For many women with breast cancer, treatment may remove or destroy the cancer. The end of treatment can be both stressful and exciting. You’ll be relieved to finish treatment, yet it’s hard not to worry about cancer coming back. This is very common among people who have had cancer.
For other women, breast cancer may never go away completely. Some women may get regular treatments with chemotherapy, radiation therapy, or other treatments to try to help keep the cancer in check. Learning to live with cancer that does not go away can be difficult and very stressful. Living with cancer is different from living after cancer.
Life after breast cancer means returning to some familiar things and also making some new choices.
Even after you have completed breast cancer treatment, your doctors will want to watch you closely. It’s very important to go to all of your follow-up appointments. During these visits, your doctors will ask if you are having any problems and may do exams and lab tests or imaging tests to look for signs of cancer or treatment side effects.
Almost any cancer treatment can have side effects. Some might only last for a few days or weeks, but others might last a long time. Some side effects might not even show up until years after you have finished treatment. Visits with your doctor are a good time for you to ask questions and talk about any changes or problems you notice or concerns you have.
Typical follow-up schedules after breast cancer
- Doctor visits: At first, your follow-up doctor visits will probably be scheduled for every few months. The longer you have been free of cancer, the less often the appointments are needed. After 5 years, they are typically done about once a year.
- Mammograms: If you had breast-conserving surgery, you will get a mammogram about 6 months after surgery and radiation are completed, and then at least every year after that. If you had a mastectomy you will still need to have yearly mammograms on the remaining breast.
- Pelvic exams: If you are taking either of the hormone drugs tamoxifen or toremifene, you should have pelvic exams every year because these drugs can increase your risk of uterine cancer. This risk is highest in women who have gone through menopause. Be sure to tell your doctor right away about any unusual vaginal bleeding, such as vaginal bleeding or spotting after menopause, bleeding or spotting between periods, or a change in your periods. Although this is usually caused by something that isn’t cancer, it can also be the first sign of uterine cancer.
- Bone density tests: If you are taking an aromatase inhibitor (anastrozole, letrozole, or exemestane) for early stage breast cancer, your doctor will want to monitor your bone health and may consider testing your bone density.
- Other tests: Other tests such as blood tests and imaging tests (like bone scans and chest x-rays) are not a standard part of follow-up because they haven’t been shown to help a woman treated for breast cancer live longer. But they might be done if you have symptoms or physical exam findings that suggest that the cancer might have come back (recurrence). These and other tests may also be done as part of evaluating new treatments by clinical trials.
If symptoms, exams, or tests suggest a possible recurrence of your cancer, imaging tests such as an x-ray, CT scan, PET scan, MRI scan, bone scan, and/or a biopsy may be done. Your doctor may also look for circulating tumor cells in the blood or measure levels of blood tumor markers such as CA-15-3, CA 27-29, or CEA. The blood levels of tumor markers go up in some women if their cancer has spread to bones or other organs such as the liver. They are not elevated in all women with recurrence, so they aren't always helpful. If they are elevated, your doctor might use them to monitor the results of therapy.
Keeping health insurance and copies of your medical records
Even after treatment, it’s very important to keep health insurance. Tests and doctor visits cost a lot, and even though no one wants to think of their cancer coming back, this could happen.
At some point after your cancer treatment, you might find yourself seeing a new doctor who doesn’t know about your medical history. It’s important to keep copies of your medical records to give your new doctor the details of your diagnosis and treatment. Learn more in Keeping Copies of Important Medical Records.
Managing long-term side effects
Most side effects go away after treatment ends, but some may continue and need special care to manage. Some of the side effects more likely to occur after breast cancer treatment include:
If the cancer comes back
If cancer does recur, your treatment options will depend on the location of the cancer and what treatments you've had before. Options might include surgery, radiation therapy, hormone therapy, chemotherapy, targeted therapy, or some combination of these. For more information on how recurrent cancer is treated, see “Treatment of breast cancer by stage.” For more general information on dealing with a recurrence, see the Cancer Recurrence section of our website.
Last Revised: 05/04/2016