The treatment of recurring breast cancer can be complex. It is important to surround yourself with a medical team that can handle all the issues involved with a chronic disease, both emotional and physical. 

The medical team would normally consist of your primary care physician (PCP) and a group of specialists, including a:

• Surgeon: specializes in surgical procedures, including biopsies and operations to remove cancers.
  
• Medical oncologist: specializes in various non-surgical cancer treatments, such as chemotherapy, hormonal (anti-estrogen) treatment, immune therapies, pain medications, and nutrition.
  
• Radiation oncologist: specializes in treating cancer with radiation.
  
• Radiologist: specializes in reading (interpreting) images produced by various imaging technologies, such as mammograms, ultrasound, bone scans, CT scans, MRIs, etc.
  
• Pathologist: specializes in testing and analyzing the sample tissue gathered during a biopsy.
  
• Palliative care: specializes in pain and symptom management, assisting with difficult decision-making, and providing additional support to patient and family.
  
• Psychiatrist, psychologist, clinical social worker, clergyperson, or other psychotherapist: specializes in dealing with the emotional and psychological issues that accompany cancer and cancer treatment.

You'll need to be able to meet with or at least contact each of these people on a regular, ongoing basis.  And each of them needs to be in contact with all the others, so that they can truly work together as a team and give you the care you need. You may also want a second opinion on some specific matter and will, therefore, want to talk to a second surgeon or medical oncologist or pathologist.  Your PCP should help you coordinate all this.

Note that while the "emotional and psychological doctors" are not at the top of the list above, their value on your team should not be minimized. If breast cancer becomes a chronic condition whose symptoms must be constantly monitored and treated as needed, the emotional and psychological symptoms must be included.  Breast cancer recurrence can create fear, anxiety, stress, and depression.  It can lead to a sense of uncertainty and lack of control. All this can be as debilitating as the disease's physical symptoms.

There are other important issues. For some women, the breasts are an essential source of female self-image. If you originally had a lumpectomy, but are now facing a mastectomy, you may experience feelings of decreased attractiveness and fear that your partner will abandon you.  As someone with recurrent breast cancer, you may, perhaps unconsciously, feel guilty, as if you "did something to make it come back." Or you may fear that you have passed a genetic predisposition for the disease to your daughters, or that you may become a burden to your loved ones.

How do you deal with all these issues?  First, you need to find some sort of psychotherapist or counselor you can trust and develop a good relationship with.  Perhaps you've worked with someone in the past. On the other hand, you may want to find a new person who specializes in helping people deal with life threatening situations, chronic illness, and cancer.

Besides working with a professional, there are other steps you can take:

• Confide in someone, a partner, a friend, about your feelings.  People who keep their anguish to themselves tend to develop more symptoms and suffer more pain than those who share their feelings. 
• Recognize (and internalize) that even really healthy people get a recurrence of breast cancer.  You are not to blame.
• Recognize (and internalize) that your breasts do not equate to who you are. 
• Allow yourself to grieve; then get up, dust yourself off, and persevere.
• Build stronger relationships with your partner, your children, and your friends through open and honest communication.
• Try to control only what you can control; let the other stuff go.

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.