo

  ASCO 2012 guidelines recommend routine clinical examination and follow-up with mammography for surveillance in the adjuvant setting. However, for lesions presenting deep in the muscle layer or in proximity to a surgical scar or the axilla, physical examination and mammography are limited in diagnosing recurrence effectively. In the presence of a recurring cancer, magnetic resonance (MR) imaging is useful to differentiate benign vs malignant disease presentation because of a higher tissue sensitivity (99%) when compared to mammography (33%). Nevertheless, MR imaging is not without drawbacks, including inhomogeneous fat suppression or altogether failure of fat suppression. In addition, in a study of 969 women, MR imaging results provided false diagnosis of recurring breast cancer in 91 women when compared with pathology results of their benign lesions; therefore, routine breast MR surveillance might expose patients to additional biopsies for benign lesions.

• #29 Disease Restaging and Diagnosis of Recurrent and Metastatic Disease Following Primary Therapy with FDG-PET Imaging

  https://pmc.ncbi.nlm.nih.gov/articles/PMC2794199/

  Locoregional recurrence involving the chest wall and supraclavicular nodes is associated with poor prognosis in terms of survival after recurrence. However, for patients presenting with LRR and no evidence of distant disease, aggressive multimodality treatment, including surgery, radiation, chemotherapy and hormonal therapy, may be warranted because many of these patients can be rendered disease-free. Supraclavicular node recurrence is technically considered stage IV disease and generally considered a harbinger to more widely disseminated disease. However, patients with supraclavicular node involvement as the sole site of disseminated disease may benefit from aggressive local radiotherapy. […] The evaluation of local recurrence in the breast, skin or chest wall with FDG PET can be problematic. A number of studies evaluating FDG PET and PET/CT have reported both false positive and false negative cases of recurrent neoplasm in the skin, residual breast and chest wall. Inflammation in these previously treated areas can be a source of FDG avidity, leading to a false positive result. The tissue volume of some local recurrences may be too small for detection or avidity of the recurrence too low (particularly in cases of lobular carcinoma), leading to a false negative result. Physical exam and conventional imaging, including a combination of mammography, ultrasound, and MR, remains the mainstay for the evaluation of locoregional recurrence. Since the majority of suspected local recurrences are easily accessible to percutaneous needle biopsy, the definitive status of the suspected lesion can be made by histologic analysis.

• #30 Breast Cancer Recurrence: Types, Rates, and More

  https://www.healthline.com/health/breast-cancer/what-type-breast-cancer-has-the-highest-recurrence-rate

  Aggressive, hard-to-treat breast cancers, such as inflammatory breast cancer (IBC) and triple-negative breast cancer (TNBC), are the types most likely to recur. […] The two types of breast cancer most likely to recur are inflammatory breast cancer (IBC) and triple-negative breast cancer (TNBC). […] Although all types of breast cancer can recur after treatment, the two types of breast cancer that are most likely to come back are inflammatory breast cancer (IBC) and triple-negative breast cancer (TNBC). […] Many factors can increase your chances of recurrence, including the type of cancer you have, its stage and size at diagnosis, as well as ER, HER2, and BRCA status. […] The chance of breast cancer recurrence is highest in the first 2 years and decreases with each passing year.

• #31 Breast Cancer Recurrence: Rates, Signs & Treatment

  https://my.clevelandclinic.org/health/diseases/8328-breast-cancer-recurrence

  Breast cancer recurrence is when cancer comes back after treatment. Recurrent breast cancer may develop where it started, or spread to nearby lymph nodes or to more distant areas of your body. Healthcare providers may use new or different treatments for recurrent breast cancer. They may also recommend clinical trials. […] Breast cancer recurrence is when you have breast cancer that comes back (recurs) after treatment. Breast cancer can come back months or years after you’ve finished treatment. Healthcare providers can treat recurrent breast cancer, but it can come back again. […] According to the American Cancer Society, inflammatory breast cancer (IBC) and triple-negative breast cancer (TNBC) are more likely to come back than other breast cancer types and subtypes. […] Its relatively uncommon, but the specific rate of recurrence depends on factors, like your breast cancer stage and treatment.

