All breast cancer survivors should have follow-up care. Follow-up care for cancer means seeing a health care provider for regular medical checkups once you’re done with treatment.
These checkups may include bloodwork, as well as other tests and procedures that look for changes in your health, or any problems that may occur due to your cancer treatment. These visits are also a time to check for physical and emotional problems that may occur months or years after treatment ends.
Your follow-up care plan, along with a summary of your cancer treatment, is part of what is called a survivorship care plan. This plan will have all the details that you and your doctor should discuss to ensure that you get regular care after your treatment ends.
Note that the information in this section focuses on follow-up care for your cancer treatment. But it’s important that you keep getting your routine care from your primary care provider in addition to follow-up cancer care.
Getting a Follow-Up Care Plan
Once your cancer treatment ends, you should receive a follow-up cancer care plan from your oncologist or someone on your treatment team. A follow-up care plan is a summary of your treatment, along with recommendations for your cancer care after treatment ends. Your plan may also include suggestions to help meet other needs, such as emotional, social, or financial issues.
- Choose your doctor. For follow-up cancer care, you may see the same doctor who treated you for cancer, or you may see another health care provider, such as one who specializes in follow-up care for cancer survivors. Or you may decide to go to your primary care doctor. You can discuss which doctor(s) to see with your health care team.
- Ask each doctor you see to share notes with your other doctors. Keep in mind that once you choose which doctor to see, it may be up to you or a loved one to make sure each doctor communicates with the other about your care. Some research has shown that sometimes treatments or tests with one doctor aren’t shared with the other doctor. Ask both your doctors to send clinic visit notes to each other so everyone can be on the same page.
Your Follow-Up Care Schedule
Each patient has a different follow-up care schedule. How often you return for follow-up visits is based on:
- The type of breast cancer you had
- The treatment you received
- Your overall health, including possible treatment-related problems
In general, people return to the doctor for follow-up appointments every 3 to 4 months during the first 2 to 3 years after treatment, and once or twice a year after that.
At these visits, you may have a physical exam along with blood tests and other necessary tests and procedures. Which tests you receive and how often you receive them will be based on what your doctor thinks is best for you when creating your follow-up care plan.
Some cancer centers and hospitals have programs that specialize in long-term follow-up care for breast cancer survivors. You may want to ask your doctor if such a clinic is available to you.
What to Tell Your Doctor During Follow-Up Visits
When you meet with your doctor for follow-up visits, it’s important to talk openly about any physical or emotional problems you’re having. Always mention any symptoms, pain, or concerns that are new or that won’t go away. Keep in mind that just because you have new symptoms, it doesn’t necessarily mean the cancer has come back. It’s normal to have fears about every ache and pain that arises, but they may just be problems that your doctor can easily address.
Some cancer treatments can cause problems that may not show up for months or years after treatment. These problems, called late effects, are specific to certain types of treatments and the dose received. When you discuss follow-up care with your doctor, they should talk with you about which late effects to watch for. Early medical attention can help reduce problems that may come from late effects.
Other things you should tell your doctor:
- Any physical problems that interfere with your daily life, such as fatigue; problems with bladder, bowel, or sexual function; having a hard time concentrating; memory changes; trouble sleeping; or weight gain or loss
- Any new medicines, vitamins, herbs, or supplements you’re taking
- Changes in your family medical history
- Any emotional problems you’re having, such as anxiety or depression
It’s important to be aware of any changes in your health between scheduled visits. Report any problems to your doctor immediately. They can decide whether the problems are related to the cancer, the treatment you received, or an unrelated health issue.
Your Treatment Summary
Your oncologist or a member of your treatment team should give you a written summary of the treatment you received. Keep this with you to share with your primary care doctor and any other doctors you see. Many people keep their treatment summary in a binder or folder, along with their medical records. This way, key facts about your treatment will always be together.
It’s important to always keep your treatment summary somewhere safe in case you need it years later. It’s also helpful to keep records of any medical visits you ever have, so you have them in the future. If your primary care doctor keeps electronic medical records, find out how you can access these when needed.
Types of health information in the treatment summary
- The date you were diagnosed
- The type of breast cancer you had
- Pathology report(s) that describe the type and stage of cancer in detail
- Places and dates of each treatment, such as the details of all surgeries; the sites and total amounts of radiation therapy; and the names and doses of chemotherapy and all other drugs
- Key lab reports, x-ray reports, CT scans, and MRI reports
- List of signs and symptoms to watch for and possible long-term effects of treatment
- Contact information for all health professionals involved in your treatment
- Any problems that occurred during or after treatment
- Any supportive care you received during treatment (such as medicines for depression or anxiety, emotional support, and nutritional supplements)
Be an active partner
Many breast cancer survivors say that getting involved with their follow-up care was a good way for them to regain some of the control they felt they lost during cancer treatment. Being an active partner with your doctor and asking for help from other members of the health care team is the first step. Knowing what to expect after cancer treatment can help you and your family make plans, lifestyle changes, and important decisions about the future.