Recurrence, other breast

pambeers

Recurrence, other breast

pambeers

HI.  This is my first time at this site and I have a (simple?) question that I can't seem to find the answer to.  I had Invasive Intraductal Adenocarcinoma of the left breast in 1998.  I had 2 surgeries to get all of the 2.7 cm tumor and another surgery to remove 19 axillary lymph nodes, only one of which was cancerous.  I then had adriamycin and cytoxin, radiation and then 5 years of Tamoxifen.  Now, 9 years later, I have a lesion in my RIGHT breast.  I am still in the process of testing to see if it is a recurrence, but the doctors all feel it is "suspicious".  All of the articles I read about recurrences talk about it happening in the same breast.  What about when it recurs in the other breast?  Does that affect the treatment (limits of radiation, chemo, etc.?) or is it just treated as a different cancer altogether?  Is this more serious (hahaha) than recurring in the same breast?  Does anyone know of a site that focuses on this type of recurrence?  I could sure use some info.  Thanks,   PAM

TenderIsOurMight

Hi Pam,



Yes, the terminology is rather inherently confusing, and I am no expert on this in any way. From what I understand, when a lump is found at the site of the previously treated breast, it generally is a 'recurrence' of left over tumor which grew. On occasion, in an area away from the first lump, a new primary may also occur in the same breast, then called a second primary rather than a recurrence.



A lump in the opposite breast is usually determined to be a new secondary primary breast cancer, and it is treated as such, with the full workup including lumpectomy and SLN biopsy and then from there. Breast cancer is always breast cancer wherever it occurs, and gets treated under it's guidelines.



Rarely, I believe, a contralateral tumor is found to be almost identical to the first breast tumor, in which case it might be called a recurrence in the opposite breast among other things.. They can tell much more about the tumor specifics now because of tumor markers, and genetic microarrays and other profiles which I don't know much about.



I'm sorry to read your post. It's a damming thing to go through breast cancer and treatments once, but then again is a double heart ache. There is a link here called "second cancers" from which you would get good information as this is a tad complicated.



I wish you all the best and hope you will post back should you wish with your questions and your findings. Soon others may come along to help you with this posts questions.



Tender

tos

I was diagnosed a second time in the other breast just this year and my tumor was considered a second primary and triple neg, the same pathology as the first tumor on the other side.

Earlier this year I could find little information on a "second primary".

I've even asked my Onc and he said the term isn't 100% and he even slipped the other day and referred to my "recurrence".  So maybe they aren't sure but assume since it isn't by the original area.

I did learn they won't give you Adriamycin again, I was given Taxotere and treated for a new tumor.

I have since find out the 5 yr count starts all over again.

Good luck to you

Beesie

Unfortunately, for any of us who've been diagnosed once with breast cancer, our risk of getting breast cancer again - a new primary, not a recurrence - is higher than that of the average population.  It differs by individual based on personal & family history, but generally, our risk to get BC again is about double that of the average women who's never been diagnosed.  This 2nd breast cancer can occur in either breast.

Pam, what that means is that if you are diagnosed, you won't be so unusual in getting this 2nd diagnosis of breast cancer.  The good news is that generally it is preferable to have a "new primary" rather than a recurrence.  A recurrence means that the original cancer has spread.  A new primary is a new cancer, which hopefully is early stage and more easily contained.   As for treatment, since you haven't had radiation on this breast, you would be able to have radiation, and if chemo is required, there's no reason why you would not be able to have chemo again.  But, having said that, hopefully this turns out to be a false alarm, or worst case, very early stage BC that doesn't require chemo.

Good luck.  Please let us know the results.

Rainenz

Pam

I was dx 1997 with a medullary ca and had AC and rads and was dx with a new primary in the other breast july 2006 and that has been tx with FEC and Taxol followed by Rads. Mine have both been triple neg and also had involved nodes each time.

I do feel it is better to have had a new primary rather than recurrance as at least it hasn't been travelling around the body looking for a new home.