• #32 Recurrent breast cancer – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/recurrent-breast-cancer/symptoms-causes/syc-20377135

  The chemotherapy, radiation, hormone therapy or other treatment you may have received after your first breast cancer diagnosis was intended to kill any cancer cells that may have remained after surgery. But sometimes these treatments aren’t able to kill all of the cancer cells. […] For breast cancer survivors, factors that increase the risk of a recurrence include: Finding cancer in nearby lymph nodes at the time of your original diagnosis increases your risk of the cancer coming back. […] Most people who choose a lumpectomy (wide local excision) for breast cancer undergo breast radiation therapy to reduce the risk of recurrence. Those who don’t undergo the radiation therapy have an increased risk of local breast cancer recurrence. […] Taking hormone therapy after your initial treatment may reduce the risk of recurrence if you have hormone receptor positive breast cancer. Hormone therapy may continue for at least five years.

• #33 Breast Cancer Recurrence: Rates, Signs & Treatment

  https://my.clevelandclinic.org/health/diseases/8328-breast-cancer-recurrence

  Most local recurrences of breast cancer occur within five years of a lumpectomy. You can lower your risk by getting radiation therapy afterward. You have a 3% to 15% chance of breast cancer recurrence within 10 years with this combined treatment. […] Recurrence rates for people who have mastectomies vary: There’s a 6% chance that cancer will recur within five years if healthcare providers didn’t find cancer in your axillary lymph nodes during your original surgery. There’s a 25% chance of cancer recurrence if your axillary lymph nodes are cancerous. This risk drops to 6% if you receive radiation therapy after a mastectomy. […] Your healthcare provider will do some of the same tests you had when you first received your breast cancer diagnosis: Mammogram, Ultrasound, MRI, CT scan or positron emission tomography (PET) scan, Blood tests for tumor markers, Biopsy.

• #34 Recurrent breast cancer – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/recurrent-breast-cancer/symptoms-causes/syc-20377135

  For people with breast cancer who have an increased risk of cancer recurrence, chemotherapy has been shown to decrease the chance that cancer will recur, and those who receive chemotherapy live longer. […] People who’ve had a breast-sparing operation to treat their breast cancer and those who had a large tumor or inflammatory breast cancer have a lower chance of the cancer recurring if they’re treated with radiation therapy.

• #35 The Likelihood of Recurrence | Breast Cancer Trials

  https://www.breastcancertrials.org.au/breast-cancer-recurrence/?srsltid=AfmBOoqHvsEqgTVr0S51DLj4iuVf-G2EG9b8tojuF4JGO83ah90vBotJ

  Whilst it is never completely certain that breast cancer has been cured, there are many treatments available that reduce the risk of recurrence. […] Women with a BRCA1 or BRCA2 gene mutation and who have already been diagnosed with breast cancer, have a higher-than-average chance of new primary breast cancers than those without this genetic mutation. […] If you have a local recurrence or new primary breast cancer, you may find symptoms similar to an initial breast cancer. […] After a diagnosis of early stage breast cancer, any remaining breast tissue should be evaluated with scans (such as mammogram or ultrasound) regularly. […] Yes. You are still at risk of breast cancer recurrence if you have had a bilateral mastectomy (surgical removal of both breasts). […] There is no definitive way to prevent breast cancer from coming back. However, treatments such as surgery, chemotherapy, radiotherapy, targeted therapy (eg trastuzumab for HER2-positive breast cancer) and/or hormone therapy (for hormone receptor positive breast cancer) do reduce the risk of recurrence, depending on the type and stage of the cancer.

