Most people worry about breast cancer coming back (recurrence). These worries are normal, and the fear and anxiety usually lessens with time.
Knowing how to continue to be breast and body aware after treatment and the symptoms you should report can help manage your feelings of uncertainty.
The treatment you received will have been given to reduce the risk of the breast cancer coming back at its original site or elsewhere in the body.
While most people have no further problems, sometimes breast cancer can return after treatment.
Find out about different types of recurrence.
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 can be difficult to know how your breast or scar area should feel after treatment. The area around the scar may feel lumpy, numb or sensitive. You’ll need to get to know how it looks and feels so you know what’s normal for you.
This will help you feel more confident about noticing changes and reporting them promptly to your GP or breast care nurse. It’s also important to be aware of any new changes in the other breast and to report these as soon as possible to your hospital team.
Changes to look and feel for in the breast and chest area include:
- change in shape or size
- change in skin texture such as puckering or dimpling
- constant pain in your breast/chest area or armpit
- lump or thickening that feels different (with your treated breast this could be on or away from the scar line)
- redness or a rash around the nipple and/or on the skin
- liquid (discharge) that comes from the nipple without squeezing it
- your nipple has become inverted (pulled in) or looks different, for example changed its position or shape
- swelling in the upper arm
- swelling on your chest, in your armpit or around your collarbone.
Secondary breast cancer
Treatment for primary breast cancer aims to prevent the cancer coming back or spreading, but some people will develop secondary breast cancer. This is when breast cancer cells spread from the first (primary) cancer in the breast to other parts of the body. When breast cancer spreads, for example to the bones, it is called secondary breast cancer in the bones. The cells in the bones are breast cancer cells.
Symptoms of secondary breast cancer
It’s difficult to list all the symptoms of secondary breast cancer but it’s important to report any symptoms you have that are new and persistent and have no obvious cause to your doctor or breast care nurse.
Many symptoms of secondary breast cancer may be the same as those of other conditions. For example, aches and pains in the bones may be due to ageing, arthritis or treatment side effects. Breathlessness and coughs can be symptoms of a cold or flu-type illness. If you have any persistent or unexplained symptoms, the best thing to do is to talk to your doctor or breast care nurse.
Symptoms you may want to report include:
- pain in your bones (for example in the back, hips or ribs) that doesn’t improve with pain relief or lasts for more than one to two weeks and is often worse at night
- unexplained weight loss and a loss of appetite
- a constant feeling of nausea (feeling sick)
- discomfort or swelling under the ribs or across the upper abdomen
- feeling constantly tired
- a dry cough or a feeling of breathlessness
- severe or ongoing headaches
- altered vision or speech.
Some of these symptoms, such as tiredness and loss of appetite, can be normal side effects that many people experience after cancer treatment. But if symptoms don’t improve, your specialist team may decide to investigate the many possible causes.
Coping with worries about recurrence
Nearly everyone who has been treated for cancer worries about it coming back. At first, every ache or pain can frighten you. But, as time passes, you may come to accept minor symptoms for what they are in most cases – warning signs of a cold or flu or the result of over-exerting yourself.
Some events may be particularly stressful – the days or weeks leading up to your check-ups, the discovery that a friend or relative has been diagnosed with cancer or the news that someone you met while having treatment is ill again or has died.
We all cope with such anxieties in our own way and there are no easy answers. But keeping quiet about them and not wanting to bother anyone is probably not the best approach.
Just as talking about your diagnosis and treatment may have helped you through the early days, talking about your fears relating to recurrence may help you later on.
Breast Cancer Care’s Forum lets you share your worries with other people in a similar situation to you.
You can also read our tips on coping with anxiety.
Follow-up after treatment
Several years ago people were followed up indefinitely after breast cancer treatment. However, research has shown this is not effective in finding recurrence or a new primary breast cancer.
How you’re followed up will depend on your individual needs and on the arrangements at the hospital where you've been treated.
Find out more about follow-up after treatment.
You should be given a name and contact number to ring (usually your breast care nurse) in case you have concerns or symptoms that could mean you need to be seen sooner. You can also contact your GP (local doctor).