| What happens after all the treatment is done? | | | | an annual checkup is sufficient for a routine exam. |
| Most women ask how they will know if their | | | | However, if you are experiencing any new |
| cancer comes back and how they will be | | | | symptoms, you should let your doctor know and |
| monitored during the years ahead. To begin with, | | | | arrange to be seen for evaluation. Although most |
| many possible tests can be performed. While | | | | recurrences happen in the first two to three |
| some are important, such as mammography, | | | | years, they can happen much later on, even up |
| others, such as CAT scans and bone scans, do | | | | to ten or more years after initial diagnosis and |
| not contribute to longer survival rates and may | | | | treatment. |
| lead to unnecessary anxiety, additional tests, and | | | | Mammography is an important part of your |
| biopsies. The American Society of Clinical | | | | follow-up. If you are treated with |
| Oncology (ASCO) has published guidelines, "A | | | | breast-conserving therapy, then you will have a |
| Patient's Guide to Follow-Up Care for Breast | | | | mammogram of the treated breast six months |
| Cancer." You can view this document on their | | | | after completing radiation. After that, |
| website. (See asco.org, the "People Living with | | | | mammograms are generally done yearly, although |
| Cancer" section.) | | | | your doctor may recommend them at additional |
| It is important to see your cancer specialist for | | | | times if any questions arise during your clinical |
| regular checkups. Medical oncologists and surgeons | | | | breast examination. If you have had a |
| often do these checkups, while radiation | | | | mastectomy, then every year you will need a |
| oncologists may see the patients only for the first | | | | mammogram of the opposite breast. |
| one to two years. Sometimes the checkups can | | | | Routine gynecological examinations are also |
| be rotated among your team of cancer | | | | important, and women taking tamoxifen need to |
| specialists. Although your family doctor should | | | | be especially careful about telling their doctors |
| continue to see you for routine physical exams, it | | | | about any abnormal bleeding. |
| is still important to see a cancer specialist, who will | | | | If you have any symptoms, or if your doctor |
| be particularly aware of issues important to | | | | finds any abnormalities on your physical exam, |
| breast cancer survivors. | | | | then appropriate tests will be ordered. These may |
| During the first three years after finishing | | | | include blood tests, x-rays, bone scans, MRIs, or |
| treatment, you should have a checkup no less | | | | CT scans. However, if you are feeling fine and |
| than every three to six months. During these | | | | your exam is normal then these tests are not |
| visits it is important for you to share with your | | | | recommended. |
| doctor any new symptoms you may be | | | | The work of identifying a blood test that is |
| experiencing. For example, do you have any | | | | sensitive and specific enough to be helpful in |
| breast lumps or changes in your breast or chest | | | | follow-up is an active area of current research |
| region? Are you experiencing any persistent bone | | | | but, unfortunately, at this time no such test |
| pain? Any problems breathing? Any abdominal pain | | | | exists. Blood tests called tumor markers CA |
| or bloating that does not go away? Unexplained | | | | 27-29, CA 15-3, and CEA are not recommended |
| weight loss? In addition to carefully examining the | | | | for routine follow-up because they are often |
| breasts, your doctor will do a full physical exam. | | | | normal when cancer has already spread, and they |
| After the first three years, these visits can be | | | | may be abnormal when there are no clinical signs |
| less frequent, perhaps every six to twelve | | | | of cancer. In other words, frequent false positive |
| months for the next two years. After five years, | | | | and false negative results make them unreliable. |