Breast cancer recurrence after partial removal. Mediterranean diet prevents recurrence of breast cancer

Breast cancer recurrence is the recurrence of the disease several months or years after the end of the course of treatment (chemotherapy, radiotherapy, surgical treatment). Cancer in this case develops both at the site of the primary tumor and remotely. This condition will be a new tumor in case of damage to another breast or another area of ​​the breast.

The recurrence of breast cancer, of course, scares a woman. After all, it seemed that she completely got rid of this ailment, as everything returns again. Involuntarily, the patient has questions about the correctness of the diagnosis and the completeness of the treatment. In most cases, the cause is not a violation of the treatment technology, but the inability to identify and destroy absolutely all malignant cells that have entered the surrounding tissues with the blood or lymph flow. The time criterion is important: if from the moment of completion combined treatment(surgery, radiation therapy, chemotherapy) more than 6 months have passed, and during this period no metastases were detected during control examinations, then such cancer is considered a relapse.

Cancer will be a recurrence if it is detected in the same mammary gland as the initial tumor lesion, as well as if the tumor focus is located in any other area other than the mammary gland. In the case of a distant location, they speak of cancer metastasis from the primary focus, and a relapse of the underlying disease. The presence of recurrence indicates in most cases the fact that individual tumor cells were insensitive to the treatment.

Most often, breast cancer recurrence occurs in the same areas as cancer metastases, including but not limited to nearby breast tissue and chest and nearby and distant lymph nodes. In addition, with a recurrence of breast cancer, the bones of the skeleton, lungs, liver, peritoneum, and brain can be affected.

When can a relapse happen?

Cancer recurrence can occur at any time, but recurrence is most common 3-5 years after treatment. They are local (the tumor occurs in the cured breast or near the mastectomy scar) or distant (the neoplasm appears in some other place).

Oncologists classify breast cancer recurrence as follows:

• local recurrence - in the area of ​​the operated mammary gland;
• regional metastases - recurrence occurs in regional lymph nodes;
• metastatic breast cancer - cancer is diagnosed outside the mammary glands - in the liver, spongy bones, brain, distant lymph nodes.

The most common lesions in breast cancer recurrence are The lymph nodes, lungs, liver and bones.

Local recurrence of breast cancer: about 1/3 of all cases of recurrence are detected during routine self-examination, 1/3 with diagnostic mammography, 1/3 of recurrences - only with a combination of ultrasound and mammography. Local recurrence of cancer in 80% of patients is not accompanied by other symptoms.

If cancer recurrence is suspected, an extensive examination is performed, including MRI and PET, as well as a breast biopsy.

Cancer recurrence in regional lymph nodes: accounts for about 40% of all cancer recurrences. It is usually observed in cases where a limited resection of the lymph nodes was performed - partial lymph node dissection. With self-identification of enlarged lymph nodes, their biopsy and histological examination are usually performed.

What factors influence the development of cancer recurrence?

There are a number of prognostic indicators that allow the doctor to predict the recurrence of cancer:

• the later the primary disease is diagnosed, the more likely it is to recur;
• the more aggressive the primary disease, the more often relapse develops;
• the larger the size of the neoplasm, the greater the likelihood of recurrence;
• in cases where the primary diagnosis of cancer reveals damage to regional lymph nodes;
• the higher the cellular atypia (histological indicator - the degree of malignancy of the cells) - the difference between the number of atypical malignant and healthy cells - the higher it is, the higher the risk of relapse;
• 2/3 of all breast cancers are accompanied by significant levels of positive estrogen receptors, meaning that malignant formations(ER+) respond better to hormone therapy and spread more slowly;
• neoplasms containing certain oncogenes often lead to recurrent diseases;
• malignant cells that have a high atomic index (the rate at which they divide) grow faster.

After surgery or radiation therapy, the oncologist assesses the situation for the likelihood of a relapse.

How do you know if you have a recurrence of breast cancer?

One of the main ways to detect cancer early is self-examination and self-examination (palpation) of the mammary glands.

Breast changes that may indicate the development of a relapse:

• burning, itching, or change in the nipple;
• any change in structure, size, contour or temperature mammary gland; pitted, reddish surface of the skin;
• an area of ​​skin of a marble-like color;
• atypical discharge from the nipple (with many diseases, but cancer is not excluded).

It is very important to undergo follow-up medical examinations, including diagnostic examinations- Ultrasound of the mammary glands, mammography, as well as laboratory examinations by doctor's prescription. Initially, after the completion of primary treatment, examinations are scheduled once a quarter, and then less frequently. It is necessary to strictly follow the recommendations of a specialist and annually do a mammogram.