• #36 The Likelihood of Recurrence | Breast Cancer Trials

  https://www.breastcancertrials.org.au/breast-cancer-recurrence/?srsltid=AfmBOoqHvsEqgTVr0S51DLj4iuVf-G2EG9b8tojuF4JGO83ah90vBotJ

  The rate of breast cancer recurrence is not the same for all patients. Understand the risk of recurrence for your type of breast cancer. […] Many breast cancer recurrences are detected in the five years after diagnosis, especially after triple negative breast cancer. However, recurrence can occur more than 20 years after the first diagnosis. […] Your individual chance of breast cancer returning depends on a number of factors including the type of breast cancer, tumour size, genetic factors and treatment types. […] A study published in the Journal of Clinical Oncology found the rate of recurrence for all breast cancers was highest in the first five years from the initial cancer diagnosis at 10.4%. […] Everyone who has received a breast cancer diagnosis is at risk of recurrence, however the risk differs markedly depending on a number of factors listed below.

• #37 Recurrent breast cancer – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/recurrent-breast-cancer/symptoms-causes/syc-20377135

  Recurrent breast cancer is breast cancer that comes back after initial treatment. Although the initial treatment is aimed at eliminating all cancer cells, a few may have evaded treatment and survived. These undetected cancer cells multiply, becoming recurrent breast cancer. […] Recurrent breast cancer may occur months or years after your initial treatment. The cancer may come back in the same place as the original cancer (local recurrence), or it may spread to other areas of your body (distant recurrence). […] After your breast cancer treatment ends, your doctor will likely create a schedule of follow-up exams for you. During follow-up exams, your doctor checks for any symptoms or signs of cancer recurrence. […] Recurrent breast cancer occurs when cells that were part of your original breast cancer break away from the original tumor and hide nearby in the breast or in another part of your body. Later, these cells begin growing again.

• #38 Diagnostic Challenges of Postsurgical Breast Cancer Recurrence

  https://www.asrt.org/promotions/insidejournals/inside-asrt-journals-mammo

  Diagnostic Challenges of Postsurgical Breast Cancer Recurrence […] Technology and treatment options available today have increased survivability rates for patients diagnosed with breast cancer. Even so, worldwide, the majority of malignant tumors among women are breast cancers. Research suggests that when patients undergo reconstruction following mastectomy, diagnostic imaging plays an important adjunct role in detecting recurring breast cancer. […] Breast cancer recurrence rates among patients who have undergone surgical treatment, range from 2% to 7.5%. However, Pan et al stated this significantly higher at 7% to 30%. Although there are recommendations, standardization of diagnostic testing or treatment across treatment specialists does not exist. The American Society of Clinical Oncology (ASCO) recommends only mammography for routine surveillance of asymptomatic patients previously treated for breast cancer. Yoo et al notes no consensus exists regarding protocols for follow-up care for patients with a history of breast cancer. Imaging options are subject to each medical institutions protocols and policies, and to the resources and clinical experience of each provider. Improvements need to be made to surveillance strategies because detecting breast cancer recurrence early increases survivability and prognosis.

• #39 All About Blood Tests for Breast Cancer | BCRF

  https://www.bcrf.org/about-breast-cancer/blood-tests-for-breast-cancer/

  At this time, there is not an approved blood test for early detection of breast cancer that could replace something like a mammogram. Blood tests may provide evidence of breast cancer and are used as aids in diagnosing the disease or detecting recurrence; the CEA and CA 27.29 blood tests for breast cancer are examples. […] The sensitivity of liquid biopsies can also be leveraged to predict the likelihood of breast cancer recurrence, as ctDNA analysis has been shown to detect minimal residual disease or evidence of cancer remaining immediately after treatment or even later. […] One such test is the Signatera Residual Disease Test for ctDNA/minimal residual disease detection. […] Still, ongoing studies are needed to specifically correlate levels of ctDNA in blood samples with patient outcomesresults that can help finetune our understanding of what different levels mean and how reliably and accurately they predict breast cancer recurrence.

