Monitoring for Recurrence

After treatment for advanced breast cancer is completed, the focus shifts to follow-up care. Follow-up care is essential to maximize or maintain the patient’s health, manage any long-term side effects from treatment, and screen for any signs or symptoms of a recurrence (cancer coming back). People with metastatic breast cancer may not have their cancer go away and may continue to have treatment to manage their condition.

For many, coming to the end of treatment causes mixed feelings. While there may be a sense of relief or gratitude that this trying period is over, many people find it difficult to deal with the fear of recurrence. In addition, there may be grief over what has been lost or survivor’s guilt thinking of others they’ve known who have died. The challenges can be significant; however, there are services that can help. Support is available through counseling, support groups, or online communities.

Elements of follow-up care

Follow-up care may include doctor’s visits, physical examinations, blood work, and screening tests. Generally, follow-up doctor visits will be scheduled every few months at first. The time between visits typically increases as a person gets further out from treatment, but each person should create a schedule for follow-up care with their doctor. These visits are a great time to discuss any lingering side effects, symptoms, or areas of concern. However, if symptoms or concerns come up between appointments, people should feel empowered to contact their doctor and not wait for their next scheduled visit.^1,2

Follow-up tests may include:²

• Mammograms
• Pelvic exams
• Bone density tests

Other imaging tests, like x-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, positron emission tomography (PET) scans, or bone scans, may be used if a patient is experiencing symptoms that may indicate a recurrence of breast cancer.²

Symptoms of a breast cancer recurrence

After a diagnosis of breast cancer, it is normal to worry about cancer recurring. While many people do not have a recurrence, it’s important to know what to look for and tell your doctor if you experience any of the following:¹

• Lumps in the breast tissue, chest wall, or underarm
• Changes in the skin of the breast or chest
• Swelling or other changes to the breast or underarm
• Pain or fractures in the bones
• Any pain that is constant, getting worse, or not relieved with over-the-counter (OTC) pain relievers (patients should check with their doctor before taking any OTC medicines for pain to make sure they are safe to take)
• Seizures
• Headaches that aren’t relieved with OTC pain relievers
• Changes in vision
• A yellowing of the whites of the eyes or skin (jaundice)
• A cough or shortness of breath that doesn’t go away
• An increase in fatigue
• A decrease in appetite and/or unintentional weight loss

Taking care of yourself after treatment for metastatic breast cancer

Many people find that making healthy lifestyle choices can optimize their health and give them a sense of control after treatment is completed. Healthy lifestyle choices may include:

• Making healthy dietary choices
• Getting regular exercise or activity (consult with your doctor before starting a new exercise program)
• Stopping smoking or tobacco use
• Keeping up with all doctor visits and tests
• Asking for help if you are feeling anxious, depressed, or overwhelmed