What happens after treatment for breast cancer in men?
For many men 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 some people, cancer may never go away completely. These people may get regular treatments with chemotherapy, radiation therapy, or other therapies 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. It has its own type of uncertainty. Our document, When Cancer Doesn't Go Away, talks more about this.
When treatment ends, your doctors will still want to watch you closely. It is very important to go to all of your follow-up appointments. During these visits, your doctors will ask questions about any problems you may have and may do exams and lab tests or x-rays and scans to look for signs of cancer or signs of treatment side effects. Almost any cancer treatment can have side effects. Some may last for a few weeks to months, but others can last the rest of your life. Now is the time for you to talk to your cancer care team about any changes or problems you notice and any questions or concerns you have.
At first, your follow-up appointments will probably be scheduled for every 3 to 6 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.
If you had breast-conserving surgery, your doctor may recommend that you have yearly mammograms of the breast that contained the cancer. Mammograms of the opposite breast may also be done, however it isn’t clear how helpful they are.
If you are taking an aromatase inhibitor or a luteinizing hormone-releasing hormone (LHRH) analog, you may be at increased risk for osteoporosis (thinning of the bones). Your doctor may want to monitor your bone health and may consider testing your bone density.
Other tests such as blood tumor marker studies, blood tests of liver function, bone scans, and chest x-rays are not a standard part of follow-up. Getting these tests doesn’t help someone treated with breast cancer live longer. They will be done (as indicated) if you have symptoms or physical exam findings that suggest that the cancer has recurred. These and other tests may be done as part of evaluating new treatments by clinical trials.
If symptoms, exams, or tests suggest cancer may have recurred, imaging tests such as a chest x-ray, CT scan, PET scan, MRI scan, bone scan, and/or a biopsy may be done. Your doctor may also measure levels of blood tumor markers such as CA15-3 or CA27-29. The blood levels of these substances go up in some men if their cancer has spread to bones or other organs such as the liver. They are not elevated in everyone with recurrence, so they aren't always helpful. If they are elevated, they may help your doctor monitor the results of therapy.
If cancer does recur, treatment will depend on the location of the cancer and what treatments you've had before. It may include surgery, radiation therapy, hormone therapy, chemotherapy, targeted therapy, or some combination of these. For more information on how recurrent cancer is treated, see “Recurrent cancer” in the section "Treatment of breast cancer in men by stage." For more general information on dealing with a recurrence, you may also want to see our document, When Your Cancer Comes Back: Cancer Recurrence.
It is also 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.
Lymphedema, or swelling of the arm due to buildup of fluid, can happen any time after breast cancer treatment. Any treatment that removes axillary (underarm) lymph nodes or treats them with radiation carries the risk of lymphedema because normal drainage of lymph fluid from the arm is changed.
One of the first symptoms of lymphedema may be a feeling of tightness in the arm or hand on the same side that was treated for breast cancer. Any swelling, tightness, or injury to the arm or hand should be reported promptly to your doctor or nurse.
There is no good way to predict who will and will not develop lymphedema. It can occur right after surgery, or months, or even years later. The possibility of developing lymphedema remains throughout a man's lifetime.
With care, lymphedema can often be avoided or, if it develops, kept under control. Injury or infection of the affected arm or hand can contribute to the development of lymphedema or make existing lymphedema worse, so preventive measures should focus on protecting the arm and hand. Most doctors recommend avoiding having blood drawn from or blood pressure taken on the arm on the side of the lymph node surgery or radiation.
To learn more, see our document, Lymphedema: What Every Woman With Breast Cancer Should Know (the information also applies to men).
Last Medical Review: 09/30/2013
Last Revised: 01/31/2014