When breast cancer comes back, it may return in the same place. This is called a "recurrence," because it is not a new cancer. But a recurrence can also appear in a place not directly related to the first breast cancer. This is called a "metastasis", and if cancer is detected in several areas, these are called "metastases". When breast cancer comes back, it tends to show up in specific areas of the body:
- the breast or the area where the breast used to be
- the chest wall
- the lymph nodes
- the bones
- the lungs or around the lungs
- the liver
- the brain
Cancers from other parts of the body rarely spread to the breast or the chest wall. If you have a tumor in your lymph nodes, lungs, liver, bones, or brain, it probably is a re-growth or recurrence of the original breast cancer rather than a new and different cancer. In other words, if you had breast cancer and you now have cancer in your bones, liver, or other places, it is probably not bone or liver cancer, but breast cancer that has spread to the bones or the liver. This is important because breast cancer—even when it has spread—is usually more treatable than a cancer that starts in the bones or liver.
Breast cancer that returns in other parts of the body is invasive cancer. However, cancer that comes back in the breast after surgery and/or radiation therapy can be either non-invasive or invasive.
If you have developed a cancer in the opposite breast from the one that was originally treated, it is probably not a recurrence. Most cancers that develop on the other side represent a new cancer rather than a recurrence.
Breast cancer can return in three general locations. It can be:
- Local: in the breast where it started, or in the skin and underlying tissues where the breast used to be.
- Regional: in the lymph nodes next to the breast.
- Metastatic: in another part of the body, such as the lung, liver, bone, or brain, or in lymph nodes far from the breast.
The following pages will give you more information on the three types of breast cancer recurrence. If you have not had a recurrence, but are just reading this section to keep informed, your mind may play tricks on you. You might develop some suspicious symptoms that seem like recurrence. This is a very natural reaction. If those symptoms don't go away within a day or so, make an appointment with your doctor to be sure.
If you've been diagnosed with metastatic cancer, skip ahead to read about Living with Metastatic Disease.
"Living with the fear of breast cancer is having a whale move into your living room. One day, it just appears and is always in the way. Over time, the whale can get smaller, but it never quite goes away. Maybe, sometimes, it gets down to the size of a magazine rack and once in a while you bump into it. Sometimes, it swells up in your face again, like when you have a mammogram and they call you back for extra views."