• #40 Breast Cancer Recurrence Screening Blood Test – Signatera

  https://www.natera.com/oncology/signatera-advanced-cancer-detection/patients/signatera-for-breast-cancer/

  Signatera can help provide an early alert that your breast cancer may be coming back at a molecular level […] Clinical studies have shown that for people with high risk breast cancer, Signatera can detect recurrence before it becomes visible on scans. […] Catching cancer recurrence early can give your doctor more options to plan ahead and develop a plan for your care. […] Signatera can assess whether your ctDNA levels increase or decrease during treatment, helping your doctor understand if your treatment is working. […] Signatera is covered by Medicare for patients with stage II-IV breast cancer in the neoadjuvant setting, regardless of subtype and stage IIb and higher breast cancer in the adjuvant and recurrence monitoring settings. […] When Danielles breast cancer molecular recurrence was detected by Signatera testing, she and her doctor had incentive to act quickly.

• #41 Current Approaches and Challenges in Early Detection of Breast Cancer Recurrence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3982041/

  Although early detection of asymptomatic relapse is known to increase survival, it is uncertain whether clinical examinations contribute to this benefit. […] The overall impact of clinical examinations on survival remains questionable. […] In addition to imaging and clinical examination, many oncologists employ the use of circulating serum tumor markers to predict relapse. […] One of the challenges with the use of serum tumor markers is what to do with a positive marker in the setting of no radiographic evidence of disease. […] The current challenge of post-treatment follow up is to best predict which patients are at increased risk of recurrence and then explore the best surveillance strategy in those patients. […] The majority of literature supports the premise that early detection of asymptomatic local recurrence via appropriate surveillance techniques, to include breast imaging, improves long-term survival when compared to late symptomatic detection.

• #42

  https://link.springer.com/article/10.1007/s10549-024-07475-8

  The overall risk of loco-regional recurrent breast cancer is low (0.30.5% per year after breast conserving therapy), but, to detect a recurrence is of great importance to the affected women. […] The risk is highest in the first five years, peaking in the second year after treatment and varies based on the patients age, features of the initial breast cancer (such as tumor stage, nodal stage, tumor biological subtype), and adjuvant treatments. […] This study corroborates previous research, stating that a majority of all recurrences (71.5%), which includes distant metastasis, and 56.0% of ipsilateral locoregional recurrences are discovered outside of scheduled surveillance. […] Importantly, the probability of detecting a recurrence outside of surveillance was higher among younger patients, patients with lymph node-positive breast cancer, and cases of the HER2-positive breast cancer subtype.

• #43 New ultra-sensitive blood test predicts recurrence of breast cancer, months or years before relapse

  https://medicalxpress.com/news/2024-06-ultra-sensitive-blood-recurrence-breast.html

  New ultra-sensitive blood test predicts recurrence of breast cancer, months or years before relapse. A new type of blood test can predict the recurrence of breast cancer in high-risk patients, months or even years before they relapse, research has shown. A team from The Institute of Cancer Research, London, used an ultra-sensitive liquid biopsy to detect the presence of tiny amounts of cancer DNA left in the body following treatment for early breast cancer. The findings, presented at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago on Sunday 2 June, involved analyzing blood samples from the ChemoNEAR sample collection study for circulating tumor DNA (ctDNA) that is released into the bloodstream by cancer cells. The researchers, based at the Breast Cancer Now Toby Robins Research Center at The Institute of Cancer Research (ICR), were able to identify all patients from the study who later went on to relapse by detecting very low levels of cancer found in the blood—known as molecular residual disease. By helping to spot the patients most likely to relapse, the ICR scientists hope the results will pave the way for a new strategy for treating recurrent breast cancer where treatment can be started much earlier, without waiting for incurable, advanced disease to develop and show up on a scan. The results showed that detection of ctDNA at any point after surgery or during the follow up period was associated with a high risk of future relapse and poorer overall survival. Molecular residual disease was detected in all 11 patients who relapsed. The median lead time to clinical relapse in this group of patients was 15 months, an increase of over three months, compared with current tests in all types of breast cancer. None of the 60 women in whom ctDNA remained undetected, relapsed throughout the follow-up period. Ultra-sensitive blood tests could offer a better approach for the long-term monitoring of patients whose cancer is at high risk of returning. Testing a patient’s blood for ctDNA will allow clinicians to diagnose the return of cancer at the very earliest stage.

