Breast cancer recurrence is a chronic disease that has to be managed. The goal of treatment is control, not necessarily cure.  Many people live full, long lives with breast cancer.

Thinking of recurrent breast cancer as a chronic disease means understanding that there will be times when it is active, other times when it is not.  In short, it means understanding that it is a disease you live with.  The key word is "live."   No one knows how long you will live with it, but no one knows how long anyone will live.  We do know that new, very effective treatments are being developed constantly.

Treatments for breast cancer recurrence are considered either local (targeted at a specific area) or systemic (affecting the entire body). Local treatments include surgery and radiation; systemic treatments include chemotherapy (drugs that kill the cancer cells), hormone therapy (drugs that stop or slow the production of the female hormone estrogen [estrogen encourages the growth of cancer cells]), and immunotherapy (drugs that act like our own disease fighting immune system and block substances that encourage the growth of cancer cells). 

Naturally, the treatment chosen depends on the specifics of the case. These include not only the nature of the current cancer (its location, size, aggressiveness, etc., all of which can be determined by a variety of tests), but also on the kind of treatment you received for the original cancer.

For example, if the recurrence is completely local (within the breast) and limited to a small lump, and you had a lumpectomy (removal of a cancerous lump) without radiation originally, then removing the new lump followed by radiation therapy may be all that's needed now. 

However, if you did have radiation originally, then the treatment would be a mastectomy (surgical removal of the breast), because a single area can't receive radiation therapy twice.  On the other hand, if you had a mastectomy originally, then the treatment would probably be to surgically remove the new cancer, followed by radiation therapy.   In either case, these local treatments might be followed by the systemic treatments of chemotherapy or hormone therapy. 

Treatment for regional recurrence will more likely involve all three forms of treatment: surgery, to remove the affected lymph nodes, followed by radiation and then by chemotherapy. Generally, treatment for distant or metastatic recurrence concentrates on systemic methods, though radiation may also be used.

The systemic methods include:

• Hormonal therapies, such as:
• Tamoxifen, an anti-estrogen drug that has been used successfully for more than twenty years
• Arimidex (chemical name: anastrozole)
• Femara (chemical name: letrozole)
• Aromasin (chemical name: exemestane)

Tamoxifen was the "first choice" for several decades, but recent studies sugest that the next three on the above list (known as aromatase inhibitors) are more effective and have fewer side effects for post-menopausal women.

• Chemotherapy, which includes a large number of drugs
• Immunotherapy, which includes a drug called Herceptin.  Herceptin is a very effective treatment for a specific type of breast cancer: known as HER2-positive breast cancer and is currently approved by the U.S. Food and Drug Administration for:
• Women with metastatic HER2-positive cancer
• Women with earlier stages of HER2-positive cancer as "adjuvant treatment" (additional treatment that follows after a different initial treatment, such as surgery) in combination with chemotherapy

The goal of all these treatments is to prolong life and improve the quality of life with as few side effects as possible.  We talk about "quality of life" often, but its meaning differs for every individual.  Only you can decide what's most important for you. But you should make that decision with the best medical advice possible in mind. 

For example, if your disease is not very aggressive, and your doctors suggest that it will not be dangerous, you may decide to "take a vacation" from medications or treatment for a while.  Under the right circumstances, it's possible to do this for a period of time (months or even years). Of course you must monitor your condition and be ready to reconsider your decision, especially if the disease spreads or becomes painful.  But having a chronic disease does not necessarily mean being on constant medication. 

Learn more about Breast Cancer Recurrence:
 
Key Point 1: Even years after the initial treatment, breast cancer can reappear either locally or in other regions of the body.