Breast cancer recurrence: what does it mean?

What is a recurrence?

A recurrence is a recurrence of breast cancer after successful treatment. The word recurrence is not only used for cancer, but for any disease that recurs after a symptom-free phase. A distinction is made between a local recurrence, a locoregional recurrence and a recurrence with metastases.

• In local recurrence , the cancer occurs in the same region of the body where the primary disease occurred.
• If the breast was completely removed, i.e. a simple mastectomy was performed, and the tumor occurs in the armpit, in the chest wall or in the nearby lymph nodes, this is referred to as a locoregional recurrence .
• Recurrence can also form in scar tissue after a mastectomy. However, the probability of this is no higher than in the surrounding tissue.
• In general, the tissue that surrounded the tumor unfortunately always has a 5-10% chance of producing a tumor again.
• In the case of a recurrence with metastases , individual cells have separated from the main tumor and settled in other organs. Bones, lungs, brain and liver are particularly affected.
• The original treatment method, regardless of whether it was chemotherapy, antibody therapy or mastectomy, hardly plays a role.
• It is therefore important to excise a large area of ​​the tumor site in order to get all the cells of the primary tumor.
• In addition to surgery, another treatment method is always used to minimize the occurrence of recurrence.

That’s how often a recurrence occurs

Depending on the type of recurrence, the statistics of the recurrence rate are different. Life expectancy also varies depending on the type of recurrence, as do the chances of recovery. There are three different types here:

• Local recurrence occurs in 5-10% within 10 years in the tissue of the treated breast.
• 4-5% is the probability of having a local recurrence on the chest wall within 10 years after the initial illness. 
• However, 25% of metastases are found in women with breast cancer. These usually occur within 3 years, so close monitoring is particularly important during this time.
• Recurrences are more common in triple-negative breast cancer . These are variants of the disease in which neither progesterone nor estrogen nor HER2/neu receptors are present.
• This makes these tumors particularly aggressive and difficult to treat, since chemotherapy is the only therapeutic method that makes sense.

control and prognosis

Unfortunately, it is not possible to completely prevent a recurrence. But the earlier the recurrence is detected, the better the prognosis for treatment and healing.

• Close monitoring is particularly important in the first three years. This is where most recurrences happen. You should definitely go for a check-up every 6 months during this time.
• Here not only the chest should be checked, but also bones, lungs, brain and liver. Most metastases occur in these tissues.
• If a local recurrence occurs, the chances of recovery are good. Local tumors can be surgically removed and healed well with radiation.
• However, if there is a recurrence with metastases, it is questionable to speak of healing. In this case, the disease becomes chronic and treatment is aimed at maintaining the patient’s quality of life.
• This is because metastases often do not show the same properties as the primary tumor disease (= the breast cancer itself) and must be treated differently.
• But here too, the earlier the whole thing is recognized, the better the chances of successful treatment.