How is recurrence treated?

The main treatments for breast cancer recurrence include:

• local treatment - surgery and radiation therapy.
• systemic treatment - chemotherapy, hormonal therapy, targeted therapy.

The type of treatment for recurrence is directly related to the type of treatment for the original disease. If at first a lumpectomy was performed, then a mastectomy is used in case of relapse; if at first there was a mastectomy, then radiation therapy is used for relapse. Chemotherapy and/or hormone therapy is used in any case.

The discovery of cancer in the other breast most likely indicates a new tumor that has nothing to do with the first disease. In this case, lumpectomy or mastectomy is used, and in certain cases, systemic treatment (hormone and / or chemotherapy) and / or radiation therapy.

Systemic therapy is used when recurrent disease occurs in the bones, brain, or lungs. Surgery or radiation therapy is used to reduce certain symptoms.

Immunotherapy (possibly in combination with hormone therapy) is recommended for patients whose malignant cells have elevated level HER2/neu protein. Also, this method is used with the ineffectiveness of chemotherapy and hormone therapy.

Why does it happen and how to find out that there was a recurrence of breast cancer after surgery?

Mammary cancer. Relapse after surgery

Breast cancer recurrence- this is the one that returns after a mastectomy.

Local recurrence after mastectomy may include skin, muscle, and fascia under the site of the original breast tumor, as well as lymph nodes.

Breast cancer recurrences can be classified as locoregional recurrence or as distant metastases.

What is the risk of breast cancer recurrence?

If cancer is found within three months of initial treatment, doctors generally do not consider it a recurrence. Instead, such a case is considered as cancer progression or treatment failure.

In order to be classified as a breast cancer recurrence, the oncology must recur at least one year after the completion of successful treatment.

breast cancer statistics

Symptoms of breast cancer recurrence. What to expect?

You must also be considerate of others. possible symptoms, including:

1. Changing the shape of the breast;
2. Change in breast mass;
3. Changes in the skin of the chest;
4. The loss ;
5. Fever, chills (not associated with a viral disease);
6. Emerging or shortness of breath;
7. in the bones;
8. Swollen lymph nodes in the neck or groin;
9. or visions;
10. Yellow or ;

Treatment of recurrent breast cancer. Methods and drugs

As with the initial diagnosis of breast cancer, treatment for recurrence of breast cancer usually combines several methods - this is called systemic treatment.

• Chemotherapy- is almost always used, since the goal of systemic treatment, first of all, is to kill cancer cells in a global sense. In other words, a systemic treatment is required that will attack cancers anywhere in the body, not just where the recurrence is;
• Surgery- may be done to remove an area of ​​the chest wall affected by a recurrence of breast cancer
• Radiation- can be used, but this will depend on whether radiation therapy was used for treatment at first diagnosis;
• therapy and targeted therapy- treatment may depend on the status of the receptors tested on repeat biopsy;
• Photodynamic therapy Recent studies suggest that photodynamic therapy may be effective way treating some people with recurrent breast cancer;

Treatment Predictions for Breast Cancer After Recurrence

The occurrence of breast cancer recurrence was considered to be a poor prognosis and almost always positive, but some studies show a very good 5-year disease-free survival.

The likelihood of breast cancer recurrence

General statistics of breast cancer recurrence

About 1 in 8 women (about 12%) will develop invasive breast cancer during her lifetime.

It is expected that in next year 252,710 new cases of invasive breast cancer will be diagnosed, as well as 63,410 new cases of non-invasive (in situ) breast cancer.

The risk of breast cancer recurrence is about 1 in 1,000.

The incidence of breast cancer has begun to decline today, after increasing over the previous two decades.

Breast cancer recurrences have decreased by 7% only. One theory is that this decline was partly due to a decline in the use of hormone replacement therapy (HRT) by women after the results of a major study called the Women's Defense Initiative were published in 2002. These results suggest an association between HRT and an increased risk of breast cancer.

About 40,610 are expected to die next year from breast cancer, although death rates are declining every year. Women younger than 50 experienced a greater reduction in breast cancer occurrence and recurrence. These reductions are believed to be the result of improvements in treatment, early detection through screening, increased awareness and more healthy lifestyle life.

For women, the death rate from recurrent breast cancer is higher than the death rate from any other cancer except lung cancer.

