We know you really don't want to be here, reading about breast cancer recurrence or metastasis. If you've had breast cancer, the possibility of recurrence and spread (metastasis) of breast cancer stays with you. You may be here because you fear this possibility. Or you may be here because it's already happened.
Keep in mind that a recurrence of breast cancer or metastatic (advanced) disease is NOT hopeless. Many women continue to live long, productive lives with breast cancer in this stage. It is also likely that your experience with treatment this time will be somewhat different from last time. There are so many options for your care and so many ways to chart your progress as you move through diagnosis, treatment, and beyond.
Recurrent breast cancer is cancer that has come back in the same or opposite breast or chest wall after a period of time when the cancer couldn't be detected.
Metastatic breast cancer is breast cancer that has spread to other parts of your body. Both are considered advanced-stage cancer.
When you had surgery to remove the original breast cancer, your surgeon removed all the cancer that could be seen and felt. But tests for cancer aren't sensitive enough to detect a tiny group of single cancer cells. These isolated cells may survive radiation therapy and chemotherapy aimed at preventing recurrence. Even a single cell that escaped treatment may be able to spread and grow into a tumor.
Being diagnosed with recurrent or metastatic breast cancer can be overwhelming. Women experiencing a recurrence may find themselves back on the emotional rollercoaster they thought they got off of after initial treatment. Other women may be angry, scared, stressed, outraged, and depressed. Some may question the treatments they had or may be mad at their doctors or themselves for not being able to beat the disease. Still other women may deal with diagnosis of recurrent or metastatic breast cancer in a matter-of-fact way. There is no right or wrong way to come to terms with the diagnosis. You need to do and feel what is best for you and your situation.
There are two important things to remember about diagnoses of recurrent and metastatic breast cancer:
- You are not alone. More and more people are living life to the fullest while being treated for advanced-stage cancer.
- You can have confidence that there are a wide variety of available treatment choices. There are many treatment options for advanced breast cancer, and new medicines are being tested every day. While recurrent or metastatic breast cancer may not go away completely, treatment may control it for a number of years. If one treatment stops working, there usually is another you can try. The cancer can be active sometimes and then go into remission at other times. Many different treatments — alone, in combination, or in sequence — are often used. Breaks in treatment can make a big difference when the disease is under control and you are feeling good.
In this section, we'll give you the support, information, and practical tips you need to deal with breast cancer that has come back or spread. In the following pages, you'll find information on diagnosis and treatment options for recurrent and metastatic breast cancer, palliative care, and information on living with metastatic breast cancer so you can find the best options for you.
Because there are so many options, this is a long section. You may want to read just a few pages at a time. You might find it very difficult to concentrate, think straight, and remember what you've read. That's natural when you're anxious, uncertain, or overwhelmed. We'll do our best to help you find what you're looking for.
- Definitions of Recurrent and Metastatic Breast Cancer
- Where Can Breast Cancer Come Back or Metastasize (Spread)?
- Planning Your Treatment for Recurrent or Metastatic Breast Cancer
- Living With Recurrent or Metastatic Breast Cancer
- Planning Ahead: End-of-Life Issues
Special thanks to Musa Mayer, author, patient advocate, and publisher of Advanced Breast Cancer: A Guide to Living with Metastatic Disease and AdvancedBC.org.
The medical experts for this section are:
Marisa Weiss, M.D., breast radiation oncologist, Lankenau Medical Center, part of Main Line Health Hospitals of the Thomas Jefferson University Health System, Wynnewood, PA
Brian Wojciechowski, M.D., medical oncologist, Riddle, Taylor, and Crozer Hospitals, Delaware County, PA
Sameer Gupta, M.D., M.P.H., medical oncologist, Bryn Mawr Hospital, Bryn Mawr, PA
Breastcancer.org and 29 other organizations have formed the Metastatic Breast Cancer Alliance to increase our ability to help patients and improve outcomes for those living with metastatic breast cancer and their families.