What is the Chance of a Recurrence of Breast Cancer After a Mastectomy?

Breast cancer recurrence describes breast cancer that comes back after treatment. Breast cancer can recur months or years after treatment ends and the patient is in remission. When an individual is in remission, tests show no signs of disease and they have no symptoms.

Anyone who develops breast cancer can have a recurrence. Recurrent breast cancer occurs when the cells that were part of the original breast cancer breakaway from the original tumor and hide nearby in the breast in in another part of the body.

Sometimes cancer cells may be dormant for years without causing harm. Then something happens that activates the cells, so they grow and spread to other parts of the body. For breast cancer survivors, factors that increase the risk of recurrence include:

• Lymph Node Involvement: Finding cancer in nearby lymph nodes at the time of the original diagnosis, increases the risk of the cancer coming back.
• Larger Tumor Size: People with larger tumors have a greater risk of recurrent breast cancer.
• Lack of Radiation Therapy Following a Mastectomy: 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 radiation therapy, have an increased risk of local breast cancer recurrence.

Cancer stage at the time of diagnosis correlates with the risk of the cancer being able to recur. Several factors determine the stage of the cancer: tumor size, cancer grade, and cancer spread to lymph nodes or other parts of the body. Cancer grade indicates how unusual (abnormal) cancer cells look in comparison to healthy cells.

You should ask your healthcare provider:

• What is the type of breast cancer recurrence?
• Has the cancer spread outside the breast?
• What stage is the breast cancer?

In a local recurrence, cancer reappears in the same area as the original cancer. If you’ve undergone a lumpectomy, the cancer can recur in the remaining breast tissue. If you’ve undergone a mastectomy, the cancer can recur in the tissue that lines the chest wall or in the skin. If an individual develops cancer in the opposite, untreated breast, she receives a new breast cancer diagnosis. This is not the same as breast cancer recurrence.

When breast cancer returns, it may be:

• Local: Cancer returns in the same breast or chest area as the original tumor.
• Regional: Cancer comes back near the original tumor, in lymph nodes in the armpit (axillary lymph nodes) or collarbone area.
• Distant: Breast cancer spreads away from the original tumor to the lungs, bones, brain or other parts of the body. This is metastatic cancer, often referred to as stage IV cancer.

Recurrence rates for people who have mastectomies vary. There is a 6% chance of cancer within 5 years if the healthcare provider did not find cancer in axillary lymph nodes during the original surgery. There is a one in four chance of cancer recurrence if axillary lymph nodes are cancerous. This risk drops to 6% if the patient gets radiation therapy after the mastectomy. If the individual has triple negative breast cancer, there is an increased risk of breast cancer recurrence.

Early diagnosis may make it easier to treat a recurrence. Your healthcare provider will conduct some of the same tests the patient had at the original diagnosis. Tests for breast cancer recurrence include:

• Blood tests for cancer tumor markers (proteins)
• Mammogram
• Ultrasound
• MRI, CT scam or PET scan
• Biopsy of the site of the suspected recurrence.

A biopsy is the only test that can make a definitive diagnosis of breast cancer.

The amount of estrogen receptor and progesterone receptor that are present in invasive breast cancer can be used to predict how the tumor will respond to treatments that lessen the hormones in your body. For estrogen-receptive breast cancer, hormonal therapies including Tamoxifen or aromatase inhibitors block either the activity of estrogen or the body’s product of estrogen.

• Routinely measure the presence of a protein called Human Epidermal Growth Factor-2 (HER2) in invasive carcinoma.
• Routinely measure the levels of the estrogen receptor and progesterone receptor in the tissue sample taken from the cancer.

Treatment for local or regional breast cancer may include:

• Mastectomy: The surgeon removes the affected breast (some both breasts) and sometimes lymph nodes.
• Chemotherapy: Chemotherapy circulates in blood, killing cancer cells.
• Hormone Therapy: Tamoxifen and other hormone therapies treat cancers that thrive on estrogen.
• Immunotherapy: Immunotherapy engages your body’s immune system to fight cancer.
• Targeted Therapy: Treatment targets specific cancer cell genes or proteins.

If you were subjected to a breast cancer misdiagnosis, call our medical malpractice attorney for more information.