Your follow-up appointments will focus on how you are feeling so you can explain any problems, symptoms or treatment side effects. It’s also your opportunity to ask questions.
Types of follow-up
How you are followed up and the time between appointments will depend on your individual needs and on the arrangements at the hospital you have been treated in. You’ll probably find your contact is more frequent at first, becoming less so as time goes on.
Many people are followed up at the hospital and will have regular appointments with their surgeon and oncologist. Some people are given a choice of being followed up by their GP (local doctor) or a combination of hospital and GP appointments.
In some areas you will be followed up by the breast care nurse unless there are any particular concerns. In other areas follow-up appointments will be over the phone and you will only need to visit the breast clinic if there’s any concern or symptom that you or your doctor feel should be checked out.
Some people won’t be given regular follow-up appointments, but can contact the breast clinic if they have concerns or symptoms and would like to be seen by a doctor or nurse at the hospital. This is called open access.
Follow-up after clinical trials
If you have taken part in a clinical trial during your treatment, your follow-up may vary depending on which trial you have been part of. In this case the research nurse will be able to give you a better idea of how you will be followed up.
After your treatment, you will have regular mammograms. If you have had breast-conserving surgery (a wide local excision or lumpectomy), you will have a mammogram on both breasts. If you have had a mastectomy, with or without reconstruction, a mammogram will be done on your other breast.
The time between mammograms may vary depending on the hospital where you have your follow-up. Most hospitals will follow the recommendations below set out by the National Institute for Health and Care Excellence (NICE), an independent organisation responsible for providing evidence-based national guidance on effective ways to prevent, diagnose and treat ill health.
You will have a yearly mammogram until you are invited to take part in a national breast screening programme, usually around the age of 50. As part of the screening programme, you’ll be invited for a mammogram every three years until the age of 70 (in England this is changing to 73)
If you were already eligible for breast screening when diagnosed, you will have a yearly mammogram for five years. After this, you will be invited to have a mammogram every three years up until the age of 70 as part of a national breast screening programme.
After the age of 70 you can still have regular mammograms but you won’t be routinely invited, so will need to arrange this yourself.
Women who remain at an increased risk due to a family history of breast cancer or who carry an altered BRCA gene will need to have regular tests for a longer period. Find out more about screening for women at an increased risk.
Other tests and scans
Many people feel they would like or should have regular body scans or blood tests to detect early signs of a possible recurrence (breast cancer coming back). You won’t normally have routine scans and tests unless you have symptoms which need checking. Several large studies have shown these are not useful in finding recurrence and do not improve overall survival.
Some treatments for breast cancer can affect your bones which can increase your risk of developing osteoporosis. To assess your bone strength (bone mineral density) you should have a DEXA (dual energy X-ray absorptiometry) scan if:
- you are starting hormone therapy with an aromatase inhibitor
- your breast cancer treatment has brought on the menopause
- you are starting ovarian suppression therapy.
DEXA scans may be repeated every one- two years for some people. Find out more about bone health and osteoporosis.
Staying breast and body aware
While most people have no further problems after their treatment, sometimes breast cancer can come back.
Whether you have had breast-conserving surgery or a mastectomy (with or without reconstruction), it’s important to be aware of any changes to the breast or surrounding area, even if you’re still having follow-up appointments or regular mammograms. It’s also important to be aware of any other new or persistent symptoms.
Find out more about staying breast and body aware after treatment.
Your family history of breast cancer
A small number of people are at an increased risk of breast cancer because of their family history. Find out more about breast cancer, genes and family history.
If you are concerned what your family history means for you and other family members, or if your family history changes, speak to your GP about having your family history risk assessed.