One of the issues that every breast cancer survivor must deal with is the possibility of the cancer coming back. We call this a recurrence and even though rates of breast cancer recurrence are lower and survival rates much higher, there is still that chance that the breast cancer will come back after the initial occurrence and treatment. There are three ways in which breast cancer can recur.

The first type of recurrence is called a local recurrence. when cancer recurs locally, it will come back in the original breast area. This is because of a failure of the original treatment. Even when there is a mastectomy, a local recurrence can happen because it is impossible remove all the breast tissue, skin and fat from the area. If even one cancer cell remains after the initial treatment, a local recurrence can happen.

The second type of recurrence is regional in nature. By regional we mean that the cancer has come back outside of the original breast and lymph node area. This is considered to be more serious than a local recurrence, but not as serious as a distant recurrence. The areas in which regional spread of the disease occur include the chest muscles (pectoral), the lymph nodes surrounding the neck area, the internal breast lymph nodes in the breast bone and rib areas and in the lymph nodes above the collarbone. This type of recurrence is rare.

The third and most serious type of recurrence is called a distant recurrence. This is also referred to as a metastasis. The areas where distant spread can occur are most likely to occur are bone (25%), liver, brain, bone marrow, lungs or other organs. Sometimes this is referred to as metastatic disease or Stage IV breast cancer. The survival rate becomes much lower once metastasis occurs, with a life expectancy of 18 months on the average after discovering it.

Symptoms of metastatic breast cancer may include bone pain, shortness of breath, lack of appetite, weight loss (possible indication of liver metastases, neurological pain or weakness and headaches.

If you are a breast cancer survivor, you should be aware of the symptoms of metastatic spread. These symptoms can include bone pain (bone), weight loss (liver), loss of appetite (liver), headaches (brain), neurological pain or weakness (brain/spine) and shortness of breath (lungs). However, keep in mind that having one or more of these symptoms does not mean you should panic. A good rule of thumb is the "three week rule". If you have a pain or other symptom that lasts more than three week, see your doctor. If you have an unrelenting pain or constant pain, see a doctor. Cancer pain does not go away compared other types of pain which will come and go. Like back pain caused by muscle spasms and/or non-cancer related disc problem.

If you suspect you have a recurrence of breast cancer, see your doctor. They will schedule some diagnostic tests like a CAT scan, bone scan, or MRI to try to find the root of your symptoms. Usually surgery is not a treatment option, but there are many other treatments, like radiation and/or chemotherapy that could possibly put a recurring cancer back into remission. There are amazing advances in treatment being made all the time.