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One of the biggest worries after breast cancer treatment is that the cancer will return. That's called a recurrence. The chances this will happen depend on the type of breast cancer you had. Your follow-up care is geared to that.
The term for follow-up care after cancer treatment is surveillance. It's important for your peace of mind. It's also the best way to find a recurrence early, if it does occur. Follow-up care is also important to treat any side effects from your treatment. It includes screening for other cancers. And, it's a good way to make sure you are staying healthy in general.
Guidelines for Follow-Up Care
Work with your doctor to create a follow-up care plan that will work for you. Here are general guidelines many doctors suggest.
After you complete your treatment, see your doctor for follow-up visits and physical exams:
- Every 3 to 6 months for the first three years
- Every 6 to 12 months for the next two years
- Every year after that
Watch for signs or symptoms of recurrence between doctor visits. Let your doctor know about:
- New lumps, especially in your breast, on your chest, or under your arm
- Bone, chest or breast pain
- Coughing or shortness of breath
- Belly pain or yellowing of your skin or eyes
- Headaches
- Vision changes
- Fatigue
- Loss of appetite or weight loss
- Swelling of your arm
Examine your breasts and your surgical area for:
- Any change in the size or shape of your breast or chest
- Any rashes or changes in the skin of your breast or chest
Your doctor may not order any special blood tests or imaging tests unless you have signs or symptoms of a recurrence. However, continue to have mammograms at these times:
- About six months after you finish radiation therapy (if it was part of your treatment)
- Every 6 to 12 months if there are any abnormalities
- Once a year if your mammograms have been normal
Special Considerations
If your treatment includes taking the hormone therapy drug tamoxifen, you may be at higher risk for endometrial cancer. That's cancer that develops in the inner lining of the uterus. Let your doctor know about any bleeding between periods or if you have any prolonged periods. If you've gone through menopause, let your doctor know about any bleeding or spotting you experience.
If you have a type of breast cancer that runs in families, your doctor might suggest genetic counseling to determine if you have gene mutations linked to cancer.
If you are taking a drug called an aromatase inhibitor after treatment, you may be at higher risk for poor bone health. Your doctor may order a bone density test to check for bone loss.
At some point, you may choose to switch from surveillance by your breast cancer doctor to your primary care doctor. You should probably see you breast cancer doctor for at least the first year of follow-up. Ask your breast cancer doctor when and if to consider switching to your primary care doctor.
Lifestyle Changes
Maintaining a healthy lifestyle is an important part of follow-up care after breast cancer treatment. This includes:
- Eating a healthy diet with plenty of fruit, vegetables, fiber and low-fat proteins
- Being physically active for at least 150 minutes every week
- Doing strengthening exercises on two non-consecutive days a week
- Maintaining a healthy weight
- Not smoking
- Not drinking or having no more than one alcoholic drink a day
Talk to your doctor about your breast cancer surveillance plan. Let your doctor know about any signs or symptoms of recurrence. Keep all of your follow-up appointments. Once you're through breast cancer treatment, good follow-up care is the best way to stay healthy.