• #44 ASCO 2024: New ultra-sensitive blood test predicts recurrence of breast cancer, months or even years before relapse

  https://www.icr.ac.uk/about-us/icr-news/detail/asco-2024-new-ultra-sensitive-blood-test-predicts-recurrence-of-breast-cancer-months-or-even-years-before-relapse

  Molecular residual disease was detected in all 11 patients who relapsed. […] The median lead time to clinical relapse in this group of patients was 15 months, an increase of over three months, compared with current tests in all types of breast cancer. […] Testing a patients blood for ctDNA will allow clinicians to diagnose the return of cancer at the very earliest stage. […] It is very exciting to see advances in technology that can detect cancer cells and DNA with greater sensitivity to pick up residual disease or detect the early signs of breast cancer recurrence while a cure is still possible. […] Early detection is one of our greatest weapons against breast cancer and these initial findings, which suggests new tests could be able to detect signs of breast cancer recurrence over a year before symptoms emerge, are incredibly exciting. […] The study shows the importance and promise of using an ultra-sensitive MRD test like NeXT Personal to detect the earliest traces of breast cancer recurrence, and more optimally guide management of breast cancer patients.

• #45 Breast cancer: New blood test can predict return, researchers say

  https://www.bbc.com/news/articles/cjjjnxdv188o

  An „ultra-sensitive” new blood test can predict if breast cancer will return years before the disease shows up on scans, researchers say. […] It picks up traces of a tumour’s DNA before a full relapse and was found to be 100% accurate at predicting which patients would see their cancer return. […] On average, the blood test detected cancer 15 months before symptoms appeared or the illness showed up on scans, according to results presented at the American Society of Clinical Oncology conference in Chicago on Sunday. […] The earliest detection was 41 months before a scan confirmed the diagnosis. […] Lead researcher Dr Isaac Garcia-Murillas, from the ICR, said: „Breast cancer cells can remain in the body after surgery and other treatments but there can be so few of these cells that they are undetectable on follow-up scans.”

• #46 Stage 0 Breast Cancer – Symptoms, Treatment & Survival Rate

  https://www.nationalbreastcancer.org/breast-cancer-stage-0/

  A mammogram, or low-dose breast x-ray, is often the best option for detecting breast cancer in its earliest stages. […] Following the discovery of a lump, abnormal nipple discharge, or other abnormal symptom, doctors will advise further testing to get to the bottom of the issue. […] When abnormal cells are detected on a mammogram, your doctor will order a follow-up needle biopsy that removes cells from the area of concern for further testing in order to determine if the cells are cancerous or not. […] Following an early-stage breast cancer diagnosis, some people opt for genetic testing to learn more about their cancer, their genetic risks, and the likelihood that the cancer will return. […] Not all Stage 0 breast cancers require treatment. […] However, DCIS is often treated because the cancerous cells can undergo additional changes that later become invasive breast cancer.

• #47 Oncotype DX Breast Recurrence Score® Test│ Precision Oncology

  https://precisiononcology.exactsciences.com/healthcare-providers/treatment-determination/breast-cancer/oncotype-dx-breast-recurrence-score

  The Oncotype DX Breast Recurrence Score test provides personalized genomic insights for early-stage HR+, HER2- breast cancer patients. […] The 21-gene assay (Oncotype DX) test is included in leading oncology guidelines, such as those from the National Comprehensive Cancer Network (NCCN).5* […] Patients are eligible for the Oncotype DX test if they are: Recently diagnosed with invasive breast cancer, Medically eligible for chemotherapy. […] The 12-year results of the Trial Assigning IndividuaLized Options for Treatment (Rx) (TAILORx) identified 85% of women with early-stage, node-negative breast cancer who may receive no benefit from chemotherapy, and 15% for whom chemotherapy can be life-saving. […] The RxPONDER trial (A Clinical Trial RX for Positive Node, Endocrine Responsive Breast Cancer) showed that most women with 1-3 positive nodes and Recurrence Score results of 0-25 can safely forgo chemotherapy.

