Recurrence Risks in Breast Cancer: Key Questions Answered

I would like to ask two questions regarding recurrence issues?

Dear Dr.
Chen,
Thank you for your previous response regarding my mother's follow-up visit after completing breast cancer treatment, specifically concerning the possibility of recurrence after the ultrasound and fine needle aspiration of the contralateral lymph nodes.
I apologize for asking two more questions:
1.
My mother underwent a high-resolution PET-CT scan at Taipei Veterans General Hospital in July of last year, which showed no signs of cancer throughout her body.
Is there a possibility of lymphatic metastasis or recurrence of breast cancer within just one year?
2.
On July 12 of this year, I took my mother to receive the Moderna COVID-19 vaccine.
On July 30, we noticed swelling in the axillary lymph nodes of the same arm where she received the vaccine.
I found information online suggesting that axillary lymphadenopathy can be a side effect of the Moderna vaccine.
Could this swelling be a side effect of the vaccine, or is it merely an internet rumor?
Thank you for your response.

Jerry, 40~49 year old female. Ask Date: 2021/08/12

Dr. Chen Sirong reply Oncology

Jerry / 44 years old / Male
1.
My mother underwent a high-level PET-CT scan at Taipei Veterans General Hospital last July, and there were no signs of cancer throughout her body.
Is it possible for her to have lymphatic metastasis or recurrence of breast cancer just one year later?
A: Typically, examinations only guarantee that there are no signs of recurrence at the time of the scan, particularly for tumors larger than 1 cm.
The purpose of these examinations is to detect early and initiate treatment.
They cannot guarantee that there will be no recurrence; for instance, a scan that was normal three months ago could show recurrence now.
2.
On July 12 of this year, I took my mother to receive the COVID-19 Moderna vaccine.
On July 30, we noticed swelling in the lymph nodes under the arm on the same side as the vaccination.
Could this be a side effect of the vaccine?
A: It is possible.
However, how can we be certain? If you do not follow the physician's advice to determine whether it is or isn't, and later find out that it is, would you feel that you have delayed addressing a potential health issue? Wishing you peace and health.

Taoyuan Hospital, Chen Si-Rong

Reply Date: 2021/08/12

More Info

Dear Patient,
Thank you for your thoughtful questions regarding breast cancer recurrence risks and the potential implications of recent events in your mother's health. Let’s address your concerns one by one.

1. Possibility of Recurrence or Metastasis: It is indeed possible for breast cancer to recur or metastasize even after a year of being cancer-free, as indicated by a PET-CT scan. Breast cancer can be unpredictable, and while many patients may remain cancer-free for extended periods, the risk of recurrence can depend on various factors, including the type of breast cancer, the stage at diagnosis, the effectiveness of the initial treatment, and individual patient factors such as genetics and overall health. In your mother's case, the fact that she had a PET-CT scan showing no signs of cancer last year is encouraging, but it does not eliminate the possibility of recurrence entirely. Regular follow-ups and monitoring are crucial in managing this risk. If there are any new symptoms or concerns, it is essential to communicate these with her healthcare provider promptly.

2. Lymphadenopathy After Vaccination: Regarding the lymph node swelling observed after your mother received the Moderna COVID-19 vaccine, it is important to note that lymphadenopathy (swelling of the lymph nodes) can indeed be a common side effect of vaccinations, including the COVID-19 vaccines. This reaction occurs as the immune system responds to the vaccine, which is a normal and expected response. However, in the context of a breast cancer survivor, any new lymphadenopathy should be evaluated carefully to rule out any potential recurrence or metastasis. It is advisable to consult with her oncologist regarding this new symptom, especially since it occurred in the same area where she had previous cancer treatment. They may recommend imaging studies or further evaluation to ensure that the swelling is a benign reaction to the vaccine and not related to her cancer history.

In summary, while the risk of recurrence exists, especially in the first few years following treatment, it is essential to maintain regular follow-ups and communicate any new symptoms to her healthcare team. The lymph node swelling post-vaccination is likely a benign reaction, but it should be assessed by her doctor to ensure her peace of mind and health safety.

In addition to these points, it is crucial for your mother to continue with her prescribed follow-up care, including regular mammograms, clinical exams, and any other recommended screenings. Lifestyle factors, such as maintaining a healthy diet, regular exercise, and avoiding tobacco, can also play a role in reducing the risk of recurrence.

Please feel free to reach out if you have further questions or concerns. Your proactive approach to your mother's health is commendable, and I wish her the best in her ongoing care.

Best regards.

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