I can't believe it's back.

Sorry you've joined us as stage 4. The odds are 30% if that makes you feel any better. Or is yours a new primary? If so then you wouldn't be stage 4 but probably just as angry.

Emily, in reading your other thread, my understanding is that you found a lump in your breast. So this may be a localized (restricted to the breast area) recurrence, or it may be a new primary breast cancer. I haven't seen anything in any of your posts (unless I've missed something) suggesting that this is a distance recurrence, i.e. mets. I hope that this is in fact a localized breast cancer, and that the others here are jumping the gun when talking about mets. Nevertheless, I understand your frustration and am so sorry that you are dealing with this.

As for the odds of this happening, if it is a localized recurrence, the odds after a MX are pretty low - probably in the range of 1% - 2%, unless you had close surgical margins after your MX, which could take the risk up considerably. If however this is a new primary cancer (which is quite likely after this amount of time), while for most women the risk after a BMX is about 1% - 2%, in your case, because you are BRCA2 positive, I believe that after a BMX your risk to develop a new primary cancer was probably more in the range of 5% - 7%. Others who are BRCA2 positive might have a better idea about this.

Good luck with your discussions with your oncologist. And hoping that this turns out to be an early stage, easily treatable new primary. That would be the best finding, given that this has happened.

Emily2008, sorry to hear your cancer is back. Sounds like you did everything to get rid of it. Hopeful this time they will get it completely out. I too am terrified that my cancer is in my spine. I have an MRI friday. I hate this disease no one seems to understand the threat we live with.

Nanpop, a BMX can never remove all the breast tissue. I've read that generally about 3% of breast tissue remains, although I don't know how accurate this is. Cells of breast tissue may remain against the chest wall, against the skin, around the bottom or sides of the breast, etc.. This is why a recurrence or the development of a new primary breast cancer is possible even after a BMX. For most women, the risk of this happening is quite low, but the risk will be higher under certain circumstances such as close surgical margins or for those who have a higher than average breast cancer due to genetics (eg. BRCA, etc.).

Nanpop, well, here's the good news about implants. Assuming that they are put in behind the chest muscle, as most are, they push the chest wall right up against the chest. So the area where a recurrence or new primary is most likely to develop, either against the chest wall or against the skin, is all just right below the surface of the skin. I had a single MX, so I have one implant reconstructed breast and one natural breast. My reconstructed breast is very firm and smooth - I would notice the development of even the tiniest nodule below the skin. My natural breast is lumpy and bumpy and much more difficult to check for lumps. So generally a recurrence or new primary in an implant reconstructed breast is quite easy to find.

Hi Emily

It can and does happen unfortunately.

Im so sorry it has happened to you again.

It is not an easy thing to deal with. And you are inbetween(hopefully) not new to it but not metastised either. It is a mental battle but you can do this. I dont have that braca gene..but I had a recurrenence a year out in left mast. Side and then again in 2012 in right mast. Side. I did originally have 1 node pos. But that is all. I did have chemo and then the rads after 1st recurrence. I am sending healing thoughts and prayers your way.

Ps . For Barb..I remember you told me you had some spread to your clavicle and or neck area. I had been puzzled as to why you thought you were stage 4. If these are the only areas of spread/recurrence then I believe you are actually stage 3 for regional not stage 4 which is for distant organs or bones. This thread is for recurrence of any kind I believe..not just for metastatic spread.

Sorry for your new diagonosis. I am discussing rads now with RO and she is telling me how radiation to chest wall keeps reoccurrences from happening with bmx. Unless nodes are involved they typically don't do rads. I guess I will do the chest wall rads even though it might mess up my recon a bit. Maybe a blessing in disguise I have one node

oh Barb I am so sorry you have this recurrence! I hope you are managing well. Have you finished treatments? I am so interested in your onc's dx for you. I have never heard of chest wall being included in stage 4. I find that scary.

I looked at a few sites for staging explanations and in different countries as well..and it alawys says chest wall or collar bone area is stage 111B ormaybe 3c? Very horrible no matter what but I like to know things precisely I guess.

Below is a link to the staging analysis on this website. I hope it is right. Even chest wall would be 3. Only 4 if it goes to lungs there which I hope it never does!! Why does it matter? Well if it was me..I know which stage I would prefer and which would give me hope for longest time with my family.I hope you think so too!

Astrid, I had 6 weeks of rads and am on Arimidex "until it stops working and we use another chemo" (as per my onc). He's hoping I'll get as much as a year out of Arimidex. I've been on it for 7 months so far....

I saw this on the bco first page that may explain it better:

Locally advanced breast cancer is breast cancer that has spread beyond the breast to nearby tissues, such as the skin or the chest wall. Both locally advanced breast cancer and metastatic breast cancer are considered advanced-stage disease.

I will be on treatment for the rest of my life so no, my treatment isn't over. Right now I'm waiting to get my pacemaker switched out to an MRI-compliant one so they can see if I have mets in my brain and if the node in my lung is cancerous. The CT was suspicious.

wishing you the longest best journey with your help Barb.

Emily, don't BRCA2 mutations confer an increased risk risk of a second breast cancer? That could be at least a contributing factor (for what it's worth).