What happens during follow-up care for breast cancer patients?

They're under surveillance. So women with breast cancer, after they've completed their treatment, they need to be followed for every 4 to 6 months for a while, and so they're going to see me and possibly some other specialists on a regular basis forever, really.

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After treatment is completed, it is very important to go to all scheduled follow-up appointments. During these visits, your doctors will ask questions about any symptoms, do physical exams and order lab tests or imaging tests as needed to look for signs of cancer or treatment side effects. Almost any cancer treatment can have side effects. Some may last for a few weeks to several months, but others can be permanent. You should never hesitate to tell your doctor or other members of your cancer care team about any symptoms or side effects that concern you.

At first, your follow-up appointments will probably be scheduled for every 4 to 6 months. The longer you have been free of cancer, the less often the appointments are needed. After 5 years, they are typically done about once a year. If you had breast-conserving surgery, you will need to continue to have mammograms every year.

If you are taking tamoxifen, you should have yearly pelvic exams, because this drug can increase your risk of uterine cancer. Be sure to tell your doctor right away about any abnormal vaginal bleeding you are having. Although this is usually caused by a non-cancerous condition, it may also be the first sign of uterine cancer.

If you are taking an aromatase inhibitor, you may be at increased risk for thinning of the bones. Your doctor will want to monitor your bone health and may consider testing your bone density. Other tests, such as blood tumor marker studies, blood tests of liver function, bone scan, and chest x-rays are not usually needed unless symptoms or physical exam findings suggest it is likely the cancer has come back or recurred. If exams and tests do suggest recurrence, imaging tests such as an x-ray, CT scan, PET scan, MRI scan, bone scan and/or a biopsy may be done. Your doctor may also measure levels of blood tumor markers such as CA-15-3, CA 27-29 or CEA. The blood levels of these substances go up in some women if their cancer has spread to bones or other organs, but this is not always the case. 

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.