Local Recurrence

One goal of your initial breast cancer treatment was to remove all the cancer in your breast and the immediate surrounding area. Sometimes, however, the cancer recurs in the remaining breast tissue, an adjacent lymph node or the chest wall.  This is called a local recurrence.  If you develop such a recurrence, be certain to undergo very careful imaging to determine exactly where the cancer is located before choosing a treatment option.

If you had a lumpectomy and the cancer recurs in the same breast, the standard of care is a mastectomy, the complete removal of the breast.  In some unusual instances, a second lumpectomy is possible.  If you have not had radiation therapy, the doctor may recommend that as well.  If your cancer appears to be more aggressive, chemotherapy many be recommended.

If you had a mastectomy and the cancer recurs in the chest wall – in the area where your breast used to be – you will probably have surgery to remove the tumor.  That may be followed by radiation therapy, depending on whether you have already had this treatment and how much radiation you had.  About 50% of patients who develop chest wall recurrences also have distant metastases, so doctors frequently recommend chemotherapy or hormone therapy in that situation.

If your cancer recurs in the lymph nodes near the primary site, you may be treated with surgery to remove the affected nodes, radiation therapy if you have not had it in that area and chemotherapy to reach any cells that might have traveled beyond the lymph nodes to other organs.
 

Breast Cancer in the Other Breast (Contralateral)
Women who have had breast cancer in one breast are at a 2 to 6-fold higher risk for developing it in the other (contralateral) breast. Contralateral breast cancers are primary tumors.  Contralateral breast cancer risk is not the same for all women and studies are ongoing to identify high-risk patients to better inform future decisions regarding ongoing surveillance.

Next: Treatment for Metastatic Disease.