Breast Cancer Survivor Follow up Instructions
The goal of treatment for breast cancer is to get rid of all cancer cells in the body, but sometimes a few cells remain. These cells can grow and cause the cancer to return (recur) later.
If this happens, the goal is to find the cancer as soon as possible. Cancer can recur just a few months after treatment or years later. Most cases of recurrent breast cancer develop within 5 years after treatment.
Will my cancer return?
There is no way to know if your breast cancer will return. However, your chance of developing recurrent breast cancer is greater if you had:
- Breast cancer before 60 years of age.
- Breast cancer that spread to the lymph nodes.
- A tumor that was bigger than 2 inches (5 cm).
- A high-grade tumor. These are tumors that have cells that grow more quickly than other types of tumors.
- A close tumor margin. This means that the space between the tumor and normal, noncancerous cells was small.
- Inflammatory breast cancer. This is an aggressive form of cancer in which cancer cells block the lymph vessels in the skin of the breast.
- Human epidermal growth factor (HER2) positive breast cancer. This is a type of cancer that grows as a result of the HER2 protein.
- Surgery to remove the tumor but not the entire breast (lumpectomy) without radiation therapy.
What are the symptoms of recurrent breast cancer?
Examine your breasts every month. You may find it helpful to do this on the same day each month. Mark your calendar as a reminder. Let your health care provider know immediately if you have any signs or symptoms of recurrent breast cancer. Signs and symptoms of recurrent breast cancer vary. Symptoms will depend on where the cancer is and how the original cancer was treated.
Recurrence in the same spot or the opposite breast
Symptoms of a cancer that comes back in the same spot (local recurrence) after a lumpectomy, or a recurrence in the opposite breast, may include:
- A new lump or thickening in the breast.
- A change in the way that the skin of the breast looks, such as a rash, dimpling, or wrinkling.
- Redness or swelling of the breast.
- Changes in the nipple. It may be leaking fluid, or it may be red, puckered, or swollen.
Recurrence after a mastectomy
Symptoms of a recurrence after breast removal surgery (mastectomy) may include:
- A lump or thickening under the skin.
- A thickening around the mastectomy scar.
Recurrence in the lymph nodes
Symptoms of a cancer that comes back in the lymph nodes near the breast (regional recurrence) may include:
- A lump under the arm or above the collarbone.
- Swelling of the arm.
- Pain in the arm, shoulder, or chest.
- Numbness in the hand or arm.
Recurrence in a different part of the body
Symptoms of cancer that comes back in an area of the body far away from the original cancer site (distant recurrence) may include:
- A cough that does not go away.
- Trouble breathing or shortness of breath.
- Pain in the bones, the spine, or the chest. This is pain that lasts or does not improve with rest and medicine.
- Headaches.
- Sudden vision problems.
- Dizziness.
- Nausea or vomiting.
- Weight loss.
- Abdominal pain that does not go away.
- Yellowing of the skin or eyes (jaundice).
- Blood in the urine or bloody vaginal discharge.
Following up with your health care provider
Most people continue to see their cancer specialist (oncologist) every 3–6 months for the first year after cancer treatment. Ask about your cancer survivor plan of care that outlines your follow-up care after treatment ends. See your primary care provider for regular checkups during this time.
- Ask
your oncologist:
- How often you should have follow-up visits.
- What symptoms to watch for.
- What to do and whom to call about any symptoms.
- What tests should be done.
- Keep a schedule of appointments for the tests and exams that you need, including physical exams, breast exams, and exams of the lymph nodes.
- For the first 3 years after being treated for breast cancer, see your health care provider every 3–6 months.
- In the fourth and fifth years after being treated for breast cancer, see your health care provider every 6–12 months.
- Starting at 5 years after your breast cancer treatment, see your health care provider at least once a year.
- Continue
to have regular breast X-rays (mammograms), even if you had a
mastectomy.
- Get a mammogram 1 year after the mammogram that first detected breast cancer.
- Get a mammogram every 6–12 months after that or as often as your health care provider suggests.
- Have a pelvic exam every year or as often as your health care provider suggests.
- Have other cancer screening tests as recommended, such as skin cancer screening and colorectal cancer screening.
- Some
tests are not recommended for routine screening. Most people recovering
from breast cancer do not need to have these tests if there are no
problems. The tests have risks, such as radiation exposure, and can be
costly. The risks of some of the following tests are thought to be greater
than the benefits:
- Blood tests.
- Chest X-rays.
- Bone scans.
- Liver ultrasound.
- CT scan.
- MRI.
- Positron emission tomography (PET scan).
Where to find more information
- American Cancer Society: www.cancer.org
- National Cancer Institute: www.cancer.gov
Contact a health care provider if:
- You have any signs or symptoms of recurrent breast cancer.
- You are taking a medicine prescribed to treat your breast cancer and you have vaginal bleeding.
- You discover new lumps or changes in your breast.
- You have headaches or have pain in your bones, spine, chest, or abdomen.
- You have shortness of breath.
- You have a cough that does not go away.
- You have discharge from your nipple.
- You have a rash on your breast.
Get help right away if:
- You have trouble breathing.
- You have chest pain.
Summary
- Most cases of recurrent breast cancer develop within 5 years after treatment.
- Examine your breasts every month. Let your health care provider know immediately if you have any signs or symptoms of recurrent breast cancer.
- Keep a schedule of appointments for the tests and exams that you need, including physical exams, breast exams, and exams of the lymph nodes.
- Continue to have regular breast X-rays (mammograms), even if you had a mastectomy.