• #48 Breast Cancer Recurrence Screening Blood Test – Signatera

  https://www.natera.com/oncology/signatera-advanced-cancer-detection/patients/signatera-for-breast-cancer/

  Personalized, tumor-informed ctDNA molecular residual disease (MRD) testing for breast cancer to inform critical decisions for care. […] The Signatera Residual Disease Test is a custom-built blood test for people who have been diagnosed with breast cancer or other solid tumors. Signatera can detect molecular residual disease (MRD) in the form of circulating tumor DNA small fragments of DNA released by cancer cells. […] Repeated Signatera testing can show changes in your ctDNA levels, helping your doctor understand if your cancer is shrinking, growing, or coming back. […] Signatera testing after surgery and/or initial treatment can help your doctor learn if residual traces of cancer remain in your body. This information can help you and your doctor understand your risk of recurrence, decide on what treatment to recommend, and plan your monitoring strategy.

• #49 Return of Breast Cancer after Treatment (Recurrence) | Susan G. Komen®

  https://www.komen.org/breast-cancer/treatment/recurrence/

  Even though the entire breast is removed in a mastectomy, breast cancer can still return to the chest area. […] Local recurrence after a mastectomy is usually treated with surgery, and radiation therapy if radiation therapy wasnt part of the initial treatment. […] Metastasis (distant recurrence) is most often found when people report new and persistent symptoms. […] If follow-up tests show metastatic breast cancer, this means the cancer has spread to other parts of the body, most often the bones, lungs, liver or brain. […] Although its spread to another part of the body, its still considered and treated as breast cancer. […] When metastasis is present, tests are done to find out which organs are involved and to check the hormone receptor status and HER2 status of the tumor. Then, you and your oncologist can discuss your treatment options. […] If you have a breast cancer recurrence, consider joining a clinical trial before treatment begins or when your health care provider is considering changing treatments.

• #50 Signs of Breast Cancer Recurrence

  https://www.healthline.com/health/breast-cancer/signs-of-recurrence

  A woman who treated her initial breast cancer with a lumpectomy may feel a palpable mass or lump, have nipple changes or bloody nipple discharge, or experience skin changes. […] This can be a sign that the breast cancer has returned. […] If a woman has had a mastectomy, recurrence is often detected by feeling a mass or lump on the skin or chest wall. […] If breast cancer is coming back systemically (distantly), symptoms can vary based on where the cancer has returned. […] For instance, if it’s coming back in the bones, symptoms may include back pain or hip pain. […] If it’s coming back in the lungs, symptoms may include a cough or shortness of breath. […] For a woman who had a lumpectomy, a recurrence is often detected on routine mammogram and ultrasound screening as either a new mass, calcifications, distortion, or asymmetry.

• #51 Signs of Breast Cancer Recurrence

  https://www.healthline.com/health/breast-cancer/signs-of-recurrence

  If a woman had a lumpectomy or mastectomy and feels an unusual lump, then usually a mammogram, ultrasound, and/or MRI is done to evaluate the palpable abnormality. […] If any skin changes are detected, a punch biopsy may be done to detect recurrence. […] A distant recurrence can be detected with: CT scans, PET scans, MRIs, bone scans. […] Call your doctor if you notice any changes to your mastectomy flap, such as: a pimple, nodule, or lump, redness, scaling of the skin. […] If you had a lumpectomy and your native breast is still intact, then call your doctor if you notice any of the following: palpable lump, nipple discharge, skin changes or dimpling, lump in the armpit. […] These could all be signs of recurrence that should be examined by your doctor. […] Following the recommended course of treatment will give you the best chance at preventing recurrence.

