Breast Cancer - Inflammatory: Follow-up Care and Monitoring

Approved by the Cancer.Net Editorial Board, 01/2021

ON THIS PAGE: You will read about your medical care after cancer treatment is completed and why this follow-up care is important. Use the menu to see other pages.

Care for people diagnosed with cancer does not end when active treatment has finished. Your health care team will continue to check that the cancer has not come back, manage any side effects, and monitor your overall health. This is called follow-up care.

Your follow-up care may include regular physical examinations, medical tests, or both. Doctors want to keep track of your recovery in the months and years ahead. In some instances, people may be able to visit a survivorship clinic that specializes in the post-treatment needs of people diagnosed with breast cancer. ASCO offers its full recommendations for follow-up care for breast cancer survivors in a separate article.

Cancer rehabilitation may be recommended, and this could mean any of a wide range of services, such as physical therapy, career counseling, pain management, nutritional planning, and/or emotional counseling. The goal of rehabilitation is to help people regain control over many aspects of their lives and remain as independent as possible. Learn more about cancer rehabilitation.

Learn more about the importance of follow-up care.

Watching for recurrence

One goal of follow-up care is to check for a recurrence, which means that the cancer has come back. Cancer recurs because small areas of cancer cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms.

During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Breast cancer can come back in the breast or other areas of the body. Generally, a recurrence is found when a person has new symptoms or an abnormal finding on physical examination. The symptoms depend on where the cancer has recurred and may 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

  • Feeling ill

Your doctor will ask specific questions about your health at follow-up visits. It is important to share how you are feeling at those visits and ask any questions you may have about your health or follow-up care plan.

The anticipation before having a follow-up visit or waiting for test results may add stress to you or a family member. Learn more about how to cope with this type of stress.

Managing long-term and late side effects

Most people expect to experience side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. Other side effects called late effects may develop months or even years afterwards. Long-term and late effects can include both physical and emotional changes.

  • Long-term effects of surgery. After a mastectomy, the chest may be scarred and have a different shape or size than before surgery. If lymph nodes were removed as part of the surgery or affected by treatment, a condition called lymphedema may develop. Lymphedema causes swelling of the hand, arm, breast, and/or chest wall, and it is a life-long risk for patients.

  • Long-term effects of radiation therapy. Some patients experience breathlessness, a dry cough, and/or chest pain 2 to 3 months after finishing radiation therapy because the treatment can cause swelling and a hardening or thickening of the lungs called fibrosis. These symptoms may seem similar to the symptoms of pneumonia but do not go away with antibiotics. The symptoms can be treated with medications called steroids. Most patients fully recover with treatment. Talk with your doctor if you develop any new symptoms after radiation therapy or if the side effects are not going away.

  • Long-term effects of trastuzumab and/or chemotherapy. Patients who received trastuzumab or certain types of chemotherapy called anthracyclines may be at risk of heart problemsTalk with your doctor about the best ways to check for heart problems. Patients treated with chemotherapy also have a risk of other long-term side effects, such as menopausal symptoms, fatigue, chemobrain, permanent numbness and tingling of the fingers and toes, and weight gain.

  • Long-term effects of hormonal therapy. Patients who take hormonal therapy for many years can have menopausal symptoms such as hot flashes and vaginal dryness. Tell your doctor or nurse if you notice any abnormal vaginal bleeding or other new symptoms, as you may need additional tests to learn more about the cause. People who are taking an AI, such as anastrozole, exemestane, or letrozole, should have a bone density test periodically during treatment since these drugs may cause some bone weakness or bone loss, which increases the risk of breaking a bone. In addition, AIs can sometimes cause aches, pains, and stiffness during treatment. Talk with your doctor about what you can do to manage these symptoms if you experience them.

Talk with your doctor about your risk of developing such side effects based on the type of cancer, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may have certain physical examinations, scans, or blood tests to help find and manage them.

Keeping personal health records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to discuss any concerns you have about your future physical or emotional health. ASCO offers forms to help keep track of the cancer treatment you received and develop a survivorship care plan when treatment is completed.

This is also a good time to talk with your doctor about who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the care of their primary care doctor or another health care professional. This decision depends on several factors, including the type and stage of cancer, side effects, health insurance rules, and your personal preferences.

If a doctor who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan with them and with all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you throughout your lifetime.

The next section in this guide is SurvivorshipIt describes how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to choose a different section to read in this guide.