What is breast cancer, metastatic or recurrent?

Breast cancer is the uncontrolled growth of abnormal cells in one or both breasts. Metastatic breast cancer means that cancer has spread to other parts of the body. It can be present when someone is first diagnosed with cancer. Recurrent breast cancer means that cancer has come back in or near the original site or in another part of the body. This may happen from a few months to many years after the first diagnosis.

The symptoms of metastatic or recurrent breast cancer depend on how much and where the cancer has spread. Not all people have symptoms.

Symptoms of metastatic breast cancer may include:

• Bone pain.
• Shortness of breath.
• Pain in the belly or yellow, itchy skin.
• Confusion, headaches, or seizures.

If cancer comes back in the same breast or in your mastectomy scar, you may have symptoms such as:

• A lump or thickening in the breast, chest wall, or armpit.
• A change in the skin on your chest or the size or shape of the breast.
• Discharge or bleeding from the nipple that occurs without squeezing the nipple.
• A change in the nipple, such as a scaly or crusty look or a nipple that pulls inward.

If cancer comes back in another part of your body, such as your lungs, you may have the same symptoms as metastatic breast cancer.

After you've been treated for breast cancer the first time, you will have regular checkups. This is to check for any signs that the cancer has spread or come back. Your checkups may include a physical exam, a clinical breast exam (CBE), or a mammogram. An MRI of the breast may also be used.

If your doctor thinks that breast cancer has spread or come back, you may have tests to check for cancer. They include:

• Blood tests, such as a complete blood count (CBC).
• Tissue tests, such as a biopsy.
• Imaging tests, such as a mammogram, an ultrasound, a bone scan, a CT scan, a PET scan, or an MRI.

Treatment for recurrent breast cancer is based on the type and location of the cancer and other things, including the treatment you had before. Treatment options for local or regional recurrence may include:

Surgery to remove the cancer.

For example, if you already had breast-conserving surgery, you may have a mastectomy. The doctor may also remove lymph nodes under the arm.

Radiation therapy.

This uses high-dose X-rays to destroy cancer cells and shrink tumors. It may be given after surgery.

Chemotherapy.

These medicines kill fast-growing cells, including cancer cells and some normal cells.

Endocrine therapy.

These medicines block hormones that cause certain cancers to grow. This helps slow or stop cancer growth.

Other treatment options may include targeted therapy or immunotherapy. A clinical trial may be a good choice.

Your doctor will talk with you about your options and then make a treatment plan.