Following Treatment for Early Breast Cancer

The end of treatment marks the end of frequent hospital visits. You will have follow up, but this varies between different patients to meet your individual needs. The most important thing is that if you have any problems or become worried you will be seen promptly. You will be invited to participate in the Moving Forward Programme, which is a programme of support and information following completion of your treatments- see link for further details.

What is the purpose of follow-up care?

• It provides you with an opportunity to raise concerns and ask questions.
• It allows health care staff to monitor your recovery, answer any questions, record the outcome of your treatment and monitor any on-going treatment you are taking.
• It may help in the organisation of follow up mammograms.
• The risk of developing secondary breast cancer is not influenced by follow up care.

What checks will be made?

There are two main methods of follow up checks:

• Mammography.
• Clinical breast examination.

Mammography

The use of mammograms (x-ray of the breast) can help detect recurrences or new cancers within the breast. Unless you have had a bilateral mastectomy, you will be invited to have a mammogram on a regular basis. You will be offered a mammogram every year for 5-10 years. After that period, if you are over 50, you will continue to have mammograms once every 3 years as part of the National Health Service Breast Screening Programme and this is usually organised through your GP. If you are under 50, you will continue to have mammograms every year until you reach the age at which you join the Breast Screening programme.

Clinical breast examination

If you do attend a hospital clinic, your doctor or nurse will examine your breasts and the area under both arms. Although clinical examination is routinely done, it is unusual for any lumps to be detected that you are unable to feel yourself. You are therefore encouraged to regularly examine your breasts. For further information on how to do this, see Breast Awareness.

What checks are not part of routine follow up?

Scans, x-rays and blood tests to try and identify whether breast cancer has spread beyond the breast are not done as a routine part of follow up. Provided you are well with no symptoms that concern you, the above checks are not necessary. The tests mentioned above are not able to detect small amounts of breast cancer cells which may be present. Normal scans do not mean there will not be problems in the future.

What to look out for?

Following treatment, many women go on to live to an old age without any cancer related problems. You will get normal coughs, colds, aches and pains. As you will be aware you are also likely to experience some side effects from the treatment you have received.

Following surgery and radiotherapy:

• Pain in the treated area. Managing your pain after your surgery may help reduce this in the long term
• Rib tenderness
• Skin changes
• Under arm numbness
• Decreased shoulder movement
• Breast swelling if you have had a lumpectomy

Following chemotherapy or as a result of hormone therapy:

• Fatigue
• Permanent menopause

Some symptoms may cause anxiety and concern, many will be nothing to worry about.

If you have any of the following symptoms listed below you should contact your GP or breast team:

• Pain which lasts more then 3-4 weeks.
• Unexplained lumps anywhere in your body.
• Persistent back pain or pains in your bones which wake you at night.
• Pain needing continual painkillers.
• Breathlessness or persistent dry cough.
• Unexplained weight loss.
• Unexpected vaginal bleeding.
• Swelling of your arm (lymphoedema).

If you have any of the symptoms it does not necessarily mean your cancer has returned. It does mean you should have a medical assessment.

Other Relevant Advice and Information

Moving Forward

Anxiety

Breast Awareness

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