After surgery, chemotherapy, and/or radiation are completed, your physician will still see you periodically. The frequency that you are seen depends somewhat on the individual characteristics of the breast cancer, but patients are generally seen every three to six months for the first five years and then yearly after that. During these visits your physician will be checking for signs that the cancer may have returned or spread by asking questions and examining you closely. Though breast cancer can return in nearly any part of the body, specific areas or parts of the body are more commonly involved. These include, in order of more common to less common, lymph nodes, the breast, the bones above the knees and elbows, lungs, skin and soft tissue, liver and brain. Signs that the breast cancer may have come back include:
- Lump or change in the shape of the breast
- New lump in the armpit or in the neck
- Persistent skin rash or change in the color of the skin over the breast or chest
- Persistent cough or shortness of breath not explained by a cold or normal exertion
- Persistent pain in the bones of the central parts of the body including the back, head, shoulders, pelvis, hips, upper arms, or upper legs that is not explained by injury, stress or strain
- Unexplained weight loss, loss of appetite or nausea
- New or persistent headache
- Any new abnormality or symptom that concerns you would be a reason to call your physician
It is important to remember that any of these signs can occur for many other reasons than the return of the cancer, but they should still be checked by your Breast Care Center physician.
In addition to regular checkups every three to six months, a mammogram will be performed on both breasts or the remaining breast once per year. Also, other tests that are part of routine health maintenance may be performed such as a Pap smear or cholesterol check.
Clinical studies have shown that routine blood tests, chest x-rays, bone scans, CT scans or MRIs are not beneficial in helping women with breast cancer live longer or better or in detecting the recurrences at a time that will change treatment. Because of this, these are no longer routinely performed, although they have been in the past. These will be ordered if medically necessary to help evaluate your disease.