What Makes Breast Cancer Come Back?

Breast cancer survivors have a greater risk of cancer than women who have not been diagnosed with breast cancer. If breast cancer is found only in your other breast it is a new cancer diagnosis and not recurrent breast cancer.

If cancer comes back, it is called recurrent breast cancer. You will have follow-up appointments with your oncologist (cancer doctor) after you have completed treatment for breast cancer.

Sometimes some of the breast cancer cells break away from the original tumor and hide in a different area of your breast tissue. This is especially true if this clump of cancer cells is small, making it undetectable during surgery.

This can happen after a lumpectomy or mastectomy. Sometimes this small clump of breast cancer cells moves to different parts of your body. There they can remain undetected for several months and even years before they start to grow. There are several types of recurrent cancer.

Local recurrence

If cancer occurs in the same breast as original cancer, it is called local recurrence. If you had a lumpectomy and the breast cancer comes back it could be because some undetected cancer cells were still in the breast after the lumpectomy.

If you had a mastectomy the breast cancer cells could be in the chest wall, behind where the breast was, or in the skin that covers the chest where the breast used to be.

Regional recurrence

If breast cancer is found in lymph nodes in your armpit, neck, and areas near your collarbones it is called regional recurrence. The lymph nodes where the cancer is will be swollen or have lumps.

Distant recurrence

Distant recurrence means that cancer has spread to other parts of your body. This is also called metastasis. Breast cancer cells are often found in organs such as your brain, lungs, or liver. Metastatic cancer can commonly be found in your bones.

If you find any suspicious lumps in your breast, chest wall, or lymph nodes it is important to see your primary care provider (PCP) or oncologist right away.

Why does breast cancer come back?

Several factors put you at higher risk for breast cancer coming back.

Tumor size

If the original tumor was large there is a greater chance of your breast cancer coming back.

Lymph nodes

Cancer cells were found in your lymph nodes when you had your original treatment. Your body has a lymph system where all your lymph nodes are connected. If cancer cells were found in the lymph nodes in your armpit some of the cancer cells may have traveled to other parts of your body via the lymph system.

Tumor margins

During the original tumor surgery, the surgeon removes some of the normal cells surrounding the tumor. This is done to create a margin of non-cancer cells around the tumor.

The tumor is analyzed under a microscope to see if the margin around the tumor contains any cancer cells. If the margin contains some cancer cells or the margin between normal cells and cancer cells is small there is an increased risk of breast cancer returning.

Lumpectomy

If you did not have radiation treatment after your lumpectomy you have a greater chance of your cancer returning. This risk is even greater if the margins around your tumor were small or included cancer cells.

Age

Women who are diagnosed with breast cancer when they are younger than 35 years of age have a greater chance of the breast cancer coming back.

Inflammatory breast cancer

There is a higher risk of breast cancer coming back in the same breast if you have had inflammatory breast cancer. This type of breast cancer is considered aggressive and hard to treat.

Hormone therapy

Hormone therapy is often used after surgery for breast cancer. If hormone therapy was not started or completed for tumors that rely on female hormones for growth, there is an increased chance of breast cancer coming back.

Triple-negative breast cancer

Women who previously had triple-negative breast cancer have a chance that it may come back.

This type of cancer is considered aggressive and hard to treat.

Obesity

Women who are obese are at increased risk of their breast cancer returning.

Biopsy

If you had a biopsy of your tumor before breast cancer treatment, there is a rare chance that some cancer cells could have escaped, entered the bloodstream, and traveled to other parts of your body during the procedure.

Practical tips

It is important to follow the treatment recommendations from your oncologist. Radiation therapy following a lumpectomy and hormone therapy, are just a couple. Your treatment recommendations are tailored to the type of breast cancer that you had.

Taking care of your mental health, eating a healthy diet, maintaining a normal weight, and exercising are also recommended to help avoid your breast cancer coming back.