In addition, breast cancer is the most commonly diagnosed cancer among women. This year, it is estimated that about 30% of newly diagnosed and recurrent cancer women will have breast cancer.

What is the survival rate for breast cancer?

Noninvasive (stage 0) and early stage invasive (stages I and II) breast cancer have better chances of survival than advanced cancers (stages III and IV).

There are various survival rates, including overall survival, relative survival, and survival.

It is important to understand the differences between these rates when you look at the survival rate.

What is the survival rate after breast cancer?

Noninvasive (stage 0) and early stage invasive breast cancer (stages I and II) have a better prognosis than advanced cancers (stages III and IV).

Cancer that has not spread outside the breast has a better prognosis than cancer that has spread to the lymph nodes.

The worst prognosis for metastatic breast cancer (stage IV) is when the cancer has spread beyond the lymph nodes to other parts of the body.

What to do if breast cancer recurs?

Overall survival is similar for treating recurrent breast cancer with lumpectomy with radiation therapy compared with mastectomy. This means that both treatments reduce the risk of death from breast cancer in the same way.

Summary clinical research on lumpectomy and radiotherapy versus mastectomy in the treatment of early breast cancer and recurrence can be found in the breast cancer research section (online).

Risk of breast cancer recurrence between treatments

The choice between lumpectomy with radiation therapy versus mastectomy will not affect your survival. However, it may affect your risk of breast cancer coming back (cancer coming back) in your breast.

What is local recurrence of breast cancer?

Most local recurrences occur within the first 5 years after diagnosis.

If you have a recurrence of breast cancer, you need more treatment.

Distant relapses (metastases)

The risk of long-term recurrence is the same for people who have had a lumpectomy with radiation therapy as they are for those who have had a mastectomy.

The chance of local recurrence of breast cancer after 10 years is about 3-15% for women who have a lumpectomy plus radiation therapy.

Risk local recurrence depends on tumor characteristics such as hormone receptor status and HER2 status.

It also depends on whether the tumor margins and axillary lymph nodes contain cancer cells.

The chance of local recurrence is lower when:

1. Tumor fields do not contain cancer;
2. Lymph nodes do not contain cancer;

Chemotherapy, hormonal therapy, and/or targeted therapy may reduce the risk of breast cancer recurrence after lumpectomy plus radiation therapy.

Mastectomy and local recurrence of breast cancer

In a mastectomy, the best predictor of local recurrence is whether the lymph nodes in the armpit contain cancer. The more lymph nodes with cancer, the higher the risk of recurrence.

When the lymph nodes do not contain cancer, the chance of local recurrence after 5 years is about 6 percent.

For cancers in the lymph nodes, the chance of local recurrence after 5 years is about 23 percent without radiation therapy after a mastectomy. Radiation therapy can reduce this risk to about 6%.

How to find local recurrence or metastases?

Breast cancer can recur at the original site (called local recurrence). It can also come back and spread to other parts of the body (called metastases or distant recurrences).

A local recurrence is usually found on a mammogram, during a physical examination by a doctor, or if you notice a change.

Metastases are usually discovered when symptoms are reported during follow-up visits to your doctor.

Learn about aftercare after breast cancer treatment.

How is local recurrence of breast cancer treated?

When local recurrence of breast cancer occurs, it is treated in much the same way as primary breast cancer.

The tumor is removed by a surgeon, examined by a pathologist, and tested for hormone receptor status, HER2 status, and other characteristics.

Other tests are also done to make sure there are no signs of metastases.

No. 1. Local recurrence after lumpectomy

Local recurrences after lumpectomy (breast-conserving surgery) can often be treated most successfully.

Treatment usually involves surgery, usually a mastectomy. Radiation therapy may be given if it is not part of the initial treatment for breast cancer. Treatment may also include chemotherapy, hormone therapy, and/or targeted therapy.

No. 2. Local recurrence after mastectomy

Even though the entire breast is removed in a mastectomy, breast cancer can still return to the chest area. The more lymph nodes with cancer at the time of a mastectomy, the more likely it is that breast cancer will recur.

Local recurrence after mastectomy is usually treated surgical intervention followed by radiation therapy (if radiation therapy was not part of the original treatment). Treatment may also include chemotherapy, hormone therapy, and/or targeted therapy.

Additional tests

1. Blood tests (including tests for the presence of tumor markers);
2. Imaging testing (eg, bone scan, CT scan, PET scan, and chest X-ray);
3. Tissue biopsy (to check if the suspicious finding is a recurrence of breast cancer)

Other tests may also be performed.