Good luck and let us know your results

Raine

GrandmaWolf

I once read that having had a breast cancer dx, that for every year out...decreases your risk of recurrence from that cancer.  HOWEVER, every year out...increases your risk of a NEW cancer.  Damned if you do, damned if you don't.  My original was 8 years ago...until this year, when I won the 2nd time lottery.   The one bit of advice I can give is if it happens again, insist on an MRI.   My first dx was ductal.. and this recent second dx is lobular, which was not readily visible on the mamagram.  Thankfully I had a radiologist with very sharp eyes. Because of the obscurness of lobular, an MRI was done.

But here is the kicker.. MRI showed two areas in the orignal breast that never showed on mamography or US.   Guess what?

With in 6 weeks, I have been diagnosed with 2 more primarys which added to my first, gives me a grand total of 3 primarys.

Starting TC and waiting for tests to see if H is added.  I think after the chemo, I better start looking at the bigger picture here and go for a bilateral.

Member_of_the_Club

I've been reading about this a lot because in the past 6 weeks I've had FOUR breast biopsies, the last for an area deemed highly likely to be malignant, but they were all benign.



yes, if it is in the other breast it is most likely a new primary. My highly suspicious area was in my affected breast but because it was in a different quadrant, about 5 to 6 cm away from the original site, they were thinking new primary. The only way to know is to get it under a micropscope and compare charactersistics but what makes this even more complicated is that -- i've read -- if you get a new breast cancer it will most likely be similar to your first one in terms of hormone status, her2neu, that sort of thing.



I think a new primary is better, you are starting from scratch in terms of treatment and prognosis. but lets hope it is benign.

veggievet

Dear Friends,

Although the risk for a second breast cancer is higher in any breast cancer survivor, it is critically important to know that having two primary breast cancers is one of the red-flags for a hereditary cancer syndrome even if you don't have a strong family history of breast cancer.

Raine, given your medullary cancer and triple negative status I am very concerned that you could have a BRCA 1 mutation.

For ANYONE diagnosed with two separate primary breast cancers I urge you to insist on a consultation with a genetics expert.  I am very happy to help people find genetic counselors in their area.  You can private me or e-mail me at: sueanddan@att.net. You can also visit the FORCE website which is devoted to hereditary breast and ovarian cancer at: http://www.facingourrisk.org for more information on hereditary breast and ovarian cancer.

I have had women ask me why they should be concerned about a BRCA mutation after a second diagnosis of breast cancer: there are two important reasons: if you carry a BRCA mutation you are also at very high risk for ovarian cancer, and your genetic test results can help family members better assess their risk for cancer. 

Even if you are not considering genetic testing, seeing a genetic expert is important and they will not try to talk you into genetic testing if you don't want to have it, but they will make sure that you are following appropriate risk-management recommendations.

Warmest regards,

Sue

GrandmaWolf

VeggieVet...

Within the past 3months, finding a 2nd and 3rd primary after 8 years since the original... I have to ask, while the risk was high for the 2nd, according to studies, the risk for a new primary after radiation for lumpectomy is also high, hence the 3rd primary...so is it hereditry, or previous tx that is responsible?  Currently I am investigating genetic testing for the sake of my daughters, but I am not convinced at this point, that I am not just following a trail of events.

Thanks for your important point of information.

Grandma Wolf aka Dakota

Member_of_the_Club

While of course Sue is our expert, I think you should take your skepticism and misgivings to a genetic counselor. Such a person would be best placed to answer your questions and give you advice. Certainly with several different bouts of bc it is something you should explore. You can meet with a genetic counselor and then decide not to take the test.



There's a lot of info on Sue's website, I think it is facingourrisk.org.

veggievet

Dear Dakota,

Member of the Club is absolutely right, please take your concerns to a genetics expert.  I promise you you will get up-to-date and credible information.  And the wonderful thing about genetic counselors is that they are trained in what is called a "nondirective approach".  They will not try to talk you into or out of genetic testing but give you the solid information on which to make an informed decision for yourself. 

You can find a genetic counselor through the website for the National Society of Genetic Counselors at:

http://www.nsgc.org/zip_search/index.cfm

leave "area of practice" blank but choose "cancer" for "area of specialization or else you might end up with a list of genetic counselors who do mostly prenatal counseling (yes, the field is that specialized).

If you need any help in finding a genetic counselor please feel free to e-mail me.

Warmest regards,

Sue