Breast cancer can recur at any time, but most recurrences occur in the first three to five years after initial treatment. Breast cancer can come back as a local recurrence (in the treated breast or near the mastectomy scar) or as a distant recurrence somewhere else in the body. The most common sites of recurrence outside the breast include the lymph nodes, the bones, liver, or lungs.

How Do I Know There Is A Recurrence?

If you've been treated for breast cancer, you should continue to practice breast self-examination, checking both the treated area and your other breast each month. You should report any changes to your doctor right away. Breast changes that might indicate a recurrence include:

• An area that is distinctly different from any other area on either breast.
• Lump or thickening in or near the breast or in the underarm that persists through the menstrual cycle.
• A change in the size, shape, or contour of the breast.
• A mass or lump, which may feel as small as a pea.
• A marble-like area under the skin.
• A change in the feel or appearance of the skin on the breast or nipple, including skin that is dimpled, puckered, scaly, or inflamed (red, warm or swollen)
• Bloody or clear fluid discharge from the nipples
• Redness of the skin on the breast or nipple

In addition to performing monthly breast self-exams, keep your scheduled follow-up appointments with your healthcare provider. During these appointments, your healthcare provider will perform a breast exam, order lab or imaging tests as needed, and ask you about any symptoms you might have. Initially, these follow-up appointments may be scheduled every three to four months. The longer you are cancer-free, the less often you will need to see your healthcare provider. Continue to follow your healthcare provider's recommendations on screening mammograms (usually recommended once a year).