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Breast cancer is the most common cancer in women and like every cancer, there is a chance of breast cancer recurrence even after completion of the prescribed treatment. Hence, every woman has to undergo regular follow up as advised by the treating doctor.
Cancer can come back to your brain, bones and lungs without a lump in sight
In an interview with HT Lifestyle, Dr Anjali Kulkarni, vice president, RWE Strategy and Analytics and oncologist at 4baseCare, shared, “Breast cancer recurrence can happen locally i.e. within the same or other breast or regionally i.e. in the axilla or neck nodes. To detect the signs of local recurrence, women can do a routine self breast examination and check overlying skin for any changes. This helps to detect local recurrence quite early. Local recurrence can be confirmed by mammography or ultrasonography.”
In many cases, recurrence happens at distant organs like liver, bone, lungs, brain and abdomen. Dr Kulkarni revealed, “For distant recurrence there can be symptoms like bone pains, jaundice, severe headache, blood in cough or loss of weight. For such advanced stages, imaging is a definitive diagnostic method for recurrence. Mainly radiology tests like PETCT, bone scan, CT, MRI or ultrasound can detect recurrence. These methods usually detect cancer recurrence when the tumour or lesion size reaches at least 7-8 mm and visible on images.”
A blood test could spot breast cancer relapse months before any scan
Currently, there is an advanced technique ctDNA to identify recurrence even before it appears on the radiology images. Dr Kulkarni explained, “This is called Circulating tumor DNA (ctDNA), a type of cell-free DNA (cfDNA) released by tumour cells into the bloodstream which can be used to identify cancer recurrence.”
She elaborated, “ctDNA detection can precede clinical or radiological evidence of recurrence by several months, allowing for early intervention. ctDNA levels can be done after treatment and can even help identify patients who are at higher risk of recurrence. Changes in ctDNA levels can be used to assess the effectiveness of treatment and guide treatment decisions.”
Dr Kulkarni pointed out, “Usually after completing the prescribed treatment, women are on follow up protocol every 3 months for the first year, then every 6 months for 5 years and then once a year. Few women with advanced breast cancer, the cancer may never go away completely. These women may continue to get treatments to help keep the cancer under check.”
The follow up regimen will vary depending on the stage of disease and certain tumour types like Triple negative breast cancer which is known to be aggressive. Dr Kulkarni said, “Women with BRCA gene mutations have a higher risk of developing bilateral breast cancer. Women who are presented with the early-stage breast cancer can be monitored clinically and radiological tests can be done at 6 monthly intervals. But aggressive cancer types require close monitoring. Technologies like ctDNA will be very helpful in these women for close surveillance.”
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
