When cancer comes back after treatment, it is called a recurrence. The cancer can come back in the same breast or near the mastectomy scar (this is called local recurrence), or farther away (distant recurrence). Rarely, breast cancer comes back in nearby lymph nodes. This is called regional recurrence. Cancer that is found in the opposite breast is not a recurrence: it is a new cancer that calls for its own treatment.
Local recurrence: Treatment of women whose breast cancer has recurred locally depends on what treatment was used before. If the woman had breast-conserving therapy, a mastectomy is usually done. If the first treatment was mastectomy, recurrence near the mastectomy site is treated by removing the tumor whenever possible. This is followed by radiation therapy, but only if none had been given after the first surgery. (Radiation can't be given to the same place twice.) In either case, hormone treatment, trastuzumab (Herceptin), chemo, or some combination of these may be used after surgery and/or radiation therapy.
Regional recurrence: When breast cancer comes back as spread to nearby lymph nodes (such as those under the arm or around the collar bone), it is treated by taking out those lymph nodes. This may be followed by radiation treatments aimed. Treatments like chemo or hormone therapy may be used after the local treatment as well.
Distant recurrence: As a rule, women who have a cancer recurrence that has spread beyond the breast and lymph nodes to other parts of the body (like the bones, lungs, brain, etc.), are treated with systemic therapy. Surgery and/or radiation may be useful in some cases. Based on many factors, this may be hormone treatment, chemo, targeted treatments such as trastuzumab, lapatinib (Tykerb) or bevacizumab (Avastin), or some combination of these treatments.
Should your cancer come back, the American Cancer Society document, When Your Cancer Comes Back: Cancer Recurrence can give you information on how to manage and cope with this phase of your treatment.
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