Diagnosis breast cancer

For early detection of recurrence, breast cancer patients have a follow-up program, which usually lasts 5 years after completion of therapy. This includes, among other things, a mammography every six months in order to detect a recurrence at an early stage. Certain tumor markers (CA 15-3, CEA) can also indicate a relapse if there is a significant increase. If there is concrete suspicion of a recurrence, further examinations are carried out. These include the (ultrasound) examination of the lymph nodes, as well as an ultrasound examination of the abdomen and a bone scintigraphy in order to rule out metastasis that has already occurred.

Probability of a relapse

About 5 to 10% of patients with breast cancer suffer a recurrence. A recurrence can occur even several years after the end of therapy. How high the individual risk of an affected person is depends on several factors. These include the size of the original breast tumor and its expansion into the surrounding structures.Therefore, different stages of breast cancer must be distinguished. The characteristics of the tumor, such as its growth pattern, the formation of certain receptors, its malignancy and the infestation of lymph nodes or other organs also have a decisive influence on the risk of recurrence.

Danger period of a relapse

For many types of cancer, one can speak of a cure 5 years after completion of the therapy and without the occurrence of a relapse, since after this period of time a relapse is very unlikely. Unfortunately, this is not true for breast cancer, so that a relapse can still occur after more than 10 years. However, the longer the time interval to the first tumor, the more favorable the prognosis is usually, since this behavior indicates a less aggressive, slowly growing tumor. An early relapse, on the other hand, which occurs months after the end of treatment, indicates a tumor that is usually more aggressive and malignant.

Treatment and therapy

In recurrence treatment, a local recurrence (renewed tumor formation in the breast or the adjacent lymph nodes, i.e. the tissue affected for the first time) must be distinguished from metastasis in other organs such as the liver, lungs, bones or brain. The therapy of a local recurrence usually aims at a complete recovery. Although there is an increased risk of recurrence, the chances of recovery are good in early stages.

In many cases it is necessary to amputate the breast together with the tumor, as far as this could be avoided during the original operation. In addition, chemotherapy and/or hormone therapy must often be repeated in order to kill cancer cells that have already been spread. If, on the other hand, a relapse occurs in other organs such as the liver, lungs, bones or brain, the treatment is usually palliative and the prognosis is therefore less good.

By surgically removing metastases (e.g. from the lung), or by radiation (e.g. from the brain), pain and other complaints can be reduced and survival can be prolonged if necessary. Chemotherapy and hormone therapy can also reduce tumor-related complaints and prolong survival, so that they can also be used, provided that the side effects are taken into account. In the case of metastasis, the primary therapeutic goal is therefore to make the patient’s remaining life as comfortable and pain-free as possible and, with acceptable side effects, to prolong life. What you should also read: Therapy options for breast cancer or breast reconstruction