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Causes
By Mayo Clinic staffRecurrent breast cancer develops from cells that originally came from the primary breast tumor. The cancer returns after the initial treatment and a period of time when no cancer was detected. This can happen because treatment did not fully destroy or remove all the cancer cells. Even with surgery, small clusters of cancer cells may have been left behind that were too small to be detected with any test.
If the cancer is aggressive, isolated cells may survive the rounds of chemotherapy and radiation meant to stop recurrence. Occasionally, cancer cells may be resistant to these treatments or develop the ability to spread (metastasize).
Sometimes a single cancer cell may be dormant for years without causing harm. Then something happens that activates the cell, so it grows and makes other cells. Not all of the growth factors for cancer have been found.
It's also possible to develop a new tumor, called a second or new primary tumor, in the same breast as the first tumor or in the other (contralateral) breast. Doctors make a distinction between recurrent breast cancer and a second primary cancer in the breast. Women who have had breast cancer are at higher risk of cancer in the other breast, when compared with women who've never had breast cancer. The risk is higher if you have a strong genetic predisposition or hereditary breast cancer. Fortunately, the vast majority of women who have cancer in one breast never develop cancer in the opposite breast.
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- Hayes DF. Overview of Treatment for Locally Advanced, Recurrent, and Metastatic Breast Cancer. http://uptodateonline.com/index. Accessed Nov. 12, 2008.
- American Cancer Society, Living With Uncertainty: The Fear of Cancer Recurrence. http://www.cancer.org/docroot/MLT/content/MLT_4_1x_Living_With_Uncertainty_-_The_Fear_of_Cancer_Recurrence.asp. Accessed May 19, 2009.
- Punglia RS et al. Local therapy and survival in breast cancer. N Engl J Med. 2007; 356:2399-2405.
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- Freedman GM et al. Identifying breast cancer patients most likely to benefit from aromatase inhibitor therapy after adjuvant radiation and tamoxifen. Cancer. 2006; 107:2552-2558.
- Hayes DF et al. Follow-up of patients with early breast cancer. N Engl J Med. 2007; 356:2505-2513. http://content.nejm.org/cgi/content/full/356/24/2505. Accessed May 19, 2009.
- National Breast Cancer Coalition, Gene-Expression Profile Testing, March 2007, accessed October 30, 2007, http://www.stopbreastcancer.org//index.php?option=com_content&task=view&id=161&Itemid=178.
- American Cancer Society, Breast Cancer Recurrence Test Gets FDA Nod, February 7, 2007, accessed May 8, 2008, http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Breast_Cancer_Recurrence_Test_Gets_FDA_Nod.asp.
- U.S. Food and Drug Administration, FDA Clears Breast Cancer Specific Molecular Prognostic Test, February 6, 2007, accessed October 5, 2007, http://www.fda.gov/bbs/topics/NEWS/2007/NEW01555.html.
- Buchanan CL, Locoregional Recurrence after Mastectomy: Incidence and Outcomes, Journal of the American College of Surgeons, October 2006, 469-474.
- Coombes RC, Survival and Safety of Exemestane versus Tamoxifen after 2-3 Years' Tamoxifen (Intergroup Exemestane Study): A Randomised Controlled Trial, The Lancet, February 17, 2007, 559-570.
- Thiebaut ACM, Dietary Fat and Breast Cancer: Contributions From a Survival Trial, Journal of the National Cancer Institute, December 20, 2006, 1753-1755.
- Pierce JP, Influence of a Diet Very High in Vegetables, Fruit, and Fiber and Low in Fat on Prognosis Following Treatment for Breast Cancer: The Women's Healthy Eating and Living (WHEL) Randomized Trial, JAMA, July 18, 2007, 289-298.
