Signs of recurrence

During breast cancer treatment and well after it has ended, fear of recurrence is a concern for nearly every person diagnosed with early-stage breast cancer. You may worry that illnesses, fatigue, unusual aches, new marks or changes in your body are signs of the cancer coming back. These fears are normal and expected.

Remember: Our bodies change naturally over time. Many things that may be signs of recurrence can be signs of other, less serious conditions. And many turn out to be the kinds of aches, pains, and illnesses everyone has throughout their lives.

But some symptoms may mean the cancer came back. As you read this page, remember:

• Not everyone will have a breast cancer recurrence
• No one symptom is a sure sign of breast cancer returning

If fear of recurrence has a lasting, strong or significant impact on your daily life, Living Beyond Breast Cancer has resources that can help. Read our Guide to Understanding Fear of Recurrence (PDF) or contact our Breast Cancer Helpline so we can match you with another person who has had a similar experience or concern.

If fear of recurrence keeps you from enjoying your favorite activities or facing your day-to-day life, consider speaking with a mental health professional.

Remember, many general symptoms are related to growing older or to other medical concerns. See your doctor if you have signs of recurrence but also ask questions at your regular appointments. Your providers can help you understand your risks for breast cancer recurrence and help you consider any symptoms and side effects that affect your life. These talks with your doctors can happen many times over the course of your care and your life.

When to speak with your doctor

Many healthcare professionals recommend waiting a few weeks before reporting minor symptoms. Keep track of new feelings, aches, or marks, if they continue for weeks, get worse or you notice other changes.

Always ask your medical team what they want you to do if you experience a new pain, illness or change in your body. Some teams may want you to report symptoms earlier. You know your body best: If you have a symptom that gets in the way of your daily activities, or gets worse day by day, contact your doctor sooner.

Some symptoms should always be reported immediately, no matter what your health status. They may be signs of more serious conditions not related to breast cancer, like a heart attack or stroke. You should see a healthcare provider as soon as possible if you have:

• Intense chest pain or chest pain that won’t go away
• Trouble breathing
• Loss of coordination
• Pain with no obvious cause that is getting worse

Local recurrence

A local recurrence is when cancer returns to the same breast where the cancer was first found. If you had a single mastectomy to remove the affected breast, the recurrence is considered local if the cancer returns to the chest wall or lymph nodes on the side of the body where you had the mastectomy.

During and after breast cancer treatment, you will have regular check-ups with your doctor to look for any signs of cancer returning. Going to these appointments should find breast cancer recurrences sooner. It’s important to go to all your follow-up appointments.

Between appointments, report it to your doctor if you notice a lump or a change in your chest or breast that you cannot explain. Common signs of a local recurrence are changes in the breast, such as skin inflammation or a lump.

Signs of recurrence may include:

• A lump or growth in the breast area
• A change in the size or shape of your breast
• Skin irritation, redness, swelling or itching
• Discharge from your nipple that is not breast milk

New breast cancer

It is possible to be diagnosed with another breast cancer, either in the same breast or the opposite breast as the first diagnosis. Your doctors may call this a second primary breast cancer. If you have a second primary breast cancer, tests may show that the breast cancer subtype is different than the first cancer, or that it is at higher or lower risk of coming back after treatment. Your treatments may even be different than those you had for the first breast cancer.

The symptoms of a new breast cancer are the same as those you would look for in a recurrence, such as a lump in the breast, changes in the size or shape of the breast, or changes to the skin in the chest area. Your doctor will do tests to find out whether the cancer is new and different from the first, or if it is a recurrence of the first.

Distant recurrence

Breast cancer can come back in organs other than the breast, in distant parts of the body. The most common distant areas are the bones, liver, lungs or brain.

When breast cancer spreads to a distant part of the body, it is called a metastatic or distant recurrence. Since a metastatic recurrence happens away from the breast, the symptoms are different than those for a local recurrence.

Often, signs of metastatic recurrence appear at the site where the cancer has spread. For example, you might feel pain in your back if the cancer spreads to the spine. Often this pain starts out vague and affects a whole area of the body rather than one specific spot. If you have this type of pain and it does not go away, you should seek medical attention. You may also have symptoms that are not specific to a body part, such as extreme tiredness or loss of appetite.

Below are signs of cancer spreading to specific areas of the body. If you have these symptoms, be sure to tell your doctor.

Symptoms of cancer in the bones

The most common place that breast cancer spreads is to the bones. Areas of breast cancer in the bones, called lesions, can cause pain and make your bones more likely to fracture or break. These problems are more likely in the bones you use often, such as:

• Spine
• Ribs
• Hip
• Skull
• Upper arm
• Upper leg

Breast cancer bone lesions can cause calcium to go into your bloodstream. Calcium in the bloodstream can result in more general symptoms, including fatigue, nausea, constipation, and irritability.

Learn more on our Bone metastases page.

Symptoms of cancer in the liver

Breast cancer in the liver can cause these general symptoms:

• Extreme tiredness
• Weight loss
• Discomfort

When breast cancer spreads to the liver, after some time it can have specific symptoms such as:

• Swelling of your abdomen
• Jaundice, a condition that causes the skin or the white part of the eyes to turn yellow
• Discomfort or pain in the abdomen, especially along the right side

Learn more on our Liver metastases page.

Symptoms of cancer in the lungs

Breast cancer that spreads to the lungs can cause breathing problems such as:

• Dry cough
• Shortness of breath
• Chest pain

Learn more on our Lung metastases page.

Symptoms of cancer in the brain

When breast cancer spreads to the brain it can cause:

• Intense headaches
• Headaches that don't go away
• Nausea
• Dizziness
• Seizures

Learn more on our Brain metastases page.