Breast cancer may be treated without removal of the breast in most cases. Chemotherapy and radiation have made this possible for more aggressive cancers, and hormone-blocking therapy is used to prevent recurrence of those cancers that support their growth with hormones. But although breast-preserving protocols do not increase the risk of recurrence or metastasis, approximately 10 to 20 percent of breast cancers do reoccur. The signs and symptoms can be subtle, according to the Cleveland Clinic.
Local Tumors
Breast cancer that is said to reoccur may actually just be a new breast cancer occurring in remaining breast tissue on the affected side or a new tumor on the opposite side. The Cleveland Clinic notes that tumors that are malignant are usually hard or granular to the touch, larger than 2 centimeters and hard to move within the breast tissue.
Lymphatic Metastases
The lymph nodes that supply the breast can be the site of metastasis even if the tumor that their cells originated from is no longer present or is too small to detect. Any hard, fixed lymph nodes under the arms should be evaluated, and in breast cancer survivors, they made be biopsied without delay.
Pulmonary Metastases
The lungs are a common initial site for breast cancer metastasis, and shortness of breath is the warning sign that pulmonary, or lung, involvement is occurring, according to the National Cancer Institute. Other signs include coughing, the presence of bloody mucus and weight loss.
Osseous Metastases and Hypercalcemia
Metastases to the bone, or osseous metastases, may first be noticed when pain occurs or a fracture is noted on an x-ray. But as the cancerous cells first start to explore bone tissue as a place to grow, they displace calcium, the major mineral component in bone. The calcium enters the blood, causing a condition called hypercalcemia. MayoClinic.com lists symptoms of this disorder as nausea and vomiting, abdominal pain, muscle pain or weakness, constipation, frequent urination, excessive thirst, confusion and a sense of fatigue and disinterest that could easily be mistaken for depression.
Since 25 percent of metastatic breast cancer first is found in bone and because medical treatment of early bone involvement is possible, the National Cancer Institute recommends that all breast cancer survivors and their family members be alerted to watch for the subtle signs of hypercalcemia.
Hepatic Metastases
Hepatic, or liver, metastases, the third most common site of metastases, may cause weight loss, loss of appetite, nausea and vomiting and, in later stages of involvement, right-sided abdominal pain and swelling, according to the National Cancer Institute.
Cerebral Metastases
Cerebral, or brain, metastases less commonly spread to other sites, because the cancer cells have to pass the blood-brain barrier. Seizures, headaches and vomiting without nausea are commonly seen symptoms that arise from tumors in the brain, causing increased pressure there.