For people who do not have symptoms of metastases, blood tests and imaging (other than mammography) are not a standard part of follow-up care. Using a blood test or imaging to check for early metastases in people without symptoms of metastases does not improve survival.

When metastases are present, tests are done to determine which organs are involved, as well as the hormone receptor status and HER2 status of the tumor. You and your doctor can then discuss treatment options.

Metastases and pain management

It is important to control any pain associated with metastatic breast cancer. Even mild pain can affect daily life, and other side effects, such as , look even worse without medication.

Scientists have long been trying to understand the causes of breast cancer recurrences, but they are still an unpredictable phenomenon. However, prevention can prevent the return of a formidable disease.

Modern medicine has the idea that even after successful treatment of pathology, tumor cells are able to migrate to other parts of the body. There, they may lie dormant, sometimes for many years, before triggering a new and often very aggressive disease outbreak.

While some experts are meticulously understanding the mechanisms underlying pathology recurrence, others have already begun to highlight lifestyle and behavioral factors in patients that reduce risks or are of little importance for prevention.

"There are numerous recommendations that promise to help women cope with breast cancer recurrence, but they are not always effective," says Ellen Warner, professor of medicine at the University of Toronto, an affiliate researcher at the Sunnybrook Research Institute. She explains what she means by the advice to avoid dairy, carbohydrates, soy, etc. These, according to Warner, do little or no help at all.

For example, soy is a good product, adds Warner. "While there is not enough evidence to support regular consumption of soy products, there is some scientific evidence that soy products may protect against breast tumor recurrence."

But, according to Warner, there are indeed some lifestyle factors in patients that can affect the development of the disease. The professor is a co-author of a recent study on lifestyle changes, which was devoted to this problem. She believes that preventing the recurrence of breast cancer can be very effective.

Find out how fitness, medication, and vitamins reduce the risk of breast cancer recurrence, and what else you can do today to protect yourself from the return of the disease tomorrow.

Dr. Warner states that regular fitness for at least 2½ hours a week is "the most important lifestyle factor" when it comes to reducing the risk of recurrence.

Unfortunately, according to medical statistics, only 13% of breast cancer survivors in the US practice regular fitness activities.

It is often difficult enough to gather strength, to find energy for active training after a debilitating war on cancer. But since regular physical exercises reduce the level chronic inflammation and optimize the levels of hormones associated with the risk of disease recurrence, fitness is the best prevention. Sports can greatly reduce the need to fight pathology in the "second round".

Weight control and prevention

Dr. Warner believes that losing excess weight, although it has undoubted health benefits, does not guarantee one hundred percent protection against recurrence of breast cancer. But there is strong evidence that avoiding weight gain and eating a healthy diet during and after treatment can reduce your risk.

Other experts agree with this point of view. "Women who are overweight and obese have a higher risk of recurrence than those who maintain a healthy body weight," says Elisa Port, MD, chief of breast surgery at Medical center Mount Sinai (New York).

Alcoholic drinks

"Moderate drinking (no more than 3-4 glasses of wine per week) is wise and safe," says Dr. Port. “You should refrain from daily consumption of alcoholic beverages,” she adds.

The study, the results of which were published in 2016 in " International magazine cancer,” showed that survivors who consumed more than one serving of alcohol-containing beverages per day were 28% more likely to experience a recurrence of the disease.

"Prevention through medicines prescribed by a doctor is essential to reduce the risk of recurrence,” says Dr. Port.

Numerous studies, including results scientific work, published in 2016 in the New England Journal of Medicine, showed that antiestrogenic agents and aromatase inhibitors can block breast cancer's attempts to return. But because of side effects and other factors, many women stop taking these drugs or take them, but not in accordance with the instructions of specialists, according to Alice Port.

Increasing your intake of vitamins C and D

Although there is little evidence to support that vitamins C and D are needed to prevent recurrence, some experts believe that they can be very beneficial.

So, Dr. Warner believes that vitamin C supplementation correlates with a decrease in mortality rates from breast cancer.

Low levels of vitamin D have also been associated with poorer outcomes, so there are proactive recommendations for vitamin D supplementation.

While research is still ongoing, your doctor may recommend that patients take supplements of vitamins C and D during and after successful treatment of a breast tumor.

There is more and more evidence that intermittent fasting or long breaks between meals can provide great health benefits.

The data from the study, the results of which were published in 2016 in JAMA, are preliminary. However, they showed that breast cancer patients who abstained from food for 13 hours or more per day significantly reduced their risk of recurrence compared to women who did not.

