Daijiworld Media Network – Mumbai

Mumbai, Oct 13: Even after a patient is declared cancer-free, breast cancer can sometimes return silently years later. Early detection of recurrence can make a critical difference, say oncologists.

Understanding recurrence

Breast cancer relapse may be local (breast or chest wall), regional (nearby lymph nodes), or distant/metastatic (bones, lungs, liver, brain). Globally, 20–30% of women experience recurrence within 5–10 years, while in India, the rate is slightly higher due to late-stage diagnosis.

Signs to watch for

• Local/Regional: New lump or thickening in the breast, scar, or chest wall; skin changes like dimpling or “orange peel” texture; nipple inversion or unusual discharge; swelling under the arm or above the collarbone.
• Systemic/Distant: Persistent bone or back pain, unexplained shortness of breath or chest discomfort, abdominal fullness, jaundice, sudden loss of appetite, headaches, dizziness, or new vision changes.
• Subtle signs may include prolonged fatigue, unexpected weight loss, or simply feeling unwell.

Why recurrence risk is higher in India

• Late diagnosis: Over half of Indian women are diagnosed after lymph node involvement; 11% at metastatic stage (ICMR-NCDIR 2023).
• Low screening coverage: Mammography uptake for women above 45 is below 5%.
• Follow-up challenges: Cost, stigma, or loss to care after treatment increases recurrence risk.

New advances

Liquid biopsy – a blood test detecting circulating tumour DNA – can predict recurrence up to 15 months earlier than imaging. Although not widely available yet, this is set to redefine survivorship care.

High-risk patterns

• Triple-negative and HER2-positive cancers, and cancers diagnosed in women under 40 tend to relapse earlier.
• Recurrence is not treatment failure; many relapses can now be managed effectively with targeted therapies and hormone treatments.

Practical tips for survivors

• Maintain regular follow-ups: every 3–6 months for the first 3 years, then annually.
• Perform monthly self-checks of breast, chest wall, and underarm.
• Report any symptom persisting beyond 3 weeks.
• Adopt a healthy lifestyle: balanced diet, sleep, physical activity, stress management.
• Discuss advanced surveillance (MRI or molecular monitoring) for high-risk cases.

Emotional guidance

Fear of recurrence is real, but denial can delay life-saving treatment. Survivors are encouraged to trust their intuition and report unusual changes promptly. Early vigilance often leads to successful second remissions.

Oncologists stress: Listening to your body and staying engaged with medical care can save lives and ensure a better long-term outcome.