Follow-up is recommended after treatment for breast cancer to check whether breast cancer has come back, to monitor side effects of treatment and to provide practical and emotional support.
Women who have been diagnosed and treated for early breast cancer have an increased risk of breast cancer coming back or developing in the other breast. Regular follow-up means that if breast cancer does come back or if a new breast cancer develops, it can be treated promptly. Follow-up also allows doctors to check for any side effects from treatment and to monitor any long-term treatments such as hormonal therapies. It also provides an opportunity for women to talk about how they’re feeling.
What does follow-up involve?
Follow-up after treatment for breast cancer involves regular physical examinations and breast imaging tests (mammogram and/or ultrasound).
Appropriate follow-up does not involve chest X-rays, bone scans or blood tests unless the woman has symptoms which suggest that cancer has spread outside the breast or armpit area.
Some women assume that they should be having regular scans and blood tests. However, studies have shown that having more tests does not improve the length or quality of life for women who have been treated for breast cancer.
A woman’s follow-up schedule will be planned based on her individual circumstances. Women who are involved in a clinical trial may have some tests in addition to those listed here.
Women who are receiving a hormonal therapy, such as tamoxifen or an aromatase inhibitor, will have follow-up tests while taking these therapies.
Some women find it reassuring to have regular follow-up tests. Others feel anxious around the time of their appointments. Both reactions are normal.
What happens if a breast change is found at follow-up?
For most women, no changes are found during follow-up appointments. However, if breast imaging tests show an abnormal area, or if the doctor finds a lump during a physical examination, the woman will need to have further tests. This may include more imaging tests and a biopsy.
If you notice a breast change or any other symptoms that concern you between follow-up appointments, don’t wait until your next appointment. See your GP or specialist as soon as possible.
Once treatment is over, you won’t be seeing health professionals as regularly as you were during treatment. This doesn’t mean you can’t seek advice or ask for help when you need it. No health problem is too small or too large to ask about. Usually something can be done to lessen side effects and improve your wellbeing. See your GP if you have side effects that are concerning you.
Feelings after breast cancer
It’s likely that women will experience a range of emotions once treatment for breast cancer is over.Feelings can range from relief that treatment is over, happiness about being able to return to things that are important, nervousness about what the future holds, or a sense of isolation because regular appointments with the treatment team have stopped.
Some women feel uncertain about the future and worried about life after breast cancer. Women manage these uncertainties in different ways. Living with uncertainty can be upsetting or overwhelming. For some people, uncertainty can be the motivation to make changes in their life.
It’s important that once treatment is over you continue to share your feelings with those close to you and seek help from a health professional if needed. Some women find it helpful to join a support group or talk to other women who have been through a similar experience.
Relationships after breast cancer
Diagnosis and treatment of breast cancer can have a significant impact on women and those close to them – partners, children, family and friends. It’s likely that a range of people supported you through your cancer journey. Supporters may have been partners, parents, children, friends, colleagues and other women with breast cancer. If you live alone or if you don’t have supportive family or friends close by, you may have found support from a local community group or neighbours.
Apart from ‘being there’, support comes in many forms. Supporters, especially carers, have their own information and support needs. Women who have completed treatment often speak of the difficulty of relating to those who care about them and for them. While there may be no lack of good intentions, there may some frustrations. Keeping the lines of communication open is important. You’re all allowed to have bad days – no-one should feel guilty if they need a ‘time out’.