• #52 Recurrent Breast Cancer | Queens NY Medical Imaging | Main Street

  https://www.mainstreetradiology.com/procedures/petct/recurrent-breast-cancer/

  Accurately diagnosing breast cancer. […] Accurately diagnosing breast cancer – and determining its stage in patients who have already had it brings its own set of challenges. […] Traditional CT scans often have trouble distinguishing between new cancers and anatomical changes brought about by the first battle with the disease. […] Whole-body positron emission tomography (PET) has been shown to be both more sensitive and specific than CT for the diagnosis of recurrent breast cancer. […] In addition, PET is less sensitive than surgical axillary node staging. PET is reserved for patients with clinical suspicion of metastatic disease or local recurrence, where PET has been shown to be superior to CT. […] Accurate staging of breast cancer recurrence is critical for therapeutic planning. […] Limitations of CT include the difficulty in distinguishing post-operative and post-radiation changes from recurrence, and inability to identify and characterize small lesions. […] Bone scan, although a sensitive study for skeletal metastases, results frequently in false positive diagnoses.

• #53 Delayed diagnosis and increased mortality risk: Assessing the effects of the COVID-19 pandemic on breast cancer recurrence | Clinics

  https://www.elsevier.es/es-revista-clinics-22-articulo-delayed-diagnosis-increased-mortality-risk-S1807593224000176

  COVID-19 profoundly affected global healthcare including breast cancer management. […] The pandemic delayed recurrence diagnosis and increased post-recurrence mortality. […] Strategies for cancer patients’ follow-up during health crises need improvements. […] The COVID-19 pandemic has disproportionately impacted cancer patients, particularly those with breast cancer. This study aims to analyze the effects of the pandemic on women diagnosed with breast cancer recurrence. […] The study included 187 patients, 45 in the pandemic group (recurrence after March 23, 2020) and 142 in the pre-pandemic group. […] Compared to the pre-pandemic group (1.8 years), the pandemic group experienced a longer mean time to recurrence detection (2.9 years) and significantly decreased median survival (9 months vs. 22 months).

• #54 Delayed diagnosis and increased mortality risk: Assessing the effects of the COVID-19 pandemic on breast cancer recurrence | Clinics

  https://www.elsevier.es/es-revista-clinics-22-articulo-delayed-diagnosis-increased-mortality-risk-S1807593224000176

  The present study is among the first to investigate the pandemic’s specific effects on breast cancer recurrence, revealing concerning delays in detection and a decrease in survival rates. […] These findings urge healthcare systems to prioritize tailored care for breast cancer patients during pandemics. […] The impact of the COVID-19 pandemic on breast cancer recurrence is a major concern. […] These findings reveal a worrying trend: the pandemic significantly delayed recurrence diagnosis and was associated with an increased risk of death after recurrence. […] The pandemic’s influence extended beyond treatment interruptions, affecting multiple variables. […] The present data indicate that survival after breast cancer recurrence is influenced by various factors, including the type and extent of the recurrence, estrogen receptor status of the primary tumor, and the age of the patient.

• #55 Delayed diagnosis and increased mortality risk: Assessing the effects of the COVID-19 pandemic on breast cancer recurrence | Clinics

  https://www.elsevier.es/es-revista-clinics-22-articulo-delayed-diagnosis-increased-mortality-risk-S1807593224000176

  This study’s identification of the COVID-19 pandemic’s detrimental impact on survival and healthcare access underscores the urgent need for adaptation and innovative strategies to optimize breast cancer care during public health crises. […] The present study provides compelling evidence for the COVID-19 pandemic’s detrimental impact on breast cancer recurrence management. The authors observed significantly extended delays in recurrence diagnosis and a heightened risk of post-recurrence mortality, highlighting the pandemic’s widespread influence beyond treatment disruptions.