Changing your eating habits is easier than you think: you need to take a break (of 13 hours or more) between the last meal in the evening and breakfast the next day. Having dinner before 8 pm, you can have breakfast the next morning at 9 o'clock.

Green tea consumption

Thus, a study conducted in Japan found a significant reduction in the risk of relapse (by 31%) among women who regularly consume green tea.

Breast cancer recurrence is an oncological pathology. It reappears some time after the completion of treatment for the primary cancer. Basically, a recurrent neoplasm appears at 3-5 years.

Causes and types of relapse

In most cases, the secondary development of oncological formation is caused by the lack of the ability to identify and remove all low-quality cells that have entered neighboring tissues through the blood or lymph. There are a number of factors that influence the development of relapse. These include:

Basically, the recurrence of breast cancer is divided into types depending on the localization of the tumor. It happens:

1. Local - oncology is formed at the site of primary cancer or near the scar from a mastectomy.
2. Distant recurrence occurs in organs and areas that are not related to the mammary glands.
3. Local recurrence (at the site of a previous surgical intervention);
4. Regional metastases (recurrent tumor in regional lymph nodes);
5. Metastatic tumor (diagnosis of recurrent cancer in areas outside the breast).

Local recurrence may develop after lumpectomy and radiation. In this situation, secondary oncology is formed inside the breast. But when identifying seals, it is important not to despair. Perhaps this is not a cancerous neoplasm, but a fat tissue destroyed during treatment, a ligature granuloma, scar tissue.

After treatment with a mastectomy, local recurrence may develop in the skin of the breast, in the area of ​​soft tissues and in the area of ​​the reconstructed breast. The recurrence of malignant tumors occurs in 6-9% of cases and the probability of their occurrence increases two years after surgery. More than 68% of recurrent formations occur near the postoperative scar.

If, along with a mastectomy, reconstructive surgery to restore the shape of the breast, then swelling and swelling (fat necrosis) is formed. These manifestations are not associated with cancer pathology.

Signs of relapse

At the end of the treatment of breast cancer, it is recommended not to miss scheduled diagnostic examinations and to conduct regular independent palpation. Suspicious signs are a reason to contact your doctor as soon as possible. The initial signs of the development of a recurrent breast tumor include:

Depending on the localization of the repeated oncological formation, the corresponding signs of recurrent breast cancer are distinguished. The main symptoms of local recurrent breast cancer:

• the appearance of a neoplasm in the chest;
• the appearance of a seal irregular shape in the region of the mammary gland;
• tension of the skin or the formation of retractions at the site of lumpectomy;
• inflammation and redness of the skin;
• compaction, indentation of the nipple and other deviations.

Recurrent signs after mastectomy:

• education on skin and in the subcutaneous layer of nodules that are not accompanied by pain;
• the appearance of thickening along the surgical scar.

In case of regional recurrence, cancerous formation occurs a second time in the lymph nodes in the armpit or collarbone. The main characteristics of regional recurrence:

• compacted and enlarged lymph nodes;
• swelling of the hand;
• permanent pain all over the arm or in the shoulder area;
• decreased sensation in the hand.

With metastatic recurrence, cancer occurs in distant parts of the body. Main characteristic features metastatic recurrence are:

• having pain in the chest or bones;
• constant presence of dry cough;
• deterioration or lack of appetite;
• labored breathing;
• severe pain in the head;
• the presence of nausea and vomiting;
• weight loss;
• increase in body temperature;
• chills.

Knowing the main signs of all types of recurrence will allow you to quickly identify the pathology and begin prompt treatment.

Diagnosis of recurrence and methods of treatment

Conducting timely mammography and self-examination helps to diagnose the development of relapse at an early stage. When the first signs appear, you should immediately contact your doctor.

If recurrent breast cancer is suspected:

• repeat mammography;
• biopsy;
• study to identify cancer markers.

After these analyzes, studies are carried out to detect cancer and the development of metastases. If required, magnetic resonance imaging and CT scan. An x-ray is prescribed if recurrence of breast cancer is detected. thoracic, mammography of the adjacent breast, densitometry. Only after the final diagnosis, the doctor begins treatment.

Before treating a recurrent mass, an oncologist considers certain factors:

• localization of metastases and their distribution;
• characterization of relapse;
• the duration of the interval between the end of the treatment of the primary oncological formation and the detection of a relapsing tumor;
• methods used to fight the primary tumor;
• efficiency hormone therapy and chemotherapy in primary cancer;
• age and general health of the patient.

