Breast Cancer Survivorship

Follow-up care 
After you finish treatment for breast cancer, you’ll see your oncologist and other members of your health care team on a regular basis, usually about every six months for the first few years. After that, you’ll see them every year for many years. 

Follow-up care after breast cancer treatment with your oncology team may include: 

• Physical exams 
• Screening mammograms 
• Bone health tests 

During follow-up visits, your doctor will ask you about any signs, symptoms or concerns you may have. If you have symptoms or concerns in between appointments, reach out to your doctor. 

Late effects of treatment
Once breast cancer treatment ends, most side effects go away. However, you may have some long-term effects. New side effects may occur months or even years after treatment ends. These long-term and new side effects may be called late effects.

Late effects of breast cancer treatment include (in alphabetical order):

• Bone health problems
• Changes after mastectomy
• Changes in the look and feel of the breast after lumpectomy
• Changes in the look and feel of the breast after radiation therapy
• Changes in the look and feel of the breast after reconstruction
• Cognitive function (problems with memory and concentration)
• Early menopause
• Emotional distress and depression
• Fatigue or insomnia (trouble sleeping)
• Fear of breast cancer recurrence
• Infertility
• Joint and muscle pain
• Lymphedema
• Menopausal symptoms (such as hot flashes and vaginal symptoms)
• Numbness (neuropathy)
• Pain
• Sexuality and intimacy issues
• Weight gain

Breast cancer recurrence
The goal of treating early breast cancer is to remove the cancer and keep it from coming back. A return of breast cancer is called a breast cancer recurrence. Most people diagnosed with breast cancer will never have a breast cancer recurrence. However, everyone who’s had breast cancer is at risk of recurrence.

Breast cancer that recurs at the original site is called a local recurrence. Breast cancer that returns and spreads to other parts of the body is called a distant recurrence (metastasis). This is metastatic breast cancer and may also be called stage 4 or advanced breast cancer.

A local recurrence is usually found on a screening mammogram, during a physical exam by a doctor, or when you notice a change in or around the breast or underarm. Metastasis is most often found when people report new and persistent symptoms.

These may include:

• Fatigue
• Shortness of breath
• Weight loss
• Bone pain
• Seizures
• Yellowing of the skin or whites of the eyes (jaundice)

Don’t panic if you have signs or symptoms like fatigue, weight change or bone pain. These are common problems for many people. Most often, they don’t mean the breast cancer has spread. For example, bone pain may be a sign of arthritis or muscle strain. And many people have fatigue for a number of reasons.

Discuss any signs or symptoms you have (especially if they last more than two weeks) with your doctor to find out the cause. It’s always OK to get a second opinion.

Learn about follow-up care after breast cancer treatment.

Stress, fears and concerns
After treatment for early or locally advanced breast cancer ends, many people are afraid they still have cancer, or are afraid the cancer will come back. These fears are normal.

There are many healthy ways to cope with the stress. Complementary therapies like mindfulness meditation may help you.

For some people, talking to a counselor or joining a support group can be helpful. Your doctor may be able to help you find a counselor or support group. Learn more about support groups and other types of social support.

People who’ve had breast cancer are often concerned about their family members’ risk of breast cancer because they may be at increased risk. If you have concerns, talk with your doctor. Your doctor can help you understand your family’s risk and can refer you to a genetic counselor if needed.

Some healthy behaviors may be linked to a lower risk of breast cancer recurrence and improved survival. Others are part of a healthy lifestyle and may be linked to a lower risk of different cancers and other diseases.

A healthy lifestyle includes:

• Maintaining a healthy weight
• Eating a healthy diet
• Limiting alcohol intake
• Getting regular physical activity (exercise)
• Not smoking

Healthy body weight
After treatment for breast cancer, being overweight or obese is linked to an increased risk of breast cancer mortality (death from breast cancer) and overall mortality (death from any cause). Women who are overweight or obese after a breast cancer diagnosis have worse survival than those who are lean. Maintaining a healthy weight is one of the best things you can do for your health.

Healthy diet
We don’t fully understand how diet is related to survival after breast cancer. There’s no diet, dietary pattern or nutrient proven to be linked to breast cancer survival. However, people who’ve had breast cancer can benefit from the same healthy diet recommended for everyone.

Limiting alcohol
Some findings suggest drinking alcohol after a breast cancer diagnosis may be linked to an increased risk of breast cancer mortality. Other studies show drinking alcohol in moderation may be linked to a decreased risk of heart disease, high blood pressure and overall mortality. After talking with your doctor, make informed choices about drinking alcohol.

Physical activity (exercise)
Some studies suggest being active is linked to a decreased risk of breast cancer mortality and overall mortality. Being physically active is one of the best things you can do for your health after treatment for breast cancer. It helps you maintain a healthy weight and is linked to a decreased risk of heart disease, stroke and diabetes.

Not smoking
Growing evidence suggests smoking is linked to an increased risk of breast cancer recurrence, breast cancer mortality and overall mortality. Stopping smoking, or never starting to smoke, is one of the best things you can do for your health. Smoking is related to an increased risk of many cancers and other health conditions.

Learn more about a healthy lifestyle for people who’ve had breast cancer.