• #56 Current Approaches and Challenges in Early Detection of Breast Cancer Recurrence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3982041/

  Early detection of breast cancer recurrence is a key element of follow-up care and surveillance after completion of primary treatment. The goal is to improve survival by detecting and treating recurrent disease while potentially still curable assuming a more effective salvage surgery and treatment. […] The current standard of care for breast cancer follow-up requires a multi-disciplinary approach from radiologists, surgeons, and primary care physicians. […] Current recommendations for breast cancer screening involve radiographic and clinical evaluations. […] Identifying the optimal imaging modality for surveillance imaging remains a significant challenge. […] The three tests usually considered for early detection in breast cancer screening include mammography, the clinical breast examination (CBE), and the self breast examination (SBE).

• #57 Breast cancer: New blood test can predict return, researchers say

  https://www.bbc.com/news/articles/cjjjnxdv188o

  He added that the cells can cause patients to relapse many years after their initial treatment. […] Dr Garcia-Murillas said the study lays the groundwork for better post-treatment monitoring and potentially life-extending treatment. […] Dr Simon Vincent, director of research, support and influencing at Breast Cancer Now – which part-funded the study – said: „Early detection is one of our greatest weapons against breast cancer and these initial findings, which suggests new tests could be able to detect signs of breast cancer recurrence over a year before symptoms emerge, are incredibly exciting.” […] Though acknowledging that the research was still in its early stages, he said catching breast cancer recurrence earlier means treatment is much more likely to destroy the cancer and stop it spreading to other parts of the body and becoming incurable.

• #58 Current Approaches and Challenges in Early Detection of Breast Cancer Recurrence

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3982041/

  Mammography is the mainstay of surveillance imaging following curative treatment of breast cancer with 8%-50% of ipsilateral recurrence and 18%-80% of contralateral metachronous cancer detected by mammography alone. […] The ACR practice guidelines for breast MR state that MRI is useful in women with a history of breast cancer and suspicion for disease recurrence when clinical, mammographic, or sonographic findings are inconclusive. […] Breast cancer relapses are rarely curable with estimates of only 1-1.5% of women who present each year with recurrent breast cancer having potentially curable disease. However, current data shows a survival benefit from early detection of asymptomatic loco-regional or contra-lateral breast cancer recurrences.

• #59 Return of Breast Cancer after Treatment (Recurrence) | Susan G. Komen®

  https://www.komen.org/breast-cancer/treatment/recurrence/

  Breast cancer that returns and spreads to other parts of the body is called a distant recurrence (metastasis). This is metastatic breast cancer and may also be called stage IV or advanced breast cancer. […] Metastasis is usually found when new and persistent symptoms are reported to a health care provider and follow-up tests are done. […] If you have a local breast cancer recurrence or metastasis, its not your fault. You did nothing to cause it. […] When a local recurrence is found, its treated in much the same way as the first breast cancer. […] If needed, tests may be done to check for signs of metastasis. […] Local recurrence after a lumpectomy (breast-conserving surgery) can most often be treated successfully. […] Treatment may also include chemotherapy, hormone therapy, HER2-targeted therapy and/or other drug therapies.

• #60 Breast cancer recurrence symptoms and signs | LBBC

  https://www.lbbc.org/about-breast-cancer/symptoms/signs-recurrence

  During breast cancer treatment and well after it has ended, fear of recurrence is a concern for nearly every person diagnosed with early-stage breast cancer. […] Many things that may be signs of recurrence can be signs of other, less serious conditions. […] But some symptoms may mean the cancer came back. […] Not everyone will have a breast cancer recurrence. […] No one symptom is a sure sign of breast cancer returning. […] If you have a symptom that gets in the way of your daily activities, or gets worse day by day, contact your doctor sooner. […] A local recurrence is when cancer returns to the same breast where the cancer was first found. […] Common signs of a local recurrence are changes in the breast, such as skin inflammation or a lump. […] Signs of recurrence may include: A lump or growth in the breast area, A change in the size or shape of your breast, Skin irritation, redness, swelling or itching, Discharge from your nipple that is not breast milk.

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