Recurrent breast cancer responds well to treatment, but a complete cure is difficult to achieve. With the local development of recurrent formation, the correct therapeutic measures will prolong the life of the patient. Hormone therapy and chemotherapy are usually used. The drug used and the treatment regimen depend on the stage of the disease.

Also, the method of treating a recurring tumor depends on the method of treating the original cancer. If lumpectomy was used, then mastectomy is used to combat recurrence. In the primary use of mastectomy, radiation exposure is used to treat recurrent disease. Hormone therapy and chemotherapy are used after radiation exposure or surgery.

For recurrent oncology in organs not associated with the mammary gland (bones, lungs and brain), systemic therapy is used. To reduce some of the symptoms, radiation exposure and surgery are used.

In the final stages of recurrent cancer, systemic therapy provides an opportunity to improve the quality of life, and the patient can live 1-2 years.

Immunotherapy may be given alone or together with chemotherapy. It is used in the treatment of patients whose cancer cells contain a high content of the HER2/neu protein. Immunotherapy is also prescribed in the absence of effectiveness. hormonal treatment and chemotherapy. After surgery or radiation therapy, the oncologist determines the risk of further oncology manifestations. In some cases, the use of Tamoxifen or chemotherapy is recommended.

Forecasting

Predictions after breast cancer recurrence and treatment are based on the Nottingham Prognostic Index, computer program scores, and the Oncotype DX test.

The Nottingham Prognostic Index is a scale used after surgery to predict the future development of cancer. Three indicators are used in forecasting:

• the size of the cancer;
• the number of pathological lymph nodes;
• degree of oncology.

Specialists in some cases use special computer programs online for forecasting. The effective value is expressed as a percentage of survival after diagnosis. Programs are able to evaluate the benefits of therapy and surgery.

Oncotype DX is an analysis of a sample of breast cancer tissue to determine its genetic makeup. The test determines the likelihood of relapse and its signs. The program determines the appropriate treatment for each individual case.

Breast cancer recurrence is prevented by a comprehensive therapeutic effect for primary education. For early detection of secondary pathology preventive examinations held quarterly for 2 years, and then less frequently.

How many people can live after a recurrence of breast cancer is difficult to say. No analysis and test can give an accurate prediction. When individual metastases are detected, the prognosis worsens significantly.

Recurrence of breast cancer often develops even after completing the full course medical therapy. At the same time, the disease does not always resume its course again a year after complex therapy - sometimes symptoms of breast cancer recurrence can be seen 10-20 years after treatment. In this condition, the tumor can reappear in the same place, or form in another breast.

What to do if the disease recurs? In this case, it is necessary to immediately begin treatment of the oncological disease in order to stop the growth malignant neoplasm and maintain the health of the mammary glands.

Recurrence of cancer after mastectomy, drug, radiation or other type of therapy is a tumor of a malignant course. Recurrence and metastasis of breast cancer can affect the same mammary gland, nearby lymph nodes, or distant tissues of the gland.

If the cancer has recurred to the other breast, the oncologist treats the disease as a separate tumor and draws up a new treatment plan. However, its metastasis to the bone tissue is also considered as breast cancer and is not a separate pathology.

Thus, there are 3 variants of cancer development:

1. Local - an increase in the number of malignant cells is again recorded in the previously treated breast (in the original place) or on postoperative scar. It often occurs without obvious symptoms and is regarded as a failure of the therapeutic therapy.
2. Regional - the number of cancer cells increases, affecting the tissues of the gland and lymph nodes located in the armpits, neck and décolleté (observed in 40% of cases). Pathology takes a more aggressive form.
3. Metastatic (distant) - cancer cells spread through the bloodstream and lymphatic system, infecting distant parts of the body, such as the liver, brain, and lungs. Also, the focus of breast cancer can originate in the opposite breast.

If the tumor managed to recur, it will develop more quickly and aggressively, which, of course, will adversely affect the health of the woman.

When can a neoplasm recur?

If the patient turns to the doctor in a timely manner, which will allow timely start of complex therapy of the disease, the survival rate in this case is 60%.

When does oncology recur?

When a breast tumor develops again, it frightens the patient even more than the previous disease. The woman begins to think that the disease cannot be cured completely, and, despite the measures taken, it will constantly occur.

Basically, the manifestation of a neoplasm occurs when, during the treatment of breast cancer, doctors fail to completely destroy cancer cells, especially if they have managed to penetrate healthy breast tissues or spread along with blood to another organ. During the operation, it is difficult to assess the degree of spread of malignant cells, since without their active growth it is impossible to identify a new location of the tumor.

According to oncologists, if more than 6 months have passed after the main therapy, and no metastases were detected during the tests, then a second exacerbation of the disease is considered a relapse. If in postoperative period new tumor cells were identified, which means that the pathology was not completely cured.

Also, a recurrence can be called the appearance of a malignant neoplasm in another organ. In this case, the tumor cells were transferred throughout the body along with the blood flow, which caused a new focus of infection. Doctors call this phenomenon metastasis of the primary neoplasm.

The appearance of metastases in a woman's body says that some malignant cells during therapy were insensitive to it. This indicator requires urgent reoperation or conservative therapy, which will preserve the health of the affected organ.

Recurrence of breast cancer in women often occurs as a result of specific circumstances. Today, oncologists know a number of factors that serve as the beginning of the recurrence of the disease:

1. Form of cancer - if the pathology proceeds in an aggressive form, the risk of tumor recurrence increases several times.
2. - if it is discovered late, the percentage of recurrence is high.
3. A large number of cancer cells in female body.
4. Damage to the lymph nodes and blood vessels located near the mammary glands.
5. Tumor growth rate and size.
6. The birth of the first child after 30-35 years.
7. Early menstruation and late menopause.
8. A certain type of oncogene found in cancer cells that also often causes the development of the disease.

After completion of treatment, the doctor will assess the risk of a recurrence of the oncological process, and will also inform the woman about the need for an annual breast examination.

As a rule, symptoms of a relapse of the disease can be noticed at any time after therapy, but often the disease begins to develop again 3-5 years after the end of the treatment course.

Who is at risk

To avoid breast cancer, you need to know which groups of women are most susceptible to the development of pathology.

As statistics show, most often the disease is diagnosed in women 35-45 years old, but sometimes the disease occurs in younger women who have reached the age of 25 years.

For starters, the risk group includes those women who have a hereditary predisposition to the disease. If cancerous tumors of the breast were observed along the female line, the disease develops in 50% of cases.

This usually depends on the type of previous therapy (meaning that only one treatment option is undertaken, not a combination of them):

Thanks to scientific research, it was possible to find out that women who have cancer genes in their blood should also be included in the risk group. These genes look like this: BRCA-II on chromosome 13 and BRCA-I on chromosome 17. In this case, metastasis can increase the risk of developing the disease by another 10%.

If neoplasms of the mammary glands are not cured in time, the disease will progress rapidly. In 10% of patients who consult a doctor, the disease is already accompanied by metastases. The complexity of the treatment lies in the fact that such patients cannot be subjected to an operation, since they have an active germination of metastases or a general exhaustion of the body.

The main danger of the disease lies in the high mortality of women who have not been helped by treatment or the doctors did not have time to perform the operation. The probability of a complete cure of the disease is only 30%, while in other cases a relapse of the disease is possible.

How does the spread of cells that were not destroyed during treatment? Together with the lymphatic fluid or blood flow, malignant cells are able to penetrate into many organs. These include:

• Lungs.
• Peritoneum.
• Brain.
• Skeleton.
• Liver.
• Rib cage.
• Healthy breast tissue, etc.

In this case, therapy is carried out more comprehensively, which will completely destroy cancer cells.

Cancer is a dangerous pathology that develops rapidly in the body, therefore early detection symptoms will help prevent the development of a large tumor that can lead the patient to death.

A recurrence of a cancerous tumor can be detected independently - for this, it is enough to carefully probe the chest and visit a doctor annually. If the disease is completely cured, the mammary gland will be soft and without hard bumps and seals.

The following signs usually indicate the development of a relapse:

1. Changing the color and appearance of the nipples.
2. Pathological discharge from the nipple.
3. Burning in chest.
4. Itching on the skin of the breast, the presence of ulcers, cracks.
5. A separate inflamed area of ​​the chest became a marble-like color.
6. The body temperature has risen.
7. The appearance of a red spot on the affected area of ​​\u200b\u200bthe chest.
8. Change in the size and contour of the affected gland.
9. General depletion of the body.
10. Decreased appetite.
11. Weight loss.
12. Anemia and hyperthermia.
13. Rapid fatigue, lethargy, loss of strength.

As a rule, it is these symptoms that indicate re-metastasis, the treatment of which must be carried out in a short time. To avoid recurrence after tumor therapy, you should regularly visit a doctor (especially the first couple of years) so that the disease can be detected in time.

To identify the prognosis of the disease, a woman should undergo all diagnostic measures that will make an accurate diagnosis, as well as identify the structure and degree of a malignant neoplasm.

The doctor will be able to identify breast cancer by examining the patient and listening to the symptoms that disturb her. You will also need to undergo a mammogram to confirm the diagnosis.

If with the help of such diagnostic methods it will not be possible to confirm the disease, the patient will need to undergo such research methods:

• Radiography.
• CT scan.
• radioisotope scanning.
• Blood tests (general and oncomarkers).

If a woman has previously had surgery, you will need to examine the scars, since it is in them that a repeated tumor most often develops.

A biopsy is necessary in order to distinguish between the formation of a new isolated tumor or the recurrence of an old one. When analyzing a biopsy, it will be possible to identify the sensitivity of cancer cells to targeted and hormonal treatment.

Which doctor to contact

In the postoperative period and as a prevention of breast cancer, it is required to visit a mammologist. If he reveals an oncology in a woman, the doctor will refer the patient directly to the oncologist, since only a narrow specialist will help to carry out complex treatment.

If the disease has metastasized to other organs, for example, to the uterus and ovaries, then the woman will also be observed by a specialist in the relevant field - a gynecologist.

Methods of therapeutic therapy after the recurrence of breast cancer

Radical treatment of the disease is carried out by several methods. These include:

1. Local treatment of the disease, which involves surgery, brachytherapy or radiation therapy.
2. Systemic treatment, in which the patient is prescribed targeted or, as well as chemotherapy.

As a rule, more often the patient is prescribed local treatment for severe disease. If the cancer develops at the initial stage, it will be necessary to carry out systemic therapy. Also, the type of treatment depends on the frequency of relapses, because sometimes they can occur frequently - it depends on the incomplete destruction of cancer cells, which eventually form a new tumor.

If the disease is detected in a woman for the first time, they can help overcome it medicines. However, the benefit of such therapy will only be if the patient strictly follows the instructions for the use of the drugs, does not violate the dosage, and also follows the doctor's advice.

Often, the reappearance of the disease indicates the aggressiveness of cancer cells, which are not so easy to destroy. In this case, the patient is assigned complex therapy(both local and systemic), which will completely overcome all pathological cells that could get into the organs, tissues or lymph nodes of the patient during the first treatment.

Repeated therapy carries more chances for a full recovery, because the doctor conducts a thorough examination to understand exactly where the cancer cells have spread in the female body. But if the patient visits the doctor untimely, breast cancer can affect most of the breast - as a result, its removal is required (partial, complete, with excision of part of the lymph nodes).

What can be done to avoid the recurrence of the disease? To prevent relapse, it is imperative to carry out prophylaxis, which will avoid the resumption of the pathology.

Usually, preventive actions it is required to be carried out immediately after therapy, since oncological cells are able to enter the bloodstream, thereby causing a recurrence of the disease.

Preventive measures include:

1. Taking special medications that reduce the production of estrogen (hormone) - this does not allow cancer cells to grow, forming a new malignant tumor in the breast or other organ.
2. Weight control - you can not drastically lose weight and gain mass. The weight indicator should correspond to your height and age.
3. Refusal of alcohol and smoking, the transition to a balanced diet.
4. Observation at the mammologist every 6 months.
5. Holding therapeutic gymnastics and massage, especially after surgery.
6. Prevent exacerbation of chronic pathologies.
7. Acceptance of any hormonal drugs, including contraceptives, must be agreed with your doctor.
8. Young women can plan pregnancy with subsequent breastfeeding.
9. Taking vitamin complexes and drugs that stimulate the immune system.

How much medication is usually required? To avoid re-infection, you should take drugs for six months.

Disease prediction

With a relapse of the local type after a mastectomy, during which the lymph nodes were not affected, the survival rate of patients is 75%. In this case, cured patients will be able to live for more than 5 years. If metastases were found in the breast, the life expectancy of women is 3 years. Identification of the disease early stage allows you to completely cure the disease.

After therapeutic treatment the patient needs to carry out prophylaxis, as well as monitor the condition of the breast - if growths, burning, seals, peeling appear on it, it is necessary to visit the doctor, as such signs indicate the development malignant tumor. In this case, only a doctor will be able to give a correct assessment. given state. He will also examine the scar in order to understand what kind of disease the patient develops, and will give a referral for tests. (No ratings yet)