What is breast cancer, metastatic or recurrent?

Breast cancer occurs when abnormal cells grow out of control in one or both breasts.

• With metastatic breast cancer, the cancer cells travel from the breast to other parts of the body and cause cancer in a new location (metastasize). The cancer cells may travel through the bloodstream or the lymph system. Some people have metastatic breast cancer when first diagnosed. Or it may occur month to years after treatment.
• With recurrent breast cancer, the cancer comes back (recurs) after treatment. This can occur in or near the original location, in nearby lymph nodes, or in other parts of the body. When cancer comes back in other places, it may be called distant recurrence or metastatic cancer.

Your treatment plan will be based on many things, such as the stage of your cancer and whether the cancer is hormone-receptor positive. It'll also be based on what treatments you may have had in the past.

The symptoms of metastatic and recurrent breast cancer depend on how much and where the cancer has spread. Some people have symptoms, but many don't.

Metastatic breast cancer

Symptoms of metastatic breast cancer will depend on the area affected. For example:

• If your bones are affected, you may have bone pain. And your bones may break more easily.
• If your lungs are affected, you may be short of breath or cough.
• If your liver is affected, you may have pain in your belly or yellow, itchy skin.
• If cancer spreads to your brain, you may have confusion, headaches, or seizures.

Recurrent breast cancer

Cancer that comes back in the same breast or in your mastectomy scar is called a local recurrence. With this type, you may have symptoms such as:

• A lump or thickening in the breast, chest wall, or armpit after you have had breast-conserving surgery or a mastectomy. You may notice that the skin of your chest looks or feels different.
• A change in the size or shape of the breast or a dimple or pucker in the skin 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.

Cancer that comes back in another part of your body, such as your lungs, is called distant recurrence. With this type, you may have some of the same symptoms as metastatic breast cancer.

Treatment for recurrent breast cancer is based on the type and location of the cancer. It's also based on other things, including the treatment you had before. You may have surgery. Other options may include radiation therapy, chemotherapy, endocrine therapy, targeted therapy, or immunotherapy. Your doctor may suggest a clinical trial.

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.

If you have received treatment for breast cancer, health professionals who can watch you for any new problems include medical oncologists, radiation oncologists, surgeons, internists, and family medicine doctors.

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.

Doctors don't know for sure what causes breast cancer to spread or come back. Even with treatment, cancer can come back. Some things increase the risk of breast cancer coming back. They include the stage and size of the tumor and whether the cancer cells have receptors for estrogen or progesterone.