What to Expect if Your Breast Cancer Returns

Unfortunately, it can reappear—even in a different part of your body

Olivia Newton-John. Scott Barbour/Getty Images

The shocking news that Olivia Newton-John’s back pain was caused by breast cancer that metastasized to her sacrum serves as a reminder of the disease can reoccur. Newton-John was diagnosed with breast cancer in 1992 and underwent chemotherapy after a modified radical mastectomy with reconstruction. She followed up with other alternative forms of treatment, including acupuncture, yoga, meditation and massage.

Breast cancer can and does reoccur. Just how likely is it for this disease to recur? It depends on several factors:

  • The size of the original tumor
  • The number of lymph nodes involved, if any
  • How aggressive the cancer was
  • How well a woman responded to her first course of treatment

Discovering a local recurrence of metastasis

When breast cancer recurs at the original site, it’s called a local recurrence. But it can also return and spread to other parts of the body, which is called metastasis or distant recurrence.

Local recurrence is usually found on a mammogram, during a physical exam by a health care provider or when a woman notices a change. Metastasis is usually found when a women notices symptoms and reports them to her health care provider.

Local recurrence

If a woman has had a lumpectomy (breast conserving surgery) and has a local recurrence, the cancer can most often be treated successfully. The treatment generally includes surgery or radiation therapy if it was not used as part of the first breast cancer treatment.

Other forms of treatment may include chemotherapy, hormone therapy and/or targeted therapy.


A distant recurrence in another area of the body or metastasis is when a woman notices changes or other symptoms that get her attention. These can include the following:

  • Shortness of breath
  • Weight loss
  • Bone pain

Women should not automatically panic if any of these symptoms occur as they can be common and usually do not mean a return of breast cancer or that it has spread. But it is advisable for any women who has had breast cancer in the past and notices these symptoms to discuss them with her doctor.

What is done to check for a breast cancer return?

What tests are done to check on a return of breast cancer and if it has spread depend on the symptoms a woman is experiencing.

Follow-up tests that may be conducted include the following:

  • Blood tests (including tumor marker tests)
  • Imaging tests (such as bone scans, CT scans, PET scans and chest X-rays)
  • A tissue biopsy to check if a suspicious finding is a recurrence of breast cancer

Treatment of a recurrence or metastasis

Metastatic breast cancer means the cancer has spread to other parts of the body. most likely the bones, lungs, liver or brain. Tests will be done to determine which organs are involved, the hormone receptor status, and the HER2 status of the tumor.

Even though the cancer has spread to a different part of the body, it is still considered breast cancer. The treatment for it will be with breast cancer drugs instead of treatment for cancer that starts originally in the bones.

Getting support

The news of a recurrence or metastasis of breast cancer can be devastating and stressful—to say the least. Now more than ever, a woman will need a strong support system to help her get through this difficult time. Some women join a cancer support group.

In the meantime, we wish Olivia Newton-John a complete recovery and remission of her next battle against cancer.

Dr. Samadi is a board-certified urologic oncologist trained in open and traditional and laparoscopic surgery and is an expert in robotic prostate surgery. He is chairman of urology, chief of robotic surgery at Lenox Hill Hospital. He is a medical correspondent for the Fox News Channel’s Medical A-Team. Follow Dr. Samadi on Twitter, Instagram, Pintrest, SamadiMD.com and Facebook

What to Expect if Your Breast Cancer Returns