Moving on after treatment for breast cancer

For many women with breast cancer, treatment may remove or destroy the cancer. Completing treatment can be both stressful and exciting. You may be relieved to finish treatment, but find it hard not to worry about cancer coming back. (When cancer comes back after treatment, it is called recurrence.) This is a very common concern in people who have had cancer.

It may take a while before your fears lessen. But it may help to know that many cancer survivors have learned to live with this uncertainty and are leading full lives. Our document, Living with Uncertainty: The Fear of Cancer Recurrence gives more detailed information on this.

For other women, the cancer may never go away completely. They may get regular treatments with chemotherapy (chemo), radiation, or other treatments to try to help keep the cancer in check. Learning to live with cancer that does not go away can be hard and stressful. It has its own type of uncertainty. Our document, When Cancer Doesn't Go Away, talks more about this.

Follow-up care

After your treatment is over, ongoing follow-up is very important. During these visits, your doctors will ask about symptoms and do a physical exam. Although you will still need to have mammograms, blood tests and imaging studies (like CT scans or MRIs) are not a standard part of follow-up for early breast cancer. These tests may only be ordered if you are having problems. Follow-up is needed to watch for treatment side effects and to check for cancer that has come back or spread.

Almost any cancer treatment can have side effects. Some may last for a few weeks or months, but others can be permanent. Please tell your cancer care team about any symptoms or side effects that bother you so they can help you manage them. Use this time to ask your health care team questions and discuss any concerns you might have.

At first, these visits are scheduled every 3 to 6 months. The longer you are free of cancer, the less often you will need visits. After 5 years, visits are usually once a year. If you had breast-conserving surgery, you will get a mammogram about 6 months after surgery and radiation are finished, and then every year. Women who had a mastectomy should keep on having yearly mammograms on the remaining breast.

If you are taking tamoxifen or toremifene, you should have a pelvic exam every year. Be sure to tell your doctor right away if you have abnormal vaginal bleeding because the drug can increase the risk of uterine cancer. The risk of this cancer is highest if you have gone through menopause. If you are taking an aromatase inhibitor, your doctor might want to have your bone density checked.

If anything suggests that the cancer might have come back, the doctor will want to do more tests. If cancer does come back, the treatment will depend on the place of the cancer and what treatments you've had before. Treatment could involve surgery, radiation, hormone therapy, targeted therapy, chemo, or some combination of these.

It is also important to keep health insurance. While you hope your cancer won't come back, it could happen. If it does, you don't want to have to worry about paying for treatment. Should your cancer come back, our document When Your Cancer Comes Back: Cancer Recurrence helps you manage and cope with this phase of your treatment.