Breast Cancer: After Treatment

Approved by the Cancer.Net Editorial Board, 05/2014

ON THIS PAGE: You will read about your medical care after cancer treatment is finished and why this follow-up care is important. To see other pages, use the menu on the side of your screen.

After treatment for breast cancer ends, talk with your doctor about developing a follow-up care plan. This plan may include regular physical examinations and/or medical tests to monitor your recovery for the coming months and years. ASCO’s recommendations for breast cancer follow-up care include regular physical examinations and mammograms, as well as other recommendations. In addition, ASCO offers cancer treatment summaries and a survivorship care plan to help keep track of the breast cancer treatment you received and develop a follow-up care plan once treatment ends. In some instances, patients may be able to visit survivorship clinics that specialize in the post-treatment needs of people diagnosed with breast cancer.

As explained in Treatment Options, breast cancer can come back in the breast or other areas of the body. The symptoms of a cancer recurrence include a new lump in the breast, under the arm, or along the chest wall; bone pain or fractures; headaches or seizures; chronic coughing or trouble breathing; extreme fatigue; and/or feeling ill. Talk with your doctor if you have any of these or other symptoms. The possibility of recurrence is a common concern among cancer survivors; learn more about coping with fear of recurrence and the tests that are not helpful to watch for a recurrence.

After a mastectomy or lumpectomy to treat breast cancer, the breast may be scarred and may have a different shape or size than before surgery. Or, the area around the surgical site may become hardened. If lymph nodes were removed as part of the surgery or affected during treatment, lymphedema may occur, even many years after treatment, and this is a life-long risk for patients.

Some patients experience breathlessness, a dry cough, and/or chest pain two to three months after finishing radiation therapy because the treatment can cause swelling and a hardening or thickening of the lungs called fibrosis. These symptoms usually go away. Talk with your doctor if you develop any new symptoms after radiation therapy or if the side effects are not going away.

Patients who received trastuzumab or certain types of chemotherapy called anthracyclines may be at risk of heart problems. Talk with your doctor about the best ways to check for heart problems.

Women taking tamoxifen should have yearly pelvic exams, because this drug can increase the risk of uterine cancer. Tell your doctor or nurse if you notice any abnormal vaginal bleeding or other new symptoms. Women who are taking an AI, such as anastrozole, exemestane, or letrozole, should have a bone density test before they start treatment and as recommended by their doctor, as these drugs may cause some bone weakness or bone loss.

In addition, women recovering from breast cancer have other side effects that may continue after treatment. However, these can often be managed. For example, medications can help manage neuropathy, menopausal symptoms, and joint pain. Vaginal dryness and a lowered sex drive are common side effects during or after treatment for breast cancer; treatment is individualized for the patient and the type of cancer and may be best managed by a gynecologist working with your oncologist. Learn about ways of coping with cancer-related fatigue and other late effects of cancer treatment.

Women recovering from breast cancer are encouraged to follow established guidelines for good health, such as maintaining a healthy weight, not smoking, eating a balanced diet, limiting alcohol, and having recommended cancer screening tests. Talk with your doctor to develop a plan that is best for your needs. Moderate physical activity can help rebuild your strength and energy level and may lower the risk of cancer recurrence. Your doctor can help you create a safe exercise plan based upon your needs, physical abilities, and fitness level.

Many breast cancer survivors need time to adapt to the “new normal.” Treatment for breast cancer may cause physical or emotional changes that affect how you view yourself. Learn more about self-image and breast cancer and the next steps to take in survivorship.

The next section offers a list of questions you may want to ask. Use the menu on the side of your screen to select Questions to Ask the Doctor, or you can select another section, to continue reading this guide.