If you were diagnosed with early-stage breast cancer—in
other words, if your tumor has not spread to other parts of your
body (Stages 0-III) then the information that you need is contained
in other chapters. You may safely skip this chapter, which deals
with advanced breast cancer.
What is advanced breast cancer? Advanced, or metastatic, breast
cancer is cancer that has spread beyond the breast and past the lymph
nodes, to form metastases in other parts of the body, such lungs,
liver, brain, and bones. This stage is called Stage IV cancer. About
one in ten breast cancers are Stage IV when they are first diagnosed.
Advanced breast cancer may also be a cancer that "came back."
In this case, it is also called recurrent cancer.
Recurrent Breast Cancer
Sometimes, after the initial treatment, your physician may find evidence
that the cancer "came back" in other words, that you have
a recurrence. The recurrence may be local (a small lesion in the breast,
along the incision, or near the chest wall), regional (in and around
the lymph nodes), or it may be in the form of distant metastases in
remote organs of the body. Cancer recurrences usually occur within
two to six years after the initial diagnosis, but sometimes even decades
You will undergo additional testing to make sure that there are
no cancer sites elsewhere in your body. The tests are probably already
familiar to you from your first encounter with breast cancer. They
include MRI, CT, bone scans, and other means of pinpointing areas
where cancer may have spread—locally or to distant areas. At
that time the decision will be made regarding additional treatment.
A local recurrence will generally be treated with the same approach
as an original cancer: surgery, with or without radiation therapy,
and possibly chemotherapy or hormone therapy, depending on the size
of the tumor and cell grade.
In advanced stages, breast cancer spreads to the lungs, liver, brain,
bones and soft tissues. If the recurrence is in another part of the
body, rather than in the breast area, treatment will require a systemic
approach targeting the entire body. Recurrences that are found in
other organs have a much more serious impact on the course of your
disease than local recurrences such as may be found near the lumpectomy
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