Monitoring for Recurrence
After cancer treatment, it’s important to maintain regular contact with your medical team so we can address any ongoing side effects and monitor for recurrence. We will also discuss lifestyle measures to reduce the risk of new or recurrent cancers.
Why is monitoring so important in breast cancer treatment?
Advances in breast cancer treatment have steadily improved outcomes over the past few decades. Australia has some of the best outcomes for breast cancer treatment in the world, with the chance of surviving at least five years after treatment for early breast cancer now 91% (Australian Institute of Health and Welfare). So while most people survive breast cancer, unfortunately, recurrences do occur.
How often will I see my treating doctors?
In addition to surgery for breast cancer, you may require chemotherapy and or radiotherapy and will be seeing your medical oncologist and/or radiation oncologist regularly throughout this period of treatment. After completing this treatment, your follow up will generally involve an annual visit with each specialist (surgeon, medical oncologist and/or radiation oncologist), spaced apart so that you see someone every 4-6 months for at least the first five years.
Prior to seeing your surgeon each year, you will be referred to have annual surveillance breast imaging with a mammogram and ultrasound (if applicable).
Prior to seeing your medical oncologist each year, you may need to have a bone mineral density test (also called a DEXA scan), or a blood test if requested.
At each consultation, you will be asked about any troubling symptoms, and a physical examination including your breasts (and/or chest wall) and armpits will be performed.
Do I need ongoing (routine) blood tests and scans?
For most people, routine scans (apart from mammograms and breast ultrasounds) and blood tests are not required. In people who show no signs or symptoms of breast cancer recurrence, having regular scans (e.g. CT scans) have not shown to improve survival outcomes or quality of life. If worrying symptoms are identified at the time of your review, further investigations may be requested at that time.
What should I look for if I am worried about a recurrence?
When you have had cancer, new symptoms can make you worry that your cancer has come back. This is natural but it’s also important to remember that that things will come up that have nothing to do with your previous cancer.
There are however a few major symptoms that could mean serious problems and therefore should be investigated. If you have worrying symptoms, including but not limited to any of the ones listed below, arrange to see your GP or contact your cancer care team for further advice.
Return of the cancer symptoms you had before (for example, a lump or new growth where your cancer first started)
New or unusual pain that’s unrelated to an injury and doesn’t go away
Difficulty breathing or a cough that doesn’t go away
New lumps, bumps or swelling with no known cause
Severe or ongoing headaches
Nausea, vomiting, diarrhea, loss of appetite or trouble swallowing
Sustained unexpected weight loss
Your GP is usually the best person to identify the cause of your symptoms and they can contact your specialists with any concerns or for further advice.
What if I still feel worried all the time?
For many people, feeling anxious, worried or scared about the cancer coming back and disrupting life again is a real concern. This is normal and expected, to some extent, especially in the first few years after cancer treatment. When this fear becomes debilitating and impacts on your daily life and decision making, it can be a good idea to seek help.
Speaking to a psychologist or social worker trained in this area can be very helpful. Someone who can help you reframe concerns, identify your priorities and manage ongoing stress.
Sometimes not having enough information can contribute to feeling scared and anxious. Research has shown that speaking to your oncologist about your individual prognosis, being informed about what symptoms to look out for that may suggest a recurrence, and receiving advice on managing worry can really help to reduce fears.
If you are worried about having a recurrence of your cancer, talk to your specialist about information